The long-term future of COVID-19 is a global concern. US researchers modeled the course of the pandemic based on immunological and epidemiological data on known endemic human coronaviruses. These include the four common childhood respiratory human coronaviruses and the two emerging coronaviruses with high mortality responsible for severe acute respiratory syndrome (SARS) and Middle-Eastern respiratory syndrome.¹ The data show that although naturally occurring infection-blocking immunity wanes fast, disease-reducing immunity is long-lasting. Their model incorporating immune characteristics was consistent with the benign clinical course of the childhood respiratory coronaviruses and the severe clinical course of SARS-CoV-2 infection. It suggested that as long as no variant emerges with greatly increased virulence in children, for which there is no evolutionary rationale, future primary exposure to SARS-CoV-2 will be a benign childhood disease likely to be no more virulent than the common cold viruses that are already established. This surprisingly optimistic prediction of future post-pandemic endemicity gives us hope of finally coming out of the pandemic and back to something like normality. What we need is to get over the initial ‘hump’ where older people's immune systems have not seen the virus before, something which vaccination provides.

COVID-19 的长期未来是全球关注的问题。美国研究人员根据已知地方性人类冠状病毒的免疫学和流行病学数据模拟了大流行的过程。其中包括四种常见的儿童呼吸道人类冠状病毒和两种导致严重急性呼吸系统综合症 (SARS) 和中东呼吸系统综合症的高死亡率的新兴冠状病毒。¹数据显示，虽然自然发生的感染阻断免疫会迅速减弱，但减少疾病的免疫是持久的。他们结合免疫特征的模型与儿童呼吸道冠状病毒的良性临床过程和 SARS-CoV-2 感染的严重临床过程一致。它表明，只要没有在儿童中出现毒力大大增加的变异（没有进化论基础），未来对 SARS-CoV-2 的主要暴露将是一种良性儿童疾病，其毒力可能不比普通感冒病毒强那些已经建立的。这种对未来大流行后流行的令人惊讶的乐观预测使我们希望最终摆脱大流行并恢复正常。