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23/11/2020 When will the COVID-19 pandemic end? | McKinsey
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When will the COVID-19 pandemic end?When will the COVID-19 pandemic end?
November 23, 2020November 23, 2020 | Article| Article
S
November 23, 2020
ince we published our �rst outlook, on September 21st, the COVID�19 pandemic
has raged on, with more than 25 million additional cases and more than 400,000
additional deaths. While the situation looks somewhat better in parts of the Southern
Hemisphere, much of Europe and North America is in the midst of a “fall wave,” with the
prospect of a di�cult winter ahead. Yet the past two weeks have brought renewed hope,
headlined by �nal data from the P�zer/BioNTech vaccine trial and interim data from the
Moderna trial, both showing e�cacy of approximately 95 percent ; and progress on
therapeutics. Is an earlier end to the pandemic now more likely?
The short answer is that the latest developments serve mainly to reduce the uncertainty of
the timeline (Exhibit 1). The positive readouts from the vaccine trials mean that the United
States will most likely reach an epidemiological end to the pandemic (herd immunity) in Q3
or Q4 2021. An earlier timeline to reach herd immunity—for example, Q1/Q2 of 2021—is
now less likely, as is a later timeline (2022). If we are able to pair these vaccines with more
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By Sarun Charumilind , Matt Craven, Jessica Lamb , Adam Sabow , and Matt Wilson
Recent news on vaccine and antibody trials has raised hopes worldwide.Recent news on vaccine and antibody trials has raised hopes worldwide.
When will vaccines be available? And is the end of COVID�19 nearer?When will vaccines be available? And is the end of COVID�19 nearer?
Here we update our September 21 outlook.Here we update our September 21 outlook.
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e�ective implementation of public-health measures and e�ective scale-up of new
treatments and diagnostics, alongside the bene�ts of seasonality, we may also be able to
reduce mortality enough in Q2 to enable the United States to transition toward normalcy.
(See sidebar “Two endpoints” for our de�nitions.)
Exhibit 1
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A secondary e�ect of the recent vaccine trials is to make Q3 2021 more likely for herd
immunity than Q4. That said, major questions are still outstanding, even about vaccines,
such as long-term safety, timely and e�ective distribution, and vaccine acceptance by the
population, to say nothing of lingering epidemiological questions such as the duration of
immunity.
These are estimates for the United States, which is likely to have fast and ready access to
vaccines. We will consider timelines for other countries in forthcoming updates; they will
vary based on the timing of access and distribution of vaccines and other factors. In this
update, we review the most recent �ndings, look deeper at �ve implications of the ongoing
scienti�c research, and discuss why our timeline estimates have not shifted meaningfully.
Revelations from vaccine and antibody
trials
The world has cheered announcements over the past two weeks by P�zer and its partner
BioNTech, and from Moderna. Their COVID�19 vaccine candidates are showing e�cacy
rates that are higher than many dared hope for. One is a �nal result, and the other is an
initial result whose sample size is large enough to give reasonable con�dence in the data.
At about 95 percent, e�cacy is higher than expected by most experts. It exceeds the
optimistic case that we included in our September article. Higher e�cacy provides greater
bene�t to any vaccinated individual and may help to encourage uptake among some
segments of the population. It also reduces the fraction of the population required to reach
herd immunity. Moderna also announced that its vaccine is more shelf-stable than
expected and would need only refrigeration to keep it stable for 30 days—another piece of
good news. Finally, there are a number of other vaccines in late-stage trials from which
data is expected in the coming months.
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Caution is still warranted. The safety records of the P�zer and Moderna vaccines appear
promising so far (no serious side e�ects reported), but the coming months will provide a
fuller picture as the sample size grows. We don’t yet know how long the protection the
vaccines o�er will last. The P�zer trial has enrolled some children (ages 12 and older), but
e�cacy in those under 18 remains unclear.
Beyond vaccines, science is also progressing in therapeutics for COVID�19. For example,
Eli Lilly’s antibody bamlanivimab was granted Emergency Use Authorization (EUA) by the
US Food and Drug Administration on November 9, and Regeneron’s EUA for its
antibody cocktail REGN�COV2 for EUA was approved on November 22. Emerging data on
these antibodies suggest that they can reduce the need for hospitalization of high-risk
patients, and hold potential for post-exposure prophylaxis. While they are not
recommended for use in hospitalized patients, these antibodies add to the growing
armamentarium of treatments and protocols for COVID�19, where every incremental
advance could help to reduce mortality. Collectively, these treatments and changes in
clinical practice have lowered mortality for those hospitalized by 18 percent or more.
