Covid-19 still has unknowns , making it more difficult to contain than had been thought. Governments that believed they had controlled the infection have too often been caught off guard by fresh outbreaks. Public health measures such as mask wearing, washing hands, social distancing and early detection and isolation remain the best way to stop its spread. Until an effective vaccine is developed and made widely available, there is every possibility that this is what the world may have to get used to. This is not what governments struggling with economies in free fall and citizens who have lost their jobs or are stressed by the restrictions want to hear. They are counting on one or more of the 175 or so vaccines that are in development proving effective in protecting against infection. But there is no certainty of that happening or that even the most promising treatment will permanently prevent people from catching the coronavirus, leading to its eradication. That is a wished-for hope; at best, there could instead be limited protection or a decreasing of the severity of the symptoms. Herd immunity, where most of the population has developed resistance, does not come about naturally; it can only happen with a vaccine. There is a possibility that the virus could become endemic or more virulent in cooler weather, just like the coronaviruses that cause colds. So, governments have to plan for less-than-perfect possibilities with strategies beyond weekly or monthly wait-and-see reactions. They have to think medium and long term, implementing health care reforms to ensure they have the testing, treatment and hospital resources and facilities for Covid-19 and other diseases likely to become more prevalent with changing climate conditions. Fresh outbreaks in Hong Kong, South Korea, New Zealand and the southern Australian state of Victoria, which occurred when governments believed they had the upper hand, prove how difficult the fight can be. The billions of doses of vaccines needed to keep the world’s population safe will take years, not months, to manufacture and distribute. Even then, people have to be convinced that the rushed testing regimes have produced drugs that are risk-free. Uncertainties require that we all need a good dose of Covid-19 reality.