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May 26, 2022
Pandemic Endgame: What ‘Endemic’ Covid Means—And When We May Get There
politics

Pandemic Endgame: What ‘Endemic’ Covid Means—And When We May Get There

Topline
Nearly two years into the pandemic, weary politicians and governments are pushing to treat Covid-19 like any other problematic but manageable illness like the seasonal flu, but experts warn the approach could be premature and paints an overly optimistic picture of what “living with Covid” actually means. 

Some countries have dropped almost all pandemic restrictions and are moving towards treating Covid … [+] like other illnesses.

AFP via Getty Images

Key Facts

Despite the contagious omicron variant driving huge waves of infections, countries including the U.K., Denmark and Sweden have dropped almost all pandemic restrictions as leaders stress we must “learn to live” with the virus and transition from treating Covid-19 as a pandemic illness to an endemic one.

But “with few exceptions, politicians do not understand the meaning or significance of endemicity,” warns Dr. John Swartzberg, an infectious disease expert at the University of California at Berkeley school of public health, who told Forbes endemic means the “stable or constant presence of a disease” within a set area. 

Dr. Elizabeth Halloran, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, told Forbes we have not yet reached this stable state with Covid, as evidenced by the “vertical rise of omicron cases” and it was “hard to say” when that might happen, saying, it would depend on the level of immunity within the population and how the virus evolves.  

Dr. Aris Katzourakis, an evolutionary virologist at the University of Oxford, expressed a similar degree of uncertainty and told Forbes that while he couldn’t say how soon we might reach it, “it’s not going to be in 2022.” 

Endemic doesn’t mean mild or infrequent disease either, both experts caution—”endemic means that it is with us to stay,” Halloran said—and many of the world’s biggest killers like malaria, tuberculosis and HIV are endemic.    

What We Don’t Know
What endemic Covid would mean for our everyday lives. This would depend on “what level the endemicity arrives at,” Swartzberg said, meaning how common the disease will be. If Covid were to be endemic at a very high level, “we will be limited in our options,” he explained, and may have to keep on using social restrictions and non-pharmaceutical interventions like masks. At a very low level, “life will return toward the pre-pandemic state.” We have some control over the level of endemicity through vaccination, Swartzberg said, which would also reduce the chance of a new variant emerging. 

Key Background
Calls to just live with the coronavirus have been prevalent since the pandemic began and many—including a not-insignificant number of politicians at the highest levels of office like former President Donald Trump and Brazil’s Jair Bolsonaro—controversially compared it to seasonal flu to illustrate the point. Though symptoms between the two diseases are similar, the comparison misleadingly downplayed the severity of the coronavirus and showed ignorance of the death toll influenza exacts every year (up to 650,000 people worldwide). Calls to treat Covid-19 as a more predictable and regular illness grew in popularity as restrictions continued into a second year of the pandemic and vaccines were rolled out and gained new momentum with the rapid spread of the delta and then the omicron variant. Though the latter variant caused higher rates of infection—which reached record levels in many countries—there were relatively low levels of hospitalization and deaths compared to previous waves. In addition to parts of Europe, leaders in many states are renewing the push to return to normal, with a number of governors feeling it’s time to treat Covid as endemic.  

Chief Critic
Tedros Adhanom Ghebreyesus, the leader of the World Health Organization, warned last week against countries lifting restrictions and claiming victory over the virus prematurely. “This virus is dangerous, and it continues to evolve before our very eyes,” he said. Continued restrictions are vital to stop transmission of the virus, he added, in response to countries relaxing measures. 

What To Watch For
“Stealth” omicron BA.2. A close relative of the omicron variant—known as BA.2 and called “stealth omicron” by some scientists—is more infectious than the original omicron variant and is rapidly overtaking it in some parts of the world. It does not appear to cause more serious disease, as with the original variant, though experts warn it could lead to more hospitalizations and deaths with more people getting infected.  

Further Reading
Don’t Treat Covid Like Flu, WHO Says, As Nations Ditch Restrictions And Live With Virus (Forbes)

COVID-19: endemic doesn’t mean harmless (Nature)

We’re Thinking About Endemicity All Wrong (Atlantic)

Full coverage and live updates on the Coronavirus

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