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How do pandemics end? History suggests diseases fade but are almost never truly gone

<span class="caption">The COVID-19 new normal might be here for quite some time.</span> <span class="attribution"><a class="link rapid-noclick-resp" href="https://www.gettyimages.com/detail/photo/reflecting-on-her-day-royalty-free-image/1263884394" rel="nofollow noopener" target="_blank" data-ylk="slk:SolStock/E+ via Getty Images">SolStock/E+ via Getty Images</a></span>
The COVID-19 new normal might be here for quite some time. SolStock/E+ via Getty Images

When will the pandemic end? All these months in, with over 37 million COVID-19 cases and more than 1 million deaths globally, you may be wondering, with increasing exasperation, how long this will continue.

Since the beginning of the pandemic, epidemiologists and public health specialists have been using mathematical models to forecast the future in an effort to curb the coronvirus’s spread. But infectious disease modeling is tricky. Epidemiologists warn that “[m]odels are not crystal balls,” and even sophisticated versions, like those that combine forecasts or use machine learning, can’t necessarily reveal when the pandemic will end or how many people will die.

As a historian who studies disease and public health, I suggest that instead of looking forward for clues, you can look back to see what brought past outbreaks to a close – or didn’t.

people in line outside a COVID-19 testing site
people in line outside a COVID-19 testing site

Where we are now in the course of the pandemic

In the early days of the pandemic, many people hoped the coronavirus would simply fade away. Some argued that it would disappear on its own with the summer heat. Others claimed that herd immunity would kick in once enough people had been infected. But none of that has happened.

A combination of public health efforts to contain and mitigate the pandemic – from rigorous testing and contact tracing to social distancing and wearing masks – have been proven to help. Given that the virus has spread almost everywhere in the world, though, such measures alone can’t bring the pandemic to an end. All eyes are now turned to vaccine development, which is being pursued at unprecedented speed.

Yet experts tell us that even with a successful vaccine and effective treatment, COVID-19 may never go away. Even if the pandemic is curbed in one part of the world, it will likely continue in other places, causing infections elsewhere. And even if it is no longer an immediate pandemic-level threat, the coronavirus will likely become endemic – meaning slow, sustained transmission will persist. The coronavirus will continue to cause smaller outbreaks, much like seasonal flu.

The history of pandemics is full of such frustrating examples.

Once they emerge, diseases rarely leave

Whether bacterial, viral or parasitic, virtually every disease pathogen that has affected people over the last several thousand years is still with us, because it is nearly impossible to fully eradicate them.

The only disease that has been eradicated through vaccination is smallpox. Mass vaccination campaigns led by the World Health Organization in the 1960s and 1970s were successful, and in 1980, smallpox was declared the first – and still, the only – human disease to be fully eradicated.

Children holding smallpox vaccination certificates
Children holding smallpox vaccination certificates

So success stories like smallpox are exceptional. It is rather the rule that diseases come to stay.

Take, for example, pathogens like malaria. Transmitted via parasite, it’s almost as old as humanity and still exacts

America’s history of racism was a preexisting condition for COVID-19

A Louisiana pastor prays as his parishioners die, first from cancer and now from COVID-19. An Indigenous community in New Mexico lacks adequate health care as the death toll mounts. A sick hospital worker in New Jersey frets about infecting others in her heavily populated neighborhood.



a group of people standing in front of a mirror posing for the camera: Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.


© Jasper Colt, USA TODAY
Parishioners stand in Our Lady of Grace Catholic Church in Reserve, LA, during a sermon by Rev. Fr. Christopher Chike Amadi.

As the country cries out for a vaccine and a return to normal, lost in the policy debates is the reality that COVID-19 kills far more people of color than white Americans. This isn’t a matter of coincidence, poor choices or bad luck — it’s by design. 

A team of USA TODAY reporters explored how the policies of the past and present have made Black, Asian, Hispanic and Indigenous Americans prime targets for COVID-19. They found:

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  • America’s education and economic systems are still unequal, disproportionately leaving people of color out of higher-wage jobs. When COVID-19 struck, more people of color were serving as essential workers directly in the path of the virus.

Put simply, America’s history of racism was itself a preexisting condition.

Of the 10 U.S. counties with the highest death rates from COVID-19, seven have populations where people of color make up the majority, according to data compiled by USA TODAY. Of the top 50 counties with the highest death rates, 31 are populated mostly by people of color. 

“COVID-19 has brought out into the open, with painful clarity, these divisions in our society that have been there for a long time but, for one reason or another, people were able to overlook them,” said Philip Landrigan, director of the Global Public Health Program at Boston College.

With nearly 1,000 people a day dying from the virus and scientists scrambling to grasp exactly how the virus spreads and kills, federal and state data has not provided enough demographic detail to show the full impact on communities of color. The race and ethnicity of people who contract the virus is known in 52% of cases, according to the Centers for Disease Control and Prevention. 

But study after study has shown clear patterns in whom the virus kills.

How systemic racism led to COVID-19’s rapid spread among people of color

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Black people are more than twice as likely to die from the virus than white people, and Hispanics and Native Americans are 1.5 times more likely to die, according to The COVID Tracking Project. 

“You can’t change the fact that America is so segregated and that people of color tend to live in communities where the environmental conditions are worse, and that can increase your risk of heart disease or lung disease and diabetes,” said Richard Besser, former acting director of the CDC and president and CEO of the Robert Wood Johnson Foundation, the nation’s largest philanthropy

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