We need a definitive exit from the pandemic. Here’s the roadmap.

No, we don’t have to live with Covid, because the Covid we are seeing now is deeply concerning. While there has not been a surge in hospitalizations, they are clearly on the increase, with more than a 20% rise in the United States over the past two weeks. The proportion of people getting hospitalized and dying among the vaccinated, as compared with unvaccinated, has substantially increased. As have the deaths: during the Delta wave in the United States, vaccinated individuals accounted for 23% of the deaths, whereas this nearly doubled to 42% during the Omicron wave. Many of these hospitalizations and deaths among vaccinated people can be attributed to lack of a booster shot or the substantially waned effectiveness that sets in by four months after a booster.

Moreover, a major misconception is that the vaccines are holding steady to protect against severe disease, hospitalizations and deaths. They are not. When a booster was given during the Delta wave, that fully restored protection against these outcomes, to the level of 95% effectiveness. But for Omicron, with a booster (or second booster) the protection was approximately 80% – which, while still high, represents a significant, fourfold dropdown (lack of effectiveness of 55% v 20%).

Accordingly, the confidence that our vaccines, created to fight the original strain from 2019, are highly protective against severe illness is exaggerated. No less concerning are the clear signs that the durability of such protection is reduced. All of this is tied to the marked evolution of the virus, and we yet lack any data on vaccine effectiveness against the BA.2.12.1 variant, soon to be dominant here.