What to expect when you’re expecting an ongoing pandemic: The next six months are likely to be a repeat of what we’ve already seen in the past year and a half. Schools could close again, hospitals will face high pressure, and more variants will emerge, writes Bloomberg in a far-from-sunny piece. For the pandemic to end, almost everyone will either be infected, vaccinated, or both, experts agree. And despite all the havoc covid-19 has wreaked so far, we’re still not there yet.

Have we already surpassed historical precedents? The longest global flu outbreak lasted for five years and consisted of two to four waves of infection over an average of two or three years, according to Lone Simonsen, an epidemiologist and professor of population health sciences. We’re already at the fourth wave of covid-19, with no clear ending in sight. Covid-19 is also more deadly than any outbreak since the 1918 Spanish flu.

Expect more outbreaks for a start: Factors such as lax precautions or the flu season are sure to cause outbreaks in classrooms, on public transport and in workplaces over the coming months as economies push ahead with reopening.

Nightmare scenario #1: A vaccine-resistant variant. As vaccine inequality continues to be a problem globally, nations where vaccination has been sparse are more likely to provide breeding grounds for new variants to emerge. Malaysia, Mexico, Iran and Australia are in the midst of their biggest outbreaks yet, fueled by the contagious delta strain. “Pandemics can in fact get more deadly during the pandemic period, as the virus is adapting to its new host,” Simonsen said. Some researchers believe that covid-19 could eventually become completely resistant to the first generation of vaccines as it adapts to its hosts and mutates.

This is already at play, with the new Mu variant showing signs of possible resistance to vaccines: More research is needed to determine whether it is in fact vaccine resistant, the World Health Organization said this month. The situation is increasingly alarming in South Africa, where Mu is co-circulating with the delta virus. While WHO hesitates to make such a large statement, researchers in Japan have found that the Mu variant is highly resistant to neutralization by vaccines, and is able to infect people who have previously contracted covid-19 before. The study is yet to be peer reviewed.

Nightmare scenario #2: A new novel influenza virus: An even more grim possibility is that a new influenza virus emerges or another coronavirus makes the leap from animals to humans. “There is that in the background, the risk of still dealing with this one when another one emerges,” warned Kanta Subbarao, director of the WHO Collaborating Center for Reference and Research on Influenza.

Experts believe covid-19 will become endemic — meaning that it will continue to circulate in pockets of the global population for years to come. In a poll by Nature, 89% of scientists found it likely or highly likely to become an endemic virus. Some went as far as to say that eradicating covid-19 is so unrealistic that it’s like “trying to plan the construction of a stepping-stone pathway to the Moon.”

Which brings us to humanity’s best option … getting everyone inoculated: Having a higher percentage of the world’s population vaccinated will lower the chances of variants emerging and reduce the transmission and severity of the virus. The percentage of vaccinated individuals in each country should reach almost 67% to provide herd immunity, scientists have said, though others have said we need to scrap the idea of herd immunity altogether.

How are we doing with combating covid in Egypt? Egypt is aiming to vaccinate 40 mn citizens by the end of the year. So far, 8 mn Egyptians have received at least one dose of a coronavirus vaccine, and 25% of that number have received two doses. State-owned vaccine-maker Vacsera is now producing 300k doses of Sinovac per day and Egypt is also in talks to locally manufacture the mRNA covid vaccine Moderna. While our vaccine rollouts are advancing steadily, restrictions and mask mandates have been more lax even as the country tried to impose fines on those who do not adhere to precautionary measures.

And then again: It’s highly likely that covid-19 will eventually become like the flu and will require regular vaccine top-ups. But if countries abandon strategies to reduce spread and let the virus reign unchecked then, in the words of one epidemiologist, “the darkest days of the pandemic are still ahead of us.”