With the end of 2022 coming tomorrow, I'm struck by how this year made Covid weirdly familiar.

At the end of 2019, the earliest reports were coming out of Wuhan of a puzzling new pneumonia besetting hospitals. The world soon shut down, as the virus flew from country to country.

At end of 2020, effective vaccines were getting shot into arms. They have saved many millions of lives worldwide. But the end of 2020 unfortunately also brought a striking demonstration of evolution in action: a new variant, which came to be known as Alpha, started surging to dominance.

At the end of 2021, a different variant was surging. Omicron wiped out Alpha, and all the other variants that had come before. Its mutations allowed it to evade some of the immunity provided by the vaccines, although the vaccines still dramatically reduced the risk of severe disease.

At the end of 2022, we are still living in the Age of Omicron, although its descendants have evolved into a staggering menagerie of subvariants, some of which are far better than 2021's Omicron at spreading. Their advantage comes partly from mutations that let them evade the antibodies we have gained either from vaccines or earlier infections. But they also appear to have other mutations that help them bind more successfully to cells, making them more transmissible.

At the end of 2022, we know that booster shots can provide extra protection, especially for the elderly and others at high risk of serious disease. This year, the United States tried to catch up with evolution by authorizing a booster that included the BA.5 subvariant of Omicron. It's not clear how much extra protection it offers beyond a booster against the virus as it existed at the end of 2020. BA.5 dominated much of the world for a few months of 2022, but now it's being outcompeted by new kids like XBB.1 and BQ.1.1.

At the end of 2022, people are back at offices, going to restaurants, and catching movies--in other words, revising the places where indoor air can harbor floating droplets expelled by people infected with Covid. Masks are rarer. Testing has slacked off.

Yet at the end of 2022, Covid remains a major threat. That is nowhere more obvious than in China, which has spent much of the past three years locked down. While China has notoriously unreliable Covid statistics, a number of studies suggest that it has experienced far fewer deaths than other major countries. But that success came at a brutal cost, with millions of people trapped in their homes for weeks or months at a time. Nor did China make good use of that time. They achieved fairly low rates of vaccination in elderly people--the ones at greatest risk from Covid. They also went all in on Chinese vaccines made from inactivated viruses, which don't appear to be as effective as vaccines based either on proteins or mRNA. As China abruptly drops many of its restrictions, a highly evolved version of the coronavirus is going to sweep through a population that has a weak wall of immunity.

All the attention now focused on China may produce the false sense that everything is fine elsewhere, that other countries are magically past the pandemic. The numbers say otherwise. In 2020, over 350,000 people died in the United States alone. But over 739,000 Americans have died since then, and well over 2,000 are currently dying of Covid every week.

I hope that things don't get worse in 2023. But I also hope that we don't fatalistically leave things to unfold on their own. Many public health measures can lower transmission, as well as hospitalizations and death. But so can scientific advances. Looking back over the stories I wrote for the New York Times over the course of the pandemic, I am struck by how many articles in 2020 and 2021 concerned fast-moving studies that led to better weapons against Covid and raised hope for even better ones in the future. But in 2022, I didn't find much innovation to write about. As we socially swing back to normal, scientific research is also swinging back to a more ordinary pace. And so the pipeline for a new generation of vaccines, antivirals, tests, and other potent weapons against Covid has gotten gummed up. I hope I can write about more scientific advances in 2023, but I'm doubtful. On the other hand, I do know for sure that I will be writing about Covid's continued evolution.

I recently dropped by the offices of This Week in Virology, to talk to virologist and podcast host Vincent Racaniello about what it's been like to report on the pandemic so far, and what this coming year may look like. You can listen or watch here. 

This winter I'm digging deep into my next book, which will fold in some of our experience with the pandemic, but hopefully fit it into a bigger picture of history and biology. I'll have more to say about it when it's fit for sharing. In the meantime, here is Mick, our cat who is currently using my research table as a fortress of solitude, wishing you a happy, healthy 2023.

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