En español | It's been a difficult year. Not long after ringing in 2020, a new virus spread across the globe, bringing life as we know it to a grinding halt. Living rooms transformed into classrooms, businesses moved to bedrooms, and masks became a must-have accessory.
Unfortunately, pandemic life will not end when the clock strikes midnight on Dec. 31, but it will be different in many ways next year. Here are five things that will change in 2021, plus a few that will remain the same.
1. There will be new COVID-19 treatments
One thing that's become clear since the start of the pandemic is that COVID-19 isn't just a respiratory illness — it can affect multiple organs in the body, making treatment a challenge. But there has been progress on this front, and experts predict that will continue into the new year.
The U.S. Food and Drug Administration (FDA) has so far approved one drug to treat COVID-19: an antiviral, called remdesivir, which has been shown to reduce recovery time in patients hospitalized with the illness. And “there's an awful lot of work going on in the field” to see if other antivirals — which stop the virus from replicating in the body — are even more effective, says Sten Vermund, M.D., dean of Yale School of Public Health. “It's plausible that in the tens of thousands of antiviral drugs out there, there may be a reasonable match better than remdesivir,” he adds.
Monoclonal antibodies, which imitate the body's immune response to a disease, are also in the spotlight when it comes to treatments. A few have been issued emergency use authorization (EUA) from the FDA after demonstrating in clinical trials that they can help keep people with COVID-19 from progressing to the point where they require hospitalization. The only problem is the authorized monoclonal antibodies continue to be in short supply and require an infusion, making the therapy inaccessible to many.
However, other candidates are being fast-tracked in the research process, and experts, including Edith Parker, dean of the University of Iowa College of Public Health, are hopeful that if proven effective, they will be made available to the public soon, bolstering the supply. “I think this may be really groundbreaking,” Parker says of the development of monoclonal antibodies for COVID-19, “and may be one of the positive things that have come out of COVID-19.”
Corticosteroids, a more recent addition to the treatment regimen, have also proven helpful in treating patients sick with COVID-19. And Vermund says he's “expecting continued therapeutic progress” over the next several months and years.
"It took us quite a while to get this point with HIV,” he said, noting that nearly six years went by from the time the disease was identified in the U.S. to the time drugs were available. “And now, we recognized [COVID-19] in January, and we're already dropping mortality rates by the fall [compared with the rates reported at the peak of the pandemic this past spring]. So I think that level of success is likely to continue. I think we'll have additional good news in 2021."
2. Therapies will be administered more effectively
The way in which these treatments are administered could also change in the coming months. For example, researchers are studying whether giving patients antivirals earlier in the course of COVID-19 — and not waiting until they are already in the hospital — will help keep people from getting really sick.
When you start a drug “very late in the course of this disease, maybe they don't have as much effect as we initially thought they had,” says Luis Ostrosky-Zeichner, M.D., a professor of medicine and an infectious disease specialist with UTHealth in Houston.
Finding ways to make COVID-19 treatments easier to access will also be a focus in the forthcoming year. Intravenous therapies such as monoclonal antibodies require hospitals and health care facilities to set up dedicated infusion centers. From a patient's perspective, receiving the medicine is more involved than swallowing a pill or showing up for a shot; the IV infusion appointments last about 21/2 hours, according to Mayo Clinic.
Ostrosky-Zeichner says he sees “a future not too far away,” where once a patient is diagnosed with COVID-19, providers will be able to prescribe something that can be filled at a pharmacy. “There's a whole bunch of new therapeutics on the horizon that are going to be not injectable, but maybe inhaled or pills that you'll be able to take as an outpatient,” he adds.
3. Doctors will be better prepared
In addition to drug therapies, advancements in supportive care have contributed to the overall decline in COVID-19 death rates since the start of the pandemic. And many experts say that's because health care providers have a better handle on how to help patients.
When a patient with COVID-19 needs respiratory therapy, for example, invasive ventilation is now often the last stop. Providers have had success positioning patients on their stomachs — a tactic known as proning — to improve the distribution of oxygen in the body. They're also supplying oxygen via face masks and nasal tubes as an alternative to ventilators, which can cause complications.
"We have advanced, noninvasive ventilation technology that is really improving,” Ostrosky-Zeichner says. And he and others expect further improvements into the new year.
4. Coronavirus testing will be faster, more accessible
The FDA in mid-December authorized a first-of-its kind coronavirus test: It doesn't require a prescription, it can be used at home and it delivers results within minutes.
Public health experts have been pushing for inexpensive and accessible at-home testing since the start of the pandemic, and many predict that 2021 will be the year when it becomes a reality, as several designs are being studied in clinical trials.
Ostrosky-Zeichner says bringing coronavirus testing out of the lab and into the home is “a big advance,” especially since traditional testing “remains kind of a big production” with long waits for appointments and results. To end the pandemic, he argues, testing “should be available everywhere — in your doctor's office, in any retail pharmacy, any drive-through kind of setting, and you should be able to get your results the same day or immediately,” he adds. “Only then will we be able to properly isolate the people that are infected.”
More readily available testing could also help people make everyday decisions that could save lives, such as whether they should go to school, go to work or board an airplane. “Imagine if you could go to the drugstore, get a test, you test positive, you find out that you are an asymptomatic carrier and you don't go visit grandma,” Vermund says. “There are very concrete benefits from having ready access to tests.”
One caveat, though, is that rapid antigen tests (like many of those that have been cleared and are being studied for at-home use) tend to be slightly less accurate than the gold-standard PCR tests that are typically conducted at testing sites and medical facilities. So if you do take a rapid test at home or elsewhere and get a negative result, don't take that as a free pass to abandon other preventive measures. Also: If you test negative but develop COVID-like symptoms, be sure to “follow up with your health care provider,” University of Iowa's Parker says.
5. Vaccines, vaccines, vaccines
The end of 2020 ushered in a wealth of excitement over advancements in coronavirus vaccines. Two different products — a vaccine from Pfizer-BioNTech and one from Moderna — were granted FDA authorization, and priority populations throughout the country have started receiving their shots. By mid-2021, health officials predict that there will be enough supply so that anyone who wants a vaccine will be able to get one, which “will really start curbing” the impact of the virus, Ostrosky-Zeichner says.
Experts are also hoping to find answers to some key vaccine questions in the next several months, including the duration of their protection and whether they help block transmission of the virus that causes COVID-19. More information on the vaccines’ long-term safety should also be available.
Staying the same in 2021: Masks, distancing, handwashing
Several pandemic protocols will need to carry over into the new year if there's going to be any hope of slowing the spread of the virus, health experts say. Until the majority of the population is vaccinated and more information is available on the vaccines’ ability to stop virus transmission, masks are still going to be needed. The same goes for physical distancing, frequent handwashing and avoiding crowded indoor areas.
"If we all work together doing that and getting vaccinated, it'll get us quicker to the end point, which is to go back to normal life,” Ostrosky-Zeichner says.
Another behavior that should carry into 2021: Get your flu shot if you haven't already, Vermund says. This will help the health care system from becoming overstressed.
"I truly believe that if we all work together, and focus for the next three or four months, we can go back to normal life as we know it,” Ostrosky-Zeichner adds.