As COVID-19 infections rise in much of the world, many are clinging to the hope that a vaccine will soon restore life as we knew it. That is wishful thinking. Even if an effective vaccine is found, COVID-19 will be with us for the foreseeable future — at least for the next five years. We are going to have to learn to live with it.

An international panel of scientists and social scientists, convened by the Wellcome Trust, recently constructed four pandemic scenarios. Key variables included what we may learn about the biology of SARS-CoV-2 (the virus that causes COVID-19) — such as the pace of mutation and the extent to which an infection elicits antibodies — and how fast we develop and deploy effective vaccines, antivirals, and other treatments.

The study then considered how each of these four scenarios would unfold in five general settings: high-, middle- and low-income countries, as well as conflict zones and vulnerable environments like refugee camps and prisons.