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Do New Strains of SARS-CoV-2 Coronavirus and Inconsistent Distribution of COVID-19 Vaccines Threaten a Return to Normalcy in 2021? McKinsey Weighs In

The latest McKinsey report addresses when the COVID-19 pandemic is “most likely” to end and what needs to happen to get there

Clinical laboratory leaders, pathologists, and diagnostics professionals everywhere want to know when the SARS-CoV-2 coronavirus will burn itself out. When can we expect to return to normal? Since there is no such thing as a crystal ball, it might be helpful to review the latest report from international management consulting firm McKinsey and Company, titled, appropriately, “When Will the COVID-19 Pandemic End?

It’s a good question, and McKinsey is not certain of the answer. Barring other factors, McKinsey predicts “Transition toward normalcy in the United States remains most likely in the second quarter of 2021 and herd immunity in the third and fourth quarters, but the emergence of new strains and a slow start to vaccine rollout raise real risks to both timelines.” The report also states, “the emergence of more-infectious variants of SARS-CoV-2 increases the risk that this milestone will not be achieved until later.

“More-infectious viruses,” McKinsey continued, “require that a higher percentage of people be simultaneously immune to reach herd immunity. While a more infectious variant likely means more people are acquiring natural immunity through infection (despite ongoing efforts to minimize new cases), the net impact of more-infectious strains is likely to be that a higher portion of the population needs to be vaccinated, which may take more time.”

Challenges That May Slow Herd Immunity to COVID-19

“It is now harder to imagine the United States or United Kingdom transitioning to normalcy before second quarter 2021 or reaching herd immunity before third quarter 2021,” McKinsey added. “Herd immunity to a pathogen is achieved when a sufficient portion of a population is simultaneously immune to prevent sustained transmission.”

But problems in [COVID-19] vaccine distribution, supply shortages, and intermittent participation by the population could push the pandemic endpoint to 2022, cautioned McKinsey.

“We believe herd immunity in the United States is still most likely in third or fourth quarter 2021, but that the chance of delay until first quarter 2022 or beyond has increased,” the report states, “Even later herd immunity remains possible if other challenges arise, especially vaccine safety concerns or ambivalence to vaccination following a transition toward normalcy.”

Other factors that went into the firm’s “most likely” set of possible timelines include:

  • “Unexpected safety issues emerging with early vaccines,
  • “Significant manufacturing or supply-chain delays,
  • “Continued slow adoption,
  • “Further mutation [of the virus],
  • “A shorter-than-anticipated duration of vaccine-conferred immunity.”
Graph from McKinsey and Co. report about covid-19 herd immunity projections into year 2023
The graph above, taken from the McKinsey and Co. report, illustrates how “the probability of reaching COVID-19 herd immunity in the United States is highest in the third or fourth quarter, but could shift.” (Graphic copyright: McKinsey and Company.)

A ‘Transition Toward Normalcy’

In its report, McKinsey notes that “During this transition, controlling the spread of SARS-CoV-2 will still require public-health measures (such as continued COVID-19 testing and mask use in many settings), but mortality will fall significantly, allowing greater normalization of business and social activities.”

In apparent agreement, according to data from the COVID Tracking Project, as of Jan. 27, 2021, 107,444 people were hospitalized in the US with COVID-19, as compared to 130,000 hospital cases on Jan. 13, 2021. Numbers of new cases appear to be dropping, however, McKinsey predicts that “COVID-19 will not disappear during this transition but will become a more normal part of the baseline disease burden in society (like flu, for example), rather than a special threat requiring exceptional societal response.”

It may help that more people are taking one of the vaccines. A recent survey conducted by London-based research and analytics firm YouGov, found that people worldwide are becoming more willing to take the COVID-19 vaccine. For example, in the UK, 80% of those surveyed gave a thumbs-up to getting vaccinated, compared to 61% in November. In the US, however, still only about 45% said they will get the vaccine, up slightly from 42% who said so in July, YouGov reported.

However, McKinsey points out that “vaccine rollout has not yet proceeded far enough to protect much of the population.”

How Should Medical Laboratories and Other Healthcare Providers Proceed?

In “No One Said it Would Be Easy,” Jan. 22, 2021, Becker’s Hospital Review, Michael Dowling, President and CEO of Northwell Health, wrote, “We will be living in a world preoccupied by COVID-19 and vaccination for many months to come … And the stark reality is that the vaccination rollout will continue well into the summer, if not longer, while at the same time we continue to care for hundreds of thousands of Americans sickened by the virus. Despite the challenges we face now and in the coming months in treating the disease and vaccinating a US population of 330 million, none of us should doubt that we will prevail.”

“To achieve that,” McKinsey notes, “we will need to see significant progress on the epidemiological end point … Favorable findings on natural and cross-immunity would help accelerate timelines.

“Five additional criteria will also contribute to the transition to a form of normalcy—the more of these that are achieved, the faster the milestone is likely to be reached:

  • “Continued improvement by governments in the application of public-health interventions (such as test and trace) that don’t significantly limit economic and social activities.
  • “Compliance with public-health measures until we achieve herd immunity.
  • “Accurate, widely available, rapid testing that effectively enables specific activities.
  • “Continued advancements in therapeutics (including pre- and post-exposure prophylactics) for and clinical management of COVID-19, leading to lower infection-fatality ratios—substantial progress has already been made through a combination of effective drugs, such as Dexamethasone and Remdesivir, and changes in clinical management.
  • “Public confidence that there aren’t significant long-term health consequences for those who recover from COVID-19.”

Finally, McKinsey notes that “Both the epidemiological and normalcy ends to the COVID-19 pandemic are important. The transition to the next normal will mark an important social and economic milestone, and herd immunity will be a more definitive end to the pandemic. In the United States, while the transition to normal might be accomplished sooner, the epidemiological end point looks most likely to be reached in the second half of 2021.”

It is not clear when clinical laboratories and pathologists will know for certain when the pandemic’s end point has been reached. Predictions coming from sources such as McKinsey’s latest report may be as close as we get to a crystal ball view of the pandemic’s future.

—Donna Marie Pocius

Related Information:

When Will the COVID-19 Pandemic End?

International Study How Many People Will Take COVID-19 Vaccine

Pandemic Will Not End for Anyone Until it Ends for Everyone

No One Said It Would Be Easy