Looking deep into the data
Research and �ndings of the past two months have shed light on a number of
uncertainties and in some cases have raised new questions. Here we review �ve
implications; each has helped re�ne our probability estimates for the COVID�19 pandemic
timeline.
Vaccine age restrictions elevate coverage
requirements to reach herd immunity
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It appears that the two vaccines mentioned will be indicated �rst for use in adults. It’s
not clear when use in children will be indicated. One consequence is that the vaccines’
contribution to population-wide herd immunity will depend on adults, at least until
vaccines are approved for use in younger populations. If vaccines are e�cacious, safe, and
distributed to all ages, vaccine coverage rates of about 45 to 65 percent—in combination
with projected levels of natural immunity—could achieve herd immunity (Exhibit 2).
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Exhibit 2
On the other hand, if vaccines are e�cacious but distributed only to adults, who comprise
only 76 percent of the US population, then higher vaccine coverage rates—
approximately 60 to 85 percent—could be required to achieve herd immunity.
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Another consequence is that older children, who have twice the COVID�19 incidence of
younger children and who have higher viralloads (and therefore greater potential
contagiousness) than adults may not have immediate access to vaccines.
We recognize that calculating herd immunity thresholds is complex. Basic formulas fail to
account for variations in the way populations interact in di�erent places. For this reason
we include relatively wide ranges.
Unclear impact of vaccines on
transmission could raise the bar on
coverage
Vaccine trials and regulatory approval will be based on safety and e�cacy in reducing
virologically con�rmed, symptomatic disease among individuals. That’s not the same as
reducing transmission. This distinction will have much to say about whether the United
States reaches normalcy in Q2 or Q3 of 2021. In practice, we have data on whether people
who are vaccinated are less likely to get sick with COVID�19 (and less likely to get severe
disease), but we won’t have data on how likely they are to transmit to others. It’s an
important distinction because what will drive herd immunity is reduction in transmission. If
vaccines are only 75 percent e�ective at reducing transmission, then coverage of about 60
to 80 percent of the population will be needed for herd immunity. And if a vaccine is only
50 percent e�ective at reducing transmission, coverage of over 90 percent would be
required (Exhibit 3).
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Wide variations in local seroprevalence
suggest heterogeneous paths to herd
immunity
Exhibit 3
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Improved estimates of seroprevalence are increasingly available for many regions. They
vary widely, from as low as 1 to 2 percent in some states like Colorado and Kansas to 14 to
20 percent in New Jersey and New York. Because achieving herd immunity relies in
part on a population’s natural immunity, it appears that some locations are closer to herd
immunity than others (and have likely also experienced worse impact on public health to
date.) Based on a range of likely vaccine scenarios and the fact that those with prior
exposure to SARS�CoV�2 will still be eligible for vaccination, every ten percentage-point
increase in seroprevalence could roughly translate into a one-month acceleration of the
timeline to the epidemiological endpoint.
However, it is possible that areas with higher seroprevalence may also have higher
thresholds for herd immunity, because their populations may mix more, which could
have contributed to higher seroprevalence to begin with. If that’s true, then while they are
further along, they may also have further to go. Well-executed distribution of e�ective
vaccines will still be paramount.
Potentially shorter duration of immunity
could prolong the path to the ‘end’
Earlier in the pandemic, it was unclear how long immunity after COVID�19 infection would
last. Duration of immunity matters, obviously; for instance, our modeling suggests that if
natural immunity to COVID�19 lasts six to nine months, as opposed to multiple years (like
tetanus) or lifelong (like measles), herd immunity is unlikely to be achieved unless adult
vaccination rates approach 85 percent. While COVID�19 reinfection is documented but
rare, there are now population-level studies that question the durability of immunity.
