OBJECTIVES: The COVID-19 pandemic has been a major global health threat since 2020. In France, since March 2020, over 30 million diagnoses of COVID-19 have been made, with likely as many undiagnosed. A lot of hope had been placed on SARS-COV-2 vaccination to control the pandemic, but the appearance of more transmissible and vaccine resistant variants have guaranteed that SARS-COV-2 will remain circulating in the population for the foreseeable future. Indeed, despite high vaccination coverage in France, two third of the COVID-19 diagnoses were made since January 2022, and new immunity-escaping variants are appearing regularly. The future of the pandemic is thus uncertain.

METHODS: Using a SARS-COV-2 agent-based model that has been previously validated in the French context, we compared several scenarios, based on new variants emergences and their characteristics, to estimate potential future trends in SARS-COV-2 for 2023. New variants were assumed to appear every 4 months, based on historical trends, with randomly draw characteristics based on previous Omicron variants. Each new variant was assumed to partially escape previous variant’s immunity. The model was calibrated to the French epidemiology until May 2022 and assumed that no new non-pharmaceutical interventions would be put in place in the future and that adults over 65 would be revaccinated every fall.

RESULTS: The model estimated that without new variants, the SARS-COV-2 pandemic would disappear by early 2023. With regular new variant emergence, depending on the contagiosity and immune escape of the variants between 69.5 million and 112.6 million infections could occur in 2023 with 26.4 and 42.8 diagnosed.

CONCLUSIONS: Based on the regular emergence of new SARS-COV-2 variant, COVID-19 is likely here to stay for the long-term. Strategies should be adapted for this possibility.