Australia's path from pandemic to endemic, and what 'living with COVID' could mean - ABC News

"I don't know if we're going to wake up one day and say, 'Oh, it's over now,'" says Eddie Holmes, an evolutionary virologist at the University of Sydney.

But even in the absence of herd immunity, vaccines considerably reduce severe disease, meaning fewer people will be hospitalised, and fewer still will die.

Evidence suggests the virus will spread most readily among people who remain unvaccinated, but there will also be cases in vaccinated people, as protection against infection wanes and the proportion of vaccine recipients grows.

"We're still going to see groups of people who will get very sick, because they can't be vaccinated or their immune system doesn't respond well.

To protect those at risk of severe disease and keep the health system from being overwhelmed, Griffith University virologist and infectious disease researcher Lara Herrero says it's essential that restrictions are lifted slowly, and certain COVID-safe measures maintained.

While data suggests COVID-19 vaccines provide strong protection against severe disease over time, evidence of waning protection against infection could mean population-wide immunity fluctuates.

Professor Holmes says health experts are closely watching highly vaccinated countries such as Denmark, which lifted all restrictions on September 10, to see how case numbers and hospitalisations fare?

According to Dr Mackay, the bumpy road to living with COVID-19 will also depend on what governments decide is an acceptable level of disease and death.

"Some people say living with COVID means just 'letting it go', with enough vaccinated people to blunt the burden of hospitalisations and deaths," he said.

Another factor that will affect how countries manage future COVID-19 threats is the evolution of the virus itself.

"But as immunity rises — and that's happening because we're vaccinating at increasing numbers — the selection pressure on the virus is going to change.".

Eventually, though it's difficult to predict, Professor Holmes says SARS-CoV-2 may start to resemble the seasonal flu

Epidemiologists say hearing of people we know catching the virus is likely to become the new normal as NSW moves to living with the virus

"What we don't know is how long that's going to take