Some experts are convinced that we are finally approaching the end of the pandemic. After all, the latest variant of COVID-19, Omicron, seems less severe than the previous Delta strain, although it is a lot more transmissible.
Of course, the pandemic ending would be thanks to natural immunity building up as well as most of the planet’s population receiving one of the vaccines available.
Furthermore, current research shows that Omicron tends to prosper more in the upper airways than in the lungs which has led to fewer and fewer hospital patients needing intensive care.
With that being said, there is a new belief that the virus causing COVID, Sars-Cov-2 is turning into another relatively benign coronavirus that mostly causes common cold symptoms upon infection.
Nowadays, there is a discourse of reaching an “endemic” stage and “learning to live with the virus” as opposed to a general panic.
Former UK vaccines minister, Nadhim Zahawi, stated not too long ago that he hoped the United Kingdom would be “one of the first major economies to demonstrate to the world how to transition from pandemic to endemic.”
Unfortunately, however, some scientists believe that this kind of discourse is rather misguided.
The meaning of “endemic” while still widely debated, generally refers to an illness that is always present in a particular area, regardless of its severity.
For instance, Malaria is considered an endemic in tropical and subtropical areas and despite that term being used, the disease still ended up killing no less than 600,000 people in 2020 alone as per the 2021 World Malaria Report.
In other words, while many continue to live with it, it is not nearly as painless as people might think.
The director of the Centre for Inference and Dynamics of Infectious Diseases in Seattle, Elizabeth Halloran, explains that “Endemicity does not imply mild disease, and mild disease does not imply endemicity. The move towards endemicity has to do with reaching a more dynamic equilibrium where on average a person infects one other person. This could include seasonality or other fluctuations.”
Besides, the stability of an endemic stage is still far away from the surges and spikes the current pandemic can still cause.
Bill Hanage, a Harvard University epidemiologist, tweeted that “For the avoidance of any doubt, Omicron isn’t endemic right now in much of the same way as the moon isn’t a hamster.”
Naturally, vaccines will certainly help but Halloran also stressed that “there is not much we can intentionally do to move towards endemicity . . . a lot depends on how the virus evolves.”
While the next step of the disease is unknown, the next strain would have to be either more transmissible or better at escaping the immune system – or both – in order to become the dominant variant instead of Omicron.
The level of severity of such a mutation is also impossible to know at this moment but the point is that there is no scientific law that says the virus will become weaker over time.
An evolutionary biologist who helped Chinese scientists publish the Sars-Cov-2 genome sequence back in January 2020, Eddie Holmes, says that “It is very hard to predict the evolution of virulence. It could go up, go down, or stay the same. It is certainly still possible for a more virulent variant to emerge in the future.”
Even Omicron, a form of the virus considered less severe, still caused a spark in hospitalizations, proving that the massive number of transmissions were enough to cause chaos in the health care system even with less serious symptoms.
Interestingly enough, one director of public health in northwest England, mentioned via the British Medical Journal that the Omicron variant could cause more non-COVID deaths because of the sheer pressure on the NHS.
So what is the solution? Well, there are four main long-term options:
- Extinction, just like it possibly happened with the 2002-2003 Sars-1 epidemic.
- Global eradication – would be achieved via mass vaccination as it happened in the case of smallpox.
- Regional or local elimination is something China is currently trying to achieve through their zero-COVID policy.
- Endemicity – a state of the virus where it’s constantly present but less destructive and dangerous, a good comparison being the flu.
Because of the fact that COVID-19 is so good at constantly finding new hosts to infect, including those it’s infected before, the first two options are pretty much impossible.
Meanwhile, local elimination needs containment policies as well as very strict border controls, which many think are draconian measures.
Of course, this leaves endemicity as the only logical and achievable solution.
Still, people need to understand that while developing immunity through vaccination or prior infection will ease the stress on the health care system, it does not mean the virus will stop trying to evolve.
It also does not involve leaving behind all of the current preventive measures such as vaccines, wearing masks and social distancing.
It’s definitely tempting to think of the endemicity as the end of all problems with COVID and going back to normal but in reality, that is far from the truth.
