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Tuesday, May 17, 2022

‘It’s never gonna be totally gone’: What it means to end COVID-19 pandemic

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For as often as it feels like the COVID-19 pandemic will never go away, the simple truth is it eventually will. The more complicated parts to figure out — how and when — are less certain.

If Google searches serve as a barometer for people’s frustration, the beginning of 2022 marked one of the highest points of impatience since the beginning of the pandemic nearly two years ago. Searches for the phrase “when will covid end” spiked going into the holidays and have kept up at a high rate through the new year.

What people likely found was a mixed bag of confusing answers — or guesses — with references to the omicron variant, the word “endemic” and a general sense of continued uncertainty.

Most scientists agree by now that eradication is not on the table.

“At this point, I think the sense is no,” Dr. Clif Knight, an associate professor of family medicine at Marian University, said of eradicating COVID-19. “It’s never gonna totally be gone.”

Think less of smallpox and polio, diseases that have effectively been eradicated, and more of the seasonal flu, which comes and goes in predictable waves. That’s a key feature of a disease that becomes endemic: Enough people gain immunity so the spread of the virus is more stable and predictable, even if there are occasional spikes.

That would also mean scientists are able to work ahead, much in the same way they do with the flu, by creating a vaccine for the variant they expect to circulate at that time.

Endemic, according to the CDC: “the constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area.”

But before that, COVID-19 can’t cause massive disruptions, which means there needs to be more widespread immunity. Natural immunity counts, but it’s not clear how much. One of the popular questions right now is if omicron, the highly contagious variant, could speed up the process.

Dr. Anthony Fauci, President Joe Biden’s top medical adviser for COVID-19, told people during the World Economic Forum’s Davos Agenda in mid-January it’s too early to tell if that will happen.

He said the number of cases (about 700,000 each day in the U.S.) could have a meaningful impact on the country’s collective immunity, but it remains to be seen if omicron is the “live virus vaccination that everyone is hoping for.”

Fauci estimates the U.S. is still a ways off from reaching endemic status. He sees five stages to a pandemic — the “truly pandemic” phase, followed by deceleration, control, elimination and eradication — and said this is still the first phase. The control phase is when it becomes endemic, and Fauci said COVID-19 won’t be eradicated.

Even if omicron ends up boosting collective immunity, Knight warned it’s only effective until another variant comes along that can bypass the protection. It will probably protect against many variants, he said, but there could be one that the body’s immune system isn’t prepared for well enough.

There isn’t a good estimate for when the U.S. and the rest of the world might leave this emergency phase of the pandemic, but there are signs to monitor that could indicate the end is near.

Dr. Virgina Caine, director of the Marion County Public Health Department, said there are certain numbers to pay attention to, including positivity rate, daily and weekly case counts, and the vaccine rate.

Here’s what success looks like, according to Caine:

• A positivity rate that stays below 5% for at least a month. (Marion County’s seven-day positivity rate was 35% as of Jan. 17; the U.S. is about 27%.)

• Less than 35 cases per 100,000 people on average for at least a month. (Marion County is at about 1,500; the U.S. is at 208.)

• A vaccination rate of at least 80%. (About 56% of people in Marion County are considered fully vaccinated, compared to 63% for the U.S. Caine hopes to get the county’s rate close to 70% by May.)

Like many others, Caine doesn’t see a total escape from COVID-19 and thinks there could be a vaccine every year.

“We will never be able to get rid of it,” she said.

Instead, society will add COVID-19 to the list of diseases that come and go, likely hospitalizing and killing some, albeit more predictably than the last two years.

Contact staff writer Tyler Fenwick at 317-762-7853 or email at tylerf@indyrecorder.com. Follow him on Twitter @Ty_Fenwick.

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