Antibody levels may wane after just two months, according to some studies, while a United
Kingdom population-monitoring e�ort reported that antibody prevalence fell by 26
percent over three months. The relationship between waning antibodies and reinfection
risk remains unclear. Other research suggests that even with waning levels of COVID�19
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antibodies, the immune system may still be able to mount a response through other
speci�c B-cell and T-cell immune pathways, where emerging evidence shows much
greater durability after six months.
Manufacturing and supply issues are
clearer, but have not vanished
If the initial e�cacy data from the P�zer and Moderna vaccine trials hold up, and if no
signi�cant safety issues emerge, then initial demand is likely to be high. Two promising
candidates are better than one, but supplies will undoubtedly be constrained in the
months following EUA and approval. The situation may be dynamic as vaccines are
approved at di�erent times, each with its own considerations in manufacturing and
distribution. For example, current data suggest that Moderna’s vaccine is stable at
refrigerated temperatures (2 to 8 degrees Celsius) for 30 days and six months at –20
degrees Celsius. P�zer’s vaccine can be stored in conventional freezers for up to �ve days,
or in its custom shipping coolers for up to 15 days with appropriate handling. Longer-term
storage requires freezing at –70 degrees Celsius, requiring special equipment. Both
P�zer’s and Moderna’s would be two-dose vaccines, necessitating rigorous follow-up for
series completion. These and other complexities create risk of delay. Timelines to reach
the desired coverage threshold will be a�ected by health systems’ abilities to adapt to
changing needs and updated information.
The pandemic’s end is more certain, and
may be a little nearer
Given all of these variables, where do we net out?
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While the winter of 2020/2021 in the Northern Hemisphere will be challenging, we are
likely to see mortality rates fall in Q2 (or possibly late Q1) of 2021. Seasonality and
associated changes in behavior will begin to work again in our favor in the spring, and the
combination of early doses of vaccines targeted to those at highest risk (and the bene�ts
of the P�zer and Moderna vaccines in reducing severe disease), advances in treatment,
expanded use of diagnostics, and better implementation of public-health measures should
serve to signi�cantly reduce deaths from COVID�19 in the second quarter. At this stage,
when monthly mortality from COVID�19 may start to resemble that of �u in an average year,
we may see a transition toward normalcy, albeit with public-health measures still in place.
We are as excited as others about the stunning developments in vaccines. We think Q3 or
Q4 of 2021 are even more likely to see herd immunity in the United States. This is based on
EUA of one or more high-e�cacy vaccines in December 2020 or January 2021, as
manufacturers are targeting ; distribution to people at highest risk (healthcare workers,
the elderly, and those with comorbidities) in the early months of 2021 ;full approval of a
vaccine in March or April; and then widespread rollout. Our estimates of three to eight
months for manufacturing, distribution, and adoption of su�cient vaccine doses to achieve
herd immunity remain unchanged, and suggest that the milestone may be reached
between July and December 2021.
Recent developments suggest that herd immunity is less likely to come in early 2021,
given that vaccines are arriving roughly on the expected timeline; and the downside
scenario stretching into 2022 is also less likely, since e�cacy is clearer. The new vaccines
may slightly accelerate the timeline—the ongoing surge in cases will likely continue into
winter, which would increase natural immunity levels going into Q2. Further, higher-than-
expected e�cacy may help o�set coverage challenges that surveys have suggested.
Those two factors could advance the timeline, and make Q3 a little more likelythan Q4.
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Our estimate is based on the widest possible reading of the current scienti�c literature and
our discussions with public-health experts in the United States and around the world. It’s
possible that unforeseen developments such as signi�cantly more infections than
expected this winter could lead to earlier herd immunity. And real downside risk remains,
especially with respect to duration of immunity and long-term vaccine safety (given the
limited data available so far). Herd immunity might not be reached until 2022 or beyond.
Even when herd immunity is achieved, ongoing monitoring, potential revaccination, and
treatment of isolated cases will still be needed to control the risk of COVID�19. But these
would fall into the category of “normal” infectious disease management—not the society-
altering interventions we have all lived through this year. The short term will be hard, but
we can reasonably hope for an end to the pandemic in 2021.
Sarun Charumilind and Jessica Lamb are both partners in McKinsey’s Philadelphia
o�ce, Matt Craven is a partner in the Silicon Valley o�ce, Adam Sabow is a senior
partner in the Chicago o�ce, and Matt Wilson is a senior partner in the New York o�ce.
