It is urgent to understand the future of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) transmission. This study used estimates of seasonality, immunity, and cross-immunity for human coronavirus OC43 (HCoV-OC43) and HCoV-HKU1 using time-series data from the United States to inform a model of SARS-CoV-2 transmission.

The authors projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, they believe that prolonged or intermittent social distancing may be necessary into 2022. They proposed additional interventions, including expanded critical care capacity and an effective therapeutic, to improve the success of intermittent distancing and hasten the acquisition of herd immunity.

Finally, they underscore the urgent need for longitudinal serological studies to determine the extent and duration of immunity to SARS-CoV-2. They believe that SARS-CoV-2 surveillance should be maintained even in the event of apparent elimination because a resurgence in contagion could be possible as late as 2024.