COVID will remain a threat in 2023 and having multiple variants in circulation has made the virus more unpredictable, but health experts say the end of the pandemic is nearing.
But before the virus can be declared endemic an ongoing COVID vaccine program will need to be implemented which will be a key challenge for authorities in the coming year.
There were more than 220,000 COVID infections reported in Canberra during 2022 and nearly 11 million across Australia.
More than 14,000 people died with the virus, including 123 Canberrans.
The recent wave of infections has been driven by the transmission of multiple variants of Omicron, a trend expected to continue.
Monash University infectious disease modeller Michael Lydeamore said this made COVID more difficult to predict, especially with less data available about infections.
"[The variants are] greater than the sum of their parts, so if we just had one of them it probably wouldn't rise to dominance but with all of them in the mix at once they have created this environmental niche that's allowed them to take hold," he said.
"Why that matters in terms of what's coming next is instead of having one main lineage there's now a huge host of them, which makes it a lot harder to work out what might or might not happen."
But the rise in variants may actually signal the pandemic could soon be declared an endemic.
"I think in many ways, the fact that we have multiple variants going at once is a big step towards that," Dr Lydeamore said.
"You think about something like endemic influenza. There is an array of flu variants around at any one time."
The recent COVID epidemiological report from ACT Health showed at least four variants had been reported in sequenced cases. Omicron BA.2 subvariants made up nearly half of these.
ACT chief health officer Kerryn Coleman told a press conference in mid-December she believed it was "about 75 per cent of the way" until the COVID pandemic would become endemic.
Dr Coleman said more needed to be understood about the evolution of COVID variants and there also needed to be an ongoing vaccine program established before the pandemic could be declared over.
"We're not quite understanding enough about COVID, what our ongoing vaccination strategies need to be and therefore what our ongoing program looks like for us to call it totally endemic and to be really comfortable," she said.
"But we are a significant way through that process."
Authorities will need to determine how often people will need to receive a COVID vaccine but there is also the challenge of when to give it to people, Dr Lydeamore saying it would be difficult to get everybody on the same vaccine cycle given people received their COVID shots at different times.
"Much like we stopped counting waves, we'll stop counting vaccines and that will be the next big thing to go to a regular program, whether it's twice-yearly or annually," he said.
"The hard part will be getting everyone on that cycle. We all have our flu shots around the same time but with COVID we've got this huge mismatch."
A big change in 2022 was the shift in COVID management as most governments dropped almost all restrictions and said management of the virus was a "personal responsibility".
Aspen Medical chief medical officer Katrina Sanders said there had been a lot of COVID fatigue over the past year and individuals and businesses had reduced mitigation strategies.
She said COVID continued to be a global threat and expected there would be ongoing waves throughout 2023. However, she said businesses did not need to focus on an intense COVID risk approach and instead needed to embed this into already existing mechanisms.
"The sort of advice we're giving is that COVID isn't going anywhere, it remains a global risk and it remains a risk to individual health and to business operations but it's becoming more predictable and manageable," Dr Sanders said.
"Our recommendation is that businesses need to shift away from an intense COVID response to more usual disease control mechanisms and health service systems and structures that they may already have in their organisations.
"The advice we're giving is, 'Let's start considering COVID as not the single greatest threat to businesses, companies or individuals but one of a number of threats, all of which require some level of mitigation'."
Dr Coleman said people may have to consider long-term behavioural changes.
"As a community we're going to have to be ready to adapt our behaviour in an ongoing way, a bit more like we see in some Asian countries," she said.
"We might need to be prepared to wear a mask in indoor crowded settings, we might need to be prepared to not go to work and not go out when we're sick and unwell and actually be quite vigilant about that."
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