The authors wish to thank Gaurav Agrawal, Xavier Azcue, Jennifer Heller, Anthony Ramirez,
Shubham Singhal, and Rodney Zemmel for their contributions to this article.
This article was edited by Mark Staples, an executive editor in the New York o�ce.
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September 21, 2020
Normalcy by spring, and herd immunity by
fall? We assess the prospects for an end in
2021.
In 1920, a world wearied by the First World War and sickened by the 1918 �u pandemic
desperately sought to move past the struggles and tragedies and start to rebuild lives.
People were in search of a “return to normalcy,” as Warren G. Harding put it. Today, nearly
every country �nds itself in a similar position.
More than eight months and 900,000 deaths into the COVID�19 pandemic, people
around the world are longing for an end. In our view, there are two important de�nitions of
“end,” each with a separate timeline:
An epidemiological end point when herd immunity is achieved. One end point will
occur when the proportion of society immune to COVID�19 is su�cient to prevent
widespread, ongoing transmission. Many countries are hoping that a vaccine will do
the bulk of the work needed to achieve herd immunity. When this end point is
reached, the public-health-emergency interventions deployed in 2020 will no longer
be needed. While regular revaccinations may be needed, perhaps similar to annual
�u shots, the threat of widespread transmission will be gone.
A transition to a form of normalcy. A second (and likely, earlier) end point will occur
when almost all aspects of social and economic life can resume without fear of
ongoing mortality (when a mortality rate is no longer higher than a country’s
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historical average) or long-term health consequences related to COVID�19. The
process will be enabled by tools such as vaccination of the highest-risk populations;
rapid, accurate testing; improved therapeutics; and continued strengthening of
public-health responses. The next normal  won’t look exactly like the old—it might be
di�erent in surprising ways, with unexpected contours, and getting there will be
gradual—but the transition will enable many familiar scenes, such as air travel,
bustling shops, humming factories, full restaurants, and gyms operating at capacity,
to resume.
The two ends are related, of course, but not linearly. At the latest, the transition to normal
will come when herd immunity is reached. But in regions with strong public-health
responses, normalcy can likely come signi�cantly before the epidemiological end of the
pandemic.
The timeline to achieve the ends will vary by location. In this article, we’ll explain the criteria
that will be key factors in determining when each is reached. In the United States and
most other developed economies, the epidemiological end point is most likely to be
achieved in the third or fourth quarter of 2021, with the potential to transition to normalcy
sooner, possibly in the �rst or second quarter of 2021. Every day matters. Beyond the
impatience that most feel to resume normal life, the longer it takes to remove the
constraints on our economies, the greater will be the economic damage .
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The epidemiological end point
Most countries have deferred the hope of achieving herd immunity until the arrival of a
vaccine. When herd immunity is reached, ongoing public-health interventions for COVID-
19 can stop without fear of resurgence. The timing of the end point will vary by country and
will be a�ected by a number of factors:
the arrival, e�cacy, and adoption of COVID�19 vaccines—the biggest drivers in the
timeline to herd immunity
the level of natural immunity in a population from exposure to COVID�19; in our
estimate, between 90 million and 300 million people globally may have natural
immunity
potential cross-immunity from exposure to other coronaviruses
potential partial immunity conferred by other immunizations, such as the bacille
Calmette–Guérin (BCG) vaccine for tuberculosis
regional di�erences in the ways that people mix, which will produce di�erent
thresholds for herd immunity
Consider the �rst and most crucial variables: the arrival of vaccines, their e�cacy, and their
adoption. We see four plausible scenarios for vaccine e�cacy and adoption, illustrated in
Exhibit 1. Di�erent combinations of those two factors will drive varying levels of
conferred immunity, implying the extent of natural immunity that will be required to reach
herd immunity under each scenario. Combinations of e�cacy and adoption beyond those
shown are possible.
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Exhibit 1
The other variables will also have much to say about the timeline to reach herd immunity
(see sidebar, “Key factors a�ecting the timeline to herd immunity”).
Based on our reading of the current state of the variables and their likely progress in the
coming months, we estimate that the most likely time for the United States to achieve herd
immunity is the third or fourth quarter of 2021. As we wrote in July 2020 , one or more
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vaccines may receive US Food and Drug Administration Emergency Use Authorization
before the end of 2020 (or early in 2021) and the granting of a Biologics License
Application (also known as approval) during the �rst quarter of 2021.
