<\/a><\/p>\nYes and no. <\/p>\n<\/div>\n<\/div>\n
For an infectious disease to be classed in the endemic phase, the rate of infections has to more or less stabilize across years (though occasional increases, say, in the winter, are expected). <\/p>\n
\u201cA disease is endemic if the reproductive number is stably at one. That means one infected person, on average, infects one other person,\u201d explained Boston University epidemiologist Eleanor Murray. \u201cRight now, we are nowhere near that. Each person who\u2019s infected is infecting more than one person.\u201d <\/p>\n
That\u2019s largely due to the hyper-contagious delta variant and the fact that most of the global population doesn\u2019t yet have immunity \u2014 whether through vaccination or infection \u2014 so susceptibility is still high. (For a while, there had been hope that the arrival of vaccines would mean we could reach herd immunity \u2014 that is, when enough of a population has gained immunity to confer protection to everyone. But those hopes have been dashed as we\u2019ve failed to vaccinate enough people and more contagious variants have circulated widely.) <\/p>\n<\/aside>\n
But getting the virus\u2019s reproductive number down to one is just \u201cthe bare minimum\u201d for earning the endemic classification, Murray said. There are other factors that come into play, too \u2014 and assessing these factors is a more subjective business.<\/p>\n
In general, a virus becomes endemic when we \u2014 health experts, governmental bodies, and the public \u2014 collectively decide that we\u2019re okay with accepting the level of impact the virus has. And obviously, that\u2019s a tricky thing: People will differ as to what constitutes an acceptable level. <\/p>\n
The multiple factors that determine when a disease is endemic<\/p>\n
The worst outcome from becoming infected with a virus is obviously death. The flu, for example, kills between 12,000 and 52,000 Americans each year, according to CDC estimates. <\/p>\n
Is that figure \u201cacceptable\u201d or too high? <\/p>\n
\u201cThe way I think about it, even with influenza, that\u2019s too much,\u201d Joshua Petrie, an epidemiologist at the University of Michigan School of Public Health, told me. <\/p>\n
But as a society, we\u2019ve implicitly decided that we will accept that level of mortality rather than taking measures to lower it by, say, wearing masks in winter or mandating flu vaccines. <\/p>\n
Similarly, with Covid-19, people will disagree about what constitutes an \u201cacceptable\u201d level of mortality. <\/p>\n
\u201cI am not prepared to say what the appropriate benchmark is yet, but it certainly is much, much lower than where we are, and much closer to where the flu is,\u201d Kates said.<\/p>\n
Mortality isn\u2019t the only type of impact we need to take seriously. Covid-19 can lead to long-haul symptoms in a minority of cases \u2014 estimates range from 10 to 30 percent in unvaccinated people, with a small number of vaccinated people also affected. The symptoms, like brain fog, memory loss, and fatigue, are sometimes so debilitating that the condition is recognized as a disability under the Americans with Disabilities Act. The reasons why some people get \u201clong Covid\u201d and others recover quickly are still not well understood, and the path to effective treatments for long-haulers is uncertain. <\/p>\n
In determining endemicity, Murray said she\u2019d look at the availability of treatments for long-haulers as well as treatments for people in the early stages of the disease (Merck\u2019s pill molnupiravir, which the pharma giant said cuts hospitalizations in half for at-risk patients, looks like it\u2019ll be helpful in this regard). She\u2019d also consider other factors like ICU and hospital bed capacity, supply-chain issues, and whether the use of medications for Covid-19 is detracting from the supply of those medications for other chronic conditions that they\u2019d normally be treating. <\/p>\n
\u201cWhat you want is to get to a stage where you don\u2019t have to worry about disruption because of Covid,\u201d Murray told me. \u201cThe pandemic is over when the crises stop \u2014 not just when we get to a certain level of death.\u201d <\/p>\n
Again, though, determining when something stops being a crisis can be a bit subjective. <\/p>\n
Will we get an official declaration saying the state of emergency is over? <\/p>\n
In March 2020, the World Health Organization declared the novel coronavirus a pandemic. Soon after, the US government declared a national emergency. Then, one by one, states followed suit. <\/p>\n
As we move toward endemicity, we can expect to watch this process happen in reverse, experts told me.<\/p>\n
First, we\u2019ll likely see individual states declaring an end to the emergency (some states already have). This will be staggered. Some areas, notably those with high vaccination rates, will reach a reasonable approximation of endemicity sooner than others. <\/p>\n
On a national level, \u201cthe CDC may pull back our state of emergency in the US if cases remain low at some point in the future,\u201d said Tara Smith, an epidemiologist at Kent State University. <\/p>\n
\u201cBut we still have a long way to go in controlling the virus around the globe,\u201d she added. \u201cA pandemic by nature is global, and while we\u2019re doing better in the US and other wealthy countries, vaccine availability in many low- and middle-income countries has been atrocious.\u201d <\/p>\n
The WHO will eventually declare an end to the global pandemic, just like it\u2019s done in the past for, say, the H1N1 \u201cswine flu\u201d pandemic. You just shouldn\u2019t expect to hear the WHO\u2019s declaration anytime soon. <\/p>\n<\/aside>\n
But that doesn\u2019t mean you can\u2019t move forward with your life in the meantime. <\/p>\n
If you live in the US, \u201cit\u2019s certainly possible\u201d your region will be reasonably classed as being in the endemic phase in 2022, Petrie said. When the time comes, your state health department and local officials will likely make an announcement, based partly on the virus\u2019s objective reproductive number and partly on the more subjective criteria above.<\/p>\n
And until then? Rather than thinking of endemicity as an on-off switch next year, plan to think of it as a dimmer switch, Petrie told me. He plans to keep an eye on the CDC\u2019s county data tracker to monitor local transmission levels. When his county is no longer in the red zone, he\u2019ll start to feel more comfortable doing more public activities. We all have different levels of risk tolerance, so, for a while yet, we\u2019ll be making our own subjective choices about which thresholds feel safe enough. <\/p>\n
\u201cAs we\u2019re transitioning to a more endemic level,\u201d he said, \u201cI think adjusting your behavior based on what\u2019s happening locally makes a lot of sense.\u201d <\/p>\n
A version of this story was initially published in the <\/em>Future Perfect newsletter. <\/em>Sign up here to subscribe!<\/em> <\/p><\/p>\n","protected":false},"excerpt":{"rendered":"You\u2019ve probably heard it by now: Covid-19 is not going away. The broad consensus among experts is that it\u2019s not realistic to think we\u2019re going to totally eradicate this virus. We will, however, see it move out of the pandemic phase and into the endemic phase. That means the virus will keep circulating in parts…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-9831","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/posts\/9831","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=9831"}],"version-history":[{"count":0,"href":"https:\/\/googmn.com\/index.php?rest_route=\/wp\/v2\/posts\/9831\/revisions"}],"wp:attachment":[{"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=9831"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=9831"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/googmn.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=9831"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}