There is a realistic expectation that the global effort in vaccination will bring the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic under control. Nonetheless, uncertainties remain about the type of long-term association the virus will establish with the human population, particularly whether the coronavirus disease 2019 (COVID-19) will become an endemic disease. Although the trajectory is difficult to predict, the conditions, concepts, and variables that influence this transition can be anticipated. Persistence of SARS-CoV-2 as an endemic virus, perhaps with seasonal epidemic peaks, may be fueled by pockets of susceptible individuals and waning immunity after infection or vaccination, changes in the virus through antigenic drift that diminish protection, and reentries from zoonotic reservoirs. Here, we review relevant observations from previous epidemics and discuss the potential evolution of SARS-CoV-2 as it adapts during persistent transmission in the presence of a level of population immunity. Lack of effective surveillance or adequate response could enable the emergence of new epidemic or pandemic patterns from an endemic infection of SARS-CoV-2. There are key pieces of data that are urgently needed in order to make good decisions. We outline these and propose a way forward.

全球疫苗接种努力将使严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 大流行得到控制，这是一个现实的期望。尽管如此，该病毒将与人类建立的长期关联类型仍然存在不确定性，尤其是 2019 年冠状病毒病 (COVID-19) 是否会成为地方病。虽然轨迹难以预测，但影响这种转变的条件、概念和变量是可以预见的。SARS-CoV-2 作为地方性病毒的持续存在，可能具有季节性流行高峰，可能是由易感个体的口袋和感染或接种疫苗后免疫力下降、病毒通过抗原漂移引起的变化导致保护作用减弱以及从人畜共患病宿主重新进入而导致的. 这里，我们回顾了以前流行病的相关观察结果，并讨论了 SARS-CoV-2 在持续传播过程中在一定水平的人群免疫力下进行适应时的潜在演变。缺乏有效的监测或充分的反应可能会导致 SARS-CoV-2 的地方性感染出现新的流行或大流行模式。为了做出正确的决策，迫切需要一些关键数据。我们概述了这些并提出了前进的道路。为了做出正确的决策，迫切需要一些关键数据。我们概述了这些并提出了前进的道路。为了做出正确的决策，迫切需要一些关键数据。我们概述了这些并提出了前进的道路。