Five years after the start of the Covid pandemic that killed more than one million Americans and shut down the world, health experts are really ready to say that it’s over - at least, for now.
After evolving through multiple variants, including omicron, the virus has become more consistent with an ‘endemic’ disease, they say.
“This pandemic did what pandemics usually do — settle into endemicity, which means constant vigilance on our part,” requiring ongoing vaccination and surveillance to keep the virus under control, Monica Gandhi, an infectious disease expert at the University of California at San Francisco, told The Washington Post on Thursday.
The endemicity of Covid is largely agreed upon in the medical community, William Schaffner, a professor of infectious diseases and preventive medicine at Vanderbilt University, told the publication.
However, it is worth noting that there are multiple definitions of what “endemic” means.
For example, an endemic disease outbreak occurs when a disease is consistently present but also at predictable and manageable levels, according to doctors at UCLA Health. The Columbia Mailman School of Public Health defines endemic as limited to a particular region, making its spread and infections predictable.
Malaria is one example, which is most common in sub-Saharan Africa. Influenza is also a common endemic virus.
Experts say that a de-escalation in terms to an ‘endemic’ is partially due to the evolution of the virus to less deadly variants, that many of those most vulnerable had already been killed and from immunity acquired through infection and vaccination.
The development of vaccines was a key step toward the pandemic transitioning into an endemic outbreak, the American Lung Association said.
It’s been two years since President Joe Biden ended the coronavirus national emergency and the World Health Organization declared an end to Covid as a public health emergency. The agency noted then that the risk still remained but said the pandemic had been “on a downward trend” for 12 months that “has allowed most countries to return to life as we knew.”
Since then, some Americans have gotten booster shots of the vaccine — but the public’s response to the threat of infection has also been different. Fewer and fewer people wear masks in public spaces or isolate when they feel sick. There’s a waning interest in getting booster shots as well.
Notably, death and hospitalization levels are not nearly as high as they once were. Flu deaths have surpassed Covid deaths this year. In 2023, Covid was projected to be the 10th leading cause of death, according to researchers.
Some people remain skeptical of whether Covid is an endemic. In a recent Axios and Ipsos survey, 46 percent of respondents somewhat or strongly disagreed that the pandemic was over.
“We’ve decided, ‘Well, the risk is OK.’ But nobody has defined ‘risk,’ and nobody has defined ‘OK,’” Dr. Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told The New York Times last year.
The virus is still out there, but rates of test positivity, hospitalizations and emergency department visits are all down, according to the most recent CDC data.
For some, Covid has been endemic for a while. The Centers for Disease Control and Prevention’s former director Dr. Mandy Cohen called the disease endemic last August.
“Endemic doesn’t necessarily mean good,” Bill Hanage, an associate professor of epidemiology at Harvard T.H. Chan School of Public Health, said last year. “Tuberculosis is endemic in some parts of the world, and malaria is endemic in some parts of the world. And neither of those are good things.”
It’s also possible to move back to a pandemic phase, Dr. John O’Horo, a Mayo Clinic infectious diseases specialist, explained in 2022.
"This isn't a one-way door. Continued vigilance and vaccination will be required at some point in the future to prevent another pandemic from disrupting our lives the way that we've seen...” he said.
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