Immunity conferred from natural infection and vaccines, patterns of social contact, and virus transmissibility will all play a role in what COVID-19 will look like as it continues to circulate in the months and years ahead, says Yonatan Grad . A: The expectation that COVID-19 will become endemic essentially means that the pandemic will not end with the virus disappearing; instead, the optimistic view is that enough people will gain immune protection from vaccination and from natural infection such that there will be less transmission and much less COVID-19-related hospitalization and death, even as the virus continues to circulate.