(CNN)The current wave of Covid-19 cases driven by the Delta coronavirus variant has the potential to be the country's last major wave of infection -- but it's far from over, and even endemic Covid will pose problems, a former Food and Drug Administration chief said.
"I think this Delta wave may be the last major wave of infection, assuming nothing unexpected happens, (such as getting) a variant that pierces the immunity offered by prior infection (and) by vaccination," former FDA Commissioner Dr. Scott Gottlieb told CNN Thursday.
"So, assuming that doesn't happen, and I think it's unlikely, this will be the last major wave of infection, and this becomes a more persistent, endemic risk," he said.
Current vaccinations and immunity from infection help prop this possibility. Still, he says, vaccination rates need to get "higher if we want to create a backstop against the kind of spread that we've seen this past summer."
He pointed to CDC data showing 76.7% of adults having received at least one vaccine dose. "We really need to get to around 80% to 85% to have enough vaccination in the population that you start to see case rates decline and the velocity of spread start to slow," Gottlieb said.
Though national daily cases are inching downward for over a week, the overall Delta-influenced wave isn't done and cases still may spike -- especially as colder weather approaches, and especially in regions like the Northeast that haven't been as hard hit as other places, he said.
"I think we're going to see infections start to pick up here (in the Northeast), as well, as kids go back to school, schools become sources of community transmission, and people start to go back to work and the weather gets cold," Gottlieb said.
"I think we're still going to have a lit of cases this winter. ... It likes to spread in the cold weather," he said.
He painted a picture of what living with Covid-19 could look like once the wave diminishes, if no other variant pierces immunity.
"This becomes a more persistent, endemic risk. So, you continue to have coronavirus spread, but not the same rates we're seeing right now, and it settles into ... more of a seasonal pattern, and basically becomes a second flu, (but) probably more pathogenic than the flu," Gottlieb said.
"The challenge is that we already have a flu, and if we have Covid circulating alongside flu, the cumulative death and disease caused by those two pathogens is going to be too much for society to bear," he said.
So society still will have to do things differently, especially in winter, he said. That includes improving indoor air quality and filtration, making offices less densely populated, and wearing masks at least voluntarily in public spaces.
"I think you're going to see masks become much more culturally acceptable and used in parts of the country," he said.
Coronavirus cases, deaths and hospitalizations jumped after the early summer, as the highly contagious Delta variant became dominant, though cases and hospitalizations have recently dipped.
The country averaged more than 130,790 new Covid-19 cases each day over the past week as of Wednesday, according to Johns Hopkins University data. That's down from the summer 2021 peak average of 172,001 daily reached September 14, but still is more than 11 times what the figure was two and a half months ago.
More than 86,920 Covid-19 patients were in US hospitals on Thursday -- a number that has dropped in recent weeks, but is still significantly higher than early summer, according to the US Department of Health and Human Services.
Across the country, nearly 80% of ICU beds are in use -- more than a quarter of those taken up by Covid-19 patients, according to the Department of Health and Human Services.
Pace of first vaccine doses is the slowest in two months
Despite the call from health care professionals for the public to get vaccinated, the current pace of people receiving a first dose of a Covid-19 vaccine is the slowest in two months, according to CDC data.
Meanwhile, federal health officials are considering expanding the groups of people eligible for boosters. Last month, the CDC recommended an extra dose of Covid-19 vaccine for some immunocompromised people.
On Wednesday, the FDA granted an emergency use authorization for Pfizer's Covid-19 vaccine booster for people 65 and older, people at high risk of severe disease and people whose jobs put them at risk of infection.
Vaccine advisers to the CDC will meet Thursday to act on the FDA's decision. The CDC must give its stamp of approval for any booster doses to be officially given.
Some schools up preventative measures, others dial back
Another consideration in managing the virus is the return of children to in-person learning, which schools are handling differently.
Some schools have amped up Covid-19 preventative measures as more students have been infected across the country.
In South Carolina, the Charleston County School District began fully enforcing its mask mandate Wednesday -- and as a result, a number of students were sent home for not complying, district spokesperson Andy Pruitt said.
Students who don't come back to school adhering to the new policy will learn virtually until at least October 15, though they are welcome to return to the classroom wearing a mask, he said.
Elsewhere, precautions are being eased.
In Florida, Gov. Ron DeSantis announced a revised rule for the school year under which parents can send asymptomatic children exposed to Covid-19 back to class.
The policy, which some educators opposed, recognizes that quarantining healthy students is "incredibly damaging" for students' educational advancement and disruptive for families, he said.