Vaccine distribution to a su�cient portion of a population to induce herd immunity could
take place in as few as six months . That will call for rapid availability of hundreds of
millions of doses, functioning vaccine supply chains, and peoples’ willingness to be
vaccinated during the �rst half of 2021. We believe that those are all reasonable
expectations, based on public statements from vaccine manufacturers and the results of
surveys on consumer sentiment about vaccines.
Herd immunity could be reached as soon as the second quarter of 2021 if vaccines are
highly e�ective and launched smoothly or if signi�cant cross-immunity is discovered in a
population (Exhibit 2). (For more on the potential for a faster resolution of the COVID�19
crisis in the United States, see “ An optimistic scenario for the US response to COVID�19 ”.)
On the other hand, the epidemiological end of the pandemic might not be reached until
2022 or later if the early vaccine candidates have e�cacy or safety issues—or if their
distribution and adoption are slow. At worst, we see a long-tail possibility that the United
States could be still battling COVID�19 into 2023 and beyond if a constellation of factors
(such as low e�cacy of vaccines and a short duration of natural immunity) align against us.
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The paths to herd immunity in other high-income countries are likely to be broadly similar
to the one in the United States. The timelines will vary based on di�erences in vaccine
access and rollout and in levels of natural immunity—and potentially, in levels of cross-
immunity and previous coverage of other vaccines, such as the BCG vaccine. Even as
some locations reach herd immunity, pockets of endemic COVID�19 disease are likely to
remain around the world, for example in areas a�ected by war or in communities with
persistently low adoption of vaccines. In such places, until herd immunity is reached,
Exhibit 2
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COVID�19 might be analogous to measles—not a day-to-day threat to most people, but a
persistent risk. If immunity wanes—for example, if booster vaccines are not fully adopted—
then COVID�19 could become more widely endemic.
The arrival of herd immunity won’t mean a complete end to all public-health interventions.
It’s possible that regular revaccinations would be required to maintain immunity, and
ongoing surveillance for COVID�19 will be required. But herd immunity would mean that
the emergency measures currently in place in many countries could be lifted.
The pace at which governments relax public-health measures will be critical. Some of
those measures (such as full lockdowns and restrictions on certain industries) have
signi�cant social and economic consequences, and others (such as testing and tracing),
while expensive, don’t. Many governments are employing packages of measures  that aim
to minimize the number of COVID�19 cases and excess mortality while maximizing social
and economic degrees of freedom.
The transition to normal
The second end point of the pandemic may be reached earlier than the �rst. We estimate
that the mostly likely time for this to occur is the �rst or second quarter of 2021 in the
United States and other advanced economies. The key factor is diminished mortality.
Society has grown used to tracking the number of COVID�19 infections (the case count).
But case counts matter primarily because people are dying from the disease and because
those who survive it may su�er long-term health consequences after infection. The latter
is an area of scienti�c uncertainty, but there is concern that some recovered patients will
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Most countries have made signi�cant progress in reducing the numbers of deaths and
hospitalizations associated with COVID�19. Some are close to eliminating excess mortality.
Those results have generally been achieved through a combination of moderately e�ective
interventions rather than a single “big bang” (Exhibit 3).
A transition to the next normal, in whatever form that takes, will come gradually when
people have con�dence that they can do what they used to do without endangering
themselves or others. Gaining that con�dence will require a continuation of the progress
made to reduce mortality and complications, as well as further scienti�c study regarding
long-term health consequences for recovered patients. When con�dence is restored,
Exhibit 3
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people will again �ll bars, restaurants, theaters, and sports venues to full capacity; �y
overseas (except for the highest-risk populations); and receive routine medical care at
levels similar to those seen prior to the pandemic.
The timing of such a transition will depend on the progress toward herd immunity, as
previously detailed (since more people with immunity means fewer deaths and long-term
health consequences), and on the e�ectiveness of a country’s public-health response.
Transitions will be gradual. They have already begun in some locations and could be well
advanced in most countries by the �rst or second quarter of 2021. Given the
interconnectedness of the global economy, country timelines to normalcy are not fully
independent of one another.
