It won’t be a pandemic forever. Here’s what could be next

But there will come a day when it will no longer be a pandemic, cases will no longer get out of hand, and hospitals will not be at great risk of overflowing with patients.

Many experts predict that the spread of the coronavirus will end up looking more like that of the seasonal flu.

“I think it’s likely that we will see this wave come and go and spring and summer are shaping up to be a lot better than they are today,” said Levy, director of the Precision Vaccines program at Boston Children’s Hospital. “There will be fewer cases, and again, next fall and winter we will see a spike in viral disease, coronavirus, flu and the like, but it will be more like an endemic cycle.

“It will be a better winter, just like this winter, with all the challenges, is even better than the previous winter.”

But this coronavirus changes and surprises frequently – and there is no official benchmark for when the pandemic is over and when a new normal has begun.

“There isn’t even a measure to say that something is an epidemic or a pandemic. It’s all in the eye of the beholder – and it’s part of the problem,” Dr Arnold Monto, professor of epidemiology at the The University of Michigan and acting chairman of the US Food and Drug Administration’s advisory committee on vaccines and related biologics, told CNN in November.

“So this is not all rules based. It is usually based on what you need to do to control the outbreak,” Monto said. “What is so different here is that our vaccines are much more effective than what we usually see.”

That’s the good news, according to Monto. The bad news comes with the power of the virus to change and evolve.

No one can predict what the future of Covid-19 might look like – and the emergence of coronavirus variants, like Delta and Omicron, has changed the trajectory.

“With the change in the modes of transmission, as the variants have emerged – I call it a parade of variants – we are now seeing much more extensive transmission and a much more uniform spread globally. This makes declaring the end of the pandemic more difficult. Said Monto. “Because the whole pattern of spread has changed, and there may still be pockets that haven’t really gone through the kind of waves the rest of the world has been through.”

“Wait and see and hold our breath”

Monto and other public health leaders predict that in the future the world could follow the spread of SARS-CoV-2, the coronavirus that causes Covid-19, in a manner similar to how seasonal flu is. monitored.

Life after the 1918 flu has lessons for our post-pandemic world

“We don’t know if we’re going to see this kind of seasonal pattern with SARS-CoV-2, but it reminds us that most of our respiratory viruses start to behave like seasonal events,” Monto said.

“There is precedent for a very seasonal pattern for some of the coronaviruses that have infected people,” he added. “If SARS-CoV-2 starts behaving like this, we don’t know, but at least it gives us a scenario that it could start behaving like this. “

As Monto said, we have to “wait and see and hold our breath” to find out what an endemic phase of the coronavirus might look like.

As government talks about vaccine recalls, it's time to cover the endemic reality of Covid
Endemic means that a disease has a constant presence in a population but does not affect an alarming number of people, as is typically seen in a pandemic.
Even in early 2020, as the pandemic only intensified, World Health Organization officials predicted that the new coronavirus “could become another endemic virus in our communities” and never go away.
“When you think of pandemics, you are in the pandemic phase, then you have a deceleration phase, then you have a control phase, then hopefully you will have elimination and maybe eradication”, Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told the U.S. Senate Committee on Health, Education, Work and Pensions at a hearing in November.

“What we hope to achieve is a level so low that even if it is not completely eliminated, it does not have a major impact on public health or on the way we lead our lives,” said Fauci . “So if we get more people around the world vaccinated and more people vaccinated now, hopefully within a reasonable timeframe, we’ll get to this point where there can sometimes be ups and downs in the background, but it will not dominate us. it’s working right now. “

Even as Covid-19 cases reach new heights, federal health officials have been considering how to measure the end of the pandemic and continue to track the coronavirus once it becomes endemic.

“There is still a lot to do”

To move from a pandemic to an endemic, the nation must develop immunity to the coronavirus – which means many more people need to be vaccinated, Dr. Philip Landrigan, pediatrician and epidemiologist at Boston College, told CNN in November. .

With some Americans still refusing to be vaccinated against Covid-19 and some refusing to wear masks, the transition could take longer.

Vaccinations against Covid-19 began a year ago.  These numbers show how it goes
About 62% of the total United States population is fully vaccinated against Covid-19. Even fewer received a booster dose.
“We have to get somewhere well north of 80%, maybe even well north of 90% of the population immune, either by infection or by vaccination,” said Landrigan, who worked at the CDC for 15 years. .
To control the spread of the measles virus in the American population, for example, “we had to increase the immunity rate above 95%, and even then we had sporadic epidemics. These outbreaks usually happen when you have a group of people in a particular place who are not immune and all of a sudden the virus is introduced because a traveler entered with the virus – and bang, you’ve got 20. measles case in one city, ”Landrigan said. “But it’s not an epidemic. It’s an epidemic against a backdrop of almost no cases or scattered endemic cases.”
Flu and Covid-19 cases on the rise in much of the United States

Health officials know the work needed to improve immunization rates.

The CDC recommends that almost everyone 6 months and older get a flu shot each year. But during the 2019-20 flu season, only about half of those people – 51.8% – made it, according to the CDC. The agency estimates that the flu caused an estimated 12,000 to 52,000 deaths each year between 2010 and 2020.
The coronavirus has killed more than 800,000 people in the United States so far. Going forward, the battle to contain the virus each year could be a lot like the annual fight against the flu.

“We’ve been thinking a lot about what an endemic phase looks like and what data we need to collect during that phase. Certainly right now we are collecting data on cases, hospitalizations, deaths,” said the CDC Director, Dr Rochelle. Walensky said during the Senate committee hearing in November. “The question is, what will be our best metrics in the future? And probably influenza modeling.”

A more probable picture of the future

The CDC works with health departments, laboratories, hospitals, and health care providers to track diagnosed influenza cases, determine which influenza viruses are circulating, and measure the impact of those viruses on hospitalizations and deaths.
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One idea is that when the coronavirus becomes endemic, a similar tracking system could be used to monitor the pathogen.

“We could deal with the cases like we do with the seasonal flu, where we can say we know we’re going to see a number of cases in the winter season, and we can have the right staff, we can have the right ones. supplies are ready and we’re ready to deal with them, as opposed to the flare-ups we’ve had here, ”Dr. Stephen Parodi, national infectious disease manager for Kaiser Permanente, told CNN in November.

“I’m still on the phone talking about ‘what’s our ICU bed capacity? What supply chains do we need to deliver patient care? Do we have enough drugs? “Parodi said.” We still have a lot of work to do to get to where we want to be, and I think we will see that transition in the year 2022. But for some places, where there is less immunity, it’s gonna be longer Course. “

Even the flu is unpredictable, and doctors have seen a lot of it over the years.

“We know there are going to be cases,” Monto said. “With influenza, we’ve had influenza pandemics before. So we generally know their behavior. This is an evolving situation with a completely new pathogen.”

CNN’s Jamie Gumbrecht contributed to this report.

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