As COVID-19 vaccines continue to roll out around the world, many are hoping it could bring an eventual return to everyday life. But health experts warn that COVID-19 could become endemic. Rather than being eradicated, the virus will now become a part of day-to-day life. In other words, the virus may never fully leave us. Physicians and experts have claimed that respiratory viruses are not easy to get rid of because they evolve over time in terms of how they impact people.
Coronavirus has changed the way it actually is over the months and has become something that's more like a circulating virus, like influenza or viral infection as we are used to calling it. The way influenza virus tends to cause problems in the wintertime but it's something that won’t become a bad pandemic spread, coronavirus may behave the same way. An infection becomes endemic when it transitions to having a low-level transmission with only small spikes in the spread.
The Centre for Disease Control and Prevention defines endemic as the constant presence and or usual prevalence of a disease in a population within a geographic area. In fact, the four common human coronaviruses (types 229E, NL63, OC43, and HKU1) are already endemic in various parts of the world. So how COVID-19 will turn into an endemic from being the current pandemic? How an endemic is different from a pandemic? Will booster shots and wearing masks become necessary forever? This article covers all.
How is an Endemic different from a Pandemic?
The term ‘pandemic’ (“pan” means entire, “demos” means population) relates to the geographic spread of disease. It refers to a sudden outbreak of disease that has spread over several countries, usually affecting a large number of people on the global level. WHO explains that an epidemic (normal outbreak in the smaller regions) becomes a pandemic when it spreads over significant geographical areas and affects a large percent of the population.
Endemic means something that is present all the time. For eg, influenza is endemic, unlike smallpox which has been eradicated. In the case of coronavirus, the disease will continue to circulate as it will be present in the animal reservoir. This also means that it will cause disease to the extent that people who are neither vaccinated nor once exposed to the virus.
However, if enough people are vaccinated or have been exposed to the infection, then the virus will cause symptomatic infection but not the actual disease. So, that is what is meant by an outbreak becoming endemic – it is there but not causing disease or serious health complications.
What if COVID-19 becomes Endemic?
COVID-19’s exit from the pandemic to the endemic stage will have its own consequences. If we look at the endemic diseases all over the world, especially those which are airborne, we see that most of them are contributed by either influenza viruses or coronavirus. Apparently, both are originally animal viruses.
Seasonal flu will affect the human population and may cause some kind of complications related to the effect of flu. It means that most people might deal with a very mild disease when tested positive for COVID-19. However, this doesn’t stand upright for the elderly age group, as COVID-19 can cause serious complications for them.
So, the best possible thing is to protect ourselves through vaccination. Whenever new SARS-CoV-2 viruses or variants are introduced to the human population, our vaccines will be modified. Even now, among the viruses which are causing flu-like symptoms among human beings. To date, 30% of the viruses that have been found causing deaths in humans, belong to the group of coronaviruses. The possibility of more such diseases is inevitable.
Doctors say that COVID-19 is will lose its severity and the fatality rate will diminish with time with vaccination but, this will continue to sustain for years. With COVID-19 becoming endemic, the world has to evolve a control strategy to prevent the rise in numbers for upcoming waves. At this stage, the prime goal is to prevent deaths and not to prevent infection.
When is SARS-CoV-2 likely to reach the endemic stage?
WHO’s Dr. Soumya Swaminathan said that hopefully by the end of 2022, we would be in a situation where we have achieved adequate vaccine coverage. The WHO is hoping that more than 70% of the population in all countries will be vaccinated by the middle of next year.
Director of AIIMS Dr. Randeep Guleria said: “It is yet too early to say that COVID-19 will enter the endemic stage, looking at the constantly rising numbers. For COVID-19 to become endemic, we need to get a large number of people vaccinated and notice if cases are coming down.”
We have seen that coronavirus variants are being found in various parts of countries worldwide. These viruses have the ability to mutate and change their form to become even more deadly. Under these conditions, one cannot predict if and when the virus mutates into something where vaccines start failing. Thus, we are actually unaware of when COVID-19 will reach the endemic stage.
Can one stop wearing Masks if COVID-19 becomes an endemic?
Double masking, hand hygiene, and physical distancing are the basic precautions against Covid. As long as there is a high circulation of the virus, we will have to continue with these protocols, especially masking even when Covid reaches the endemic stage.
The problem is that we are viewing this basic behavior in a negative way. We need to alter that state of mind at the population level. Whether or not you are vaccinated, you are still at the risk of getting an infection and transmitting it. Double vaccination among children is yet to happen. Children and the elderly population are still vulnerable to COVID-19. So to protect yourself from getting Covid or any flu-like symptoms it’s a good idea to wear a mask and follow other Covid protocols as well.
Do we need to get booster shots every year?
In general, a booster dose of a vaccine is required depending upon how quickly the antibody level comes down in the average individual.
While the effectiveness of the vaccine does appear to decline over time, there is still expected to be substantial protection. But as the new variants of Novel Coronavirus emerge, there are reports that some of the variants may be more infectious and evade vaccines.
This essentially means, we might need a booster or a second-generation vaccine, which would be better in terms of the immunity it provides. And with the possibility of COVID entering the endemic stage, we might need to take these shots annually like the people in the US take regular influenza booster shots.
To sum up -
It’s likely to see the cases go up due to workplace clusters and school/colleges reopening in most of the states. Seeing rapid new hikes in Covid cases again after the deadly second wave, it’s almost impossible to predict when we will exit the pandemic stage. But Covid becoming an endemic is inevitable. Resuming normalcy with the Covid and following the protocols is what we need to do to survive - Learn To Live With COVID.