To achieve that, we will need to see signi�cant progress on the epidemiological end point,
including an e�ective vaccine receiving Emergency Use Authorization approval during the
fourth quarter of 2020 or the �rst quarter of 2021, followed by a smooth rollout and
adoption by high-risk populations. Favorable �ndings 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 signi�cantly limit economic and
social activities
compliance with public-health measures until we achieve herd immunity
accurate, widely available, rapid testing that e�ectively enables speci�c activities
continued advancements in therapeutics (including pre- and postexposure
prophylactics) for and clinical management of COVID�19, leading to lower infection-
fatality ratios—substantial progress has already been made through a combination
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1. “P�zer and BioNTech conclude Phase 3 study of COVID�19 vaccine candidate, meeting all primary
e�cacy endpoints,” P�zer, November 18, 2020, p�zer.com.
2. “Moderna’s COVID�19 vaccinecandidate meets its primary e�cacy endpoint in the �rst interim
analysis of the Phase 3 COVE study, Moderna, November 16, 2020, modernatx.com.
3. “P�zer vaccine e�cacy could be a ‘game changer,’” Cornell University, November 8, 2020,
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US Food and Drug Administration, November 9, 2020, fda.gov.
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6. Leora Horwitz et al., “Trends in COVID�19 risk-adjusted mortality rates,” Journal of Hospital
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of e�ective drugs, such as dexamethasone and remdesivir, and changes in clinical
management
public con�dence that there aren’t signi�cant long-term health consequences for
those who recover from COVID�19
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 de�nitive 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. Other advanced
economies are probably on similar timetables.
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9. Rebecca Leeb et al., COVID�19 trends among school-aged children—United States, March 1–
September 19, 2020, Centers for Disease Control and Prevention, October 2, 2020, cdc.gov; Lael
Yonker et al., “Pediatric severe acute respiratory syndrome coronavirus 2 (SARS�CoV�2): Clinical
presentation, infectivity, and immune response,” Journal of Pediatrics, August 19, 2020 jpeds.com.
10. Kevin Hartnett, “The tricky math of herd immunity for COVID�19,” Quanta Magazine, June 30,
2020, quantamagazine.org.
11. Marc Lipsitch et al., “Understanding COVID�19 vaccine e�cacy,” Science, November 13, 2020,
science.sciencemag.org.
12. “Nationwide commercial laboratory seroprevalence survey,” Centers for Disease Control and
Prevention, accessed November 15, 2020, covid.cdc.gov.
13. Anthony Ives and Claudio Bozzuto, “State-by-state estimates of R0 at the start of COVID�19
outbreaks in the USA,” MedRxiv, May 27, 2020, medrxiv.org.
14. F. Javier Ibarrondo et al., “Rapid decay of anti-SARS�CoV�2 antibodies in persons with mild
COVID�19,” New England Journal of Medicine, September 10, 2020, nejm.org; Helen Ward et al.,
“Declining prevalence of antibody positivity to SARS�CoV�2: A community study of 365,000 adults,”
MedRxiv, October 27, 2020, medrxiv.org.
15. Rebecca Cox and Karl Brokstad, “Not just antibodies: B cells and T cells mediate immunity to
COVID�19,” Nature Reviews Immunology, August 24, 2020, nature.com; Jennifer Dan et al.,
“Immunological memory to SARS�CoV�2 assessed for greater than six months after infection,”
BioRxiv, November 16, 2020, biorxiv.org.
16. Katie Thomas, “New P�zer results: Coronavirus vaccine is safe and 95% e�ective,” New York
Times, November 18, 2020, nytimes.com.
17. “P�zer and BioNTech to submit Emergency Use Authorization request today to the US FDA for
COVID�19 vaccine,” P�zer, November 20, 2020, p�zer.com; “Moderna’s COVID�19 vaccine candidate
meets its primary e�cacy endpoint in the �rst interim analysis of the Phase 3 COVE study,” Moderna,
November 16, 2020, moderna.com.
18. The COVID�19 vaccination program interim operational guidance for jurisdictions playbook,
Centers for Disease Control and Prevention, October 29, 2020, cdc.gov.
19. Coronavirus Resource Center, Johns Hopkins University & Medicine, September 18, 2020,
coronavirus.jhu.edu.
