It's hard to believe that nearly four years ago the world closed for a virus few people had heard of previously - coronavirus.
Since then, around 7 million COVID-related deaths have been reported to the World Health Organisation, including nearly 24,000 Australians.
COVID is very unlikely to go away, but will 2024 be the year we finally learn to live with it?
In October this year, the Australian chief medical officer removed COVID-19 from the Communicable disease Incident of National Significance.
Unlike previous years, politicians have not warned Australians against giving nan the spicy cough at Christmas, and you might even get some side-eye wearing a mask on the bus.
More immunity, less illness
COVID outbreaks are trending to be smaller and less impactful over time, Deakin University epidemiologist Professor Catherine Bennett says.
"In each wave people's prior immunity is helping them avoid infection, not just have a more mild infection," she said.
"We're seeing less people seriously ill because the hospital numbers themselves [in] the ICU are also coming down each wave.
"The number of deaths associated with each wave is diminishing."
Scientists compare the amount of deaths in post-COVID years to pre-COVID years to try predict its impact on mortality.
There were 6.1 per cent more deaths nationwide in 2023, according to the Australian Bureau of Statistics.
In 2022, there were 12 per cent more deaths in 2022 than normal, In 2020, 3.1 per cent fewer people died than expected.
COVID was so devastating when it was first introduced to humans because we had no immunity.
Immunisation works by exposing the body to small amount of a virus and letting it attack it, creating an immunity. This can occur through vaccination and exposure to other people shedding the virus.
"If you're out and about, you may not become infected, but you're still potentially bumping into people who are infectious," Dr Bennett said.
"You don't have to have an infection to have an immune benefit. And in fact, that's actually the best way because you end up not having the problem with an infection itself, not running a risk of long COVID but at the same time, you're still boosted."
Australians should get a booster so their "immunity stays in peak condition", Murdoch University Professor of Immunology Cassandra Berry said.
"Seven virus variants of COVID-19 are out there circulating."
Looking to 2024
While it's impossible to predict what will happen next year, patterns from the past two years may indicate there will be one or two COVID waves a year, Dr Bennett said.
There was about five to six months between the spring COVID-19 wave and the current one.
"That was the longest gap between waves and it was also the biggest drop in infections between waves that we've seen since Omicron arrived," Dr Bennett said.
This summer may see two smaller peaks of infections.
"The trend might still be the same, that even if you don't have a single peak, but you have two closely associated peaks in summer, that we still won't see that really strong take off," Dr Bennett said.
"It's not going to be clear, it's not to say that every wave will be smaller than the last but we've had a lot in succession where that's true."
The devastating impact
A key difference between COVID-19 and other viruses is the risk of getting a post-viral infection, or long-COVID.
He is only 35-years-old, but Jack Flynn cannot work or exercise. If he sits at the computer for more than ten minutes, he will begin to shake, slur and lose his vision.
The public servant was fit, healthy and double vaccinated when he contracted COVID in early 2022.
"I'm sitting around between 25 and 35 per cent capacity mentally and physically, depending on what kind of day it is," he said.
"I can't exercise anymore [and] I'm living at home. I get up in the day, watch TV, maybe I can go to the shops.
"I have the sort of friends that would do things and invite you, but if you don't show up they're not gonna go out of their way to see you, so it's completely impacted my relationships."
Mr Flynn said he understands the community needs to get back to normality, but wants to ensure people disabled by the virus aren't forgotten.
"The vast majority of people are completely disabled and can't return to their normal lives," he said.
"[You] get abandoned by the health care system and get left to manage it on your own."
Mr Flynn has noticed people in health settings, like a general practice clinic, not wearing masks.
According to a recent Pfizer Australia survey, a third of 1000 people surveyed did not think COVID safe measures were important, and a third did not believe staying up to date with vaccinations was important.
There needs to be more research to ensure Australian health settings are consistent when it comes to using COVID-safe measure like wearing masks, former Australian deputy chief medical officer and infectious disease physician Dr Nick Coatsworth said.
"Are we going to put masks on every winter? And if we are, I don't mind. But I'd love to see us actually do some studies on it," he said.
There is no conclusive data, but it is possible that fewer people are getting long COVID, Dr Bennett said.
"It doesn't mean people cannot get long COVID now and that's why there's this advice of still do what you can to reduce your risk of infection," she said.
"Even a small change in your functioning, even if it's not permanent, can still actually mean people can no longer live on their own or do their job, so it's not to say long COVID Isn't impactful."
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