20. Virus-neutralizing antibodies could also confer immunity but are less likely to be deployed at
su�cient scale to achieve herd immunity in large populations.
21. For calculation and sources, see sidebar, “Key factors a�ecting the timeline to herd immunity.”
22. Jose Mateus et al., “Selective and cross-reactive SARS�CoV�2 T cell epitopes in unexposed
humans,” Science, August 4, 2020, science.sciencemag.org.
23/11/2020 When will the COVID-19 pandemic end? | McKinsey
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23. Martha K. Berg et al., “Mandated Bacillus Calmette-Guérin (BCG) vaccination predicts �attened
curves for the spread of COVID�19,” Science Advances, August 2020, Volume 6, Number 32,
advances.sciencemag.org.
24. Exhibit 1 assumes a basic reproductive number (R0) of 2.4 and uses a standard formula to arrive at
an estimated herd-immunity threshold of 58 percent.
25. Coronavirus Resource Center, Johns Hopkins University & Medicine, September 18, 2020,
coronavirus.jhu.edu.
26. Charlie Giattino, “How epidemiological models of COVID�19 help us estimate the true number of
infections,” Our World in Data, August 24, 2020, ourworldindata.org; Hazhir Rahmandad, John
Sterman, and Tse Yang Lim, “Estimating COVID�19 under-reporting across 86 nations: Implications for
projections and control,” medRxiv, August 3, 2020, medrxiv.org.
27. Not all serosurveys have used random-sampling methodologies.
28. “COVID�19: Data,” NYC Health, September 21, 2020, nyc.gov. Summary statistics, SeroTracker,
September 16, 2020, serotracker.com.
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uninfected controls,” Nature, August 20, 2020, Volume 584, pp. 457�62, nature.com.
30. Martha K. Berg et al., “Mandated Bacillus Calmette-Guérin (BCG) vaccination predicts �attened
curves for the spread of COVID�19,” Science Advances, August 2020, Volume 6, Number 32,
advances.sciencemag.org.
31. The basic reproductive number (R0) is a measure of contagiousness or transmissibility. For COVID-
19, it can be generally thought of as the expected number of cases directly generated by a single case
in a population in which all people are susceptible. The R0 value for COVID�19 is under debate, with
estimates ranging from two to four. For an example of a low-end estimate, see Max Fisher, “R0, the
messy metric that may soon shape our lives, explained,” New York Times , April 23, 2020, nytimes.com.
For an example of a high-end estimate, see Seth Flaxman et al., “Estimating the e�ects of non-
pharmaceutical interventions on COVID�19 in Europe,” Nature, August 13, 2020, Volume 584, pp.
257�61, nature.com.
32. Frank Ball, Tom Britton, and Pieter Trapman, “A mathematical model reveals the in�uence of
population heterogeneity on herd immunity to SARS�CoV�2,” Science, August 14, 2020, Volume 369,
Number 6,505, pp. 846�9, science.sciencemag.org.
33. Abstractions Blog, “The tricky math of herd immunity for COVID�19,” blog entry by Kevin Hartnett,
June 30, 2020, quantamagazine.org; Apoorva Mandavilli, “What if ‘herd immunity’ is closer than
scientists thought?,” New York Times , August 17, 2020, nytimes.com.
34. Joe Myers, “3 in 4 adults around the world say they would get a COVID�19 vaccine,” World
Economic Forum, September 1, 2020, weforum.org.
35. “COVID�19 (coronavirus): Long-term e�ects,” Mayo Clinic, August 18, 2020, mayoclinic.org.
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ABOUT THE AUTHOR(S)Sarun Charumilind and Jessica Lamb are both partners in McKinsey’s
Philadelphia o�ce, Matt Craven is a partner in the Silicon Valley o�ce, Adam
Sabow is a senior partner in the Chicago o�ce, and Matt Wilson is a senior
partner in the New York o�ce.
The authors wish to thank Gaurav Agrawal, Xavier Azcue, Jennifer Heller,
Anthony Ramirez, Taylor Ray, and Sven Smit for their contributions to this article.
This article was edited by Mark Staples, an executive editor in the New York
o�ce.
Talk to us
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https://www.mckinsey.com/our-people/matt-wilson