Almost two years after the COVID pandemic, some countries have announced their intention to start treating COVID-19 as other endemic diseases, such as seasonal flu.
Although we have witnessed relatively high levels of infection amid the frantic spread of the Omicron variant, which appears to cause less severe disease but is highly transmitted according to early studies, countries including England and Ireland have drastically eased restrictions on public life. .
Denmark has announced plans to lift all restrictions next week, as its health ministry said COVID “will no longer be categorized as dangerous to society”.
Official statements from political leaders in Spain, the United Kingdom and elsewhere emphasize that societies need to learn to live with the virus.
“COVID is not disappearing. It will be with us for many, many years, maybe forever, and we need to learn to live with it, “said Sajid Javid, the UK’s health minister last week.
“I think we are leading Europe in the transition from pandemic to endemic and we are leading the way in showing the world how you can live with COVID.
However, officials at the World Health Organization have warned that it is too early to treat COVID-19 as an endemic disease, stressing that the evolution of the virus is uncertain and noting that the global pandemic continues to rage.
“We still have a huge amount of uncertainty and a virus that is evolving quite fast, imposing new challenges. We are certainly not at the moment when we can call it endemic, “said Catherine Smallwood, senior WHO emergency official for Europe, at a press briefing.
The Omicron variant continues to cause waves of infections that put increased pressure on public health systems. According to the WHO, 21 million new cases of coronavirus were reported worldwide last week, the largest number of weekly infections since the pandemic began. The Pan American Health Organization (PAHO) said on Wednesday that the American region had the highest number of infections since the pandemic began, with more than eight million new cases.
Meanwhile, a large part of the world’s population is not fully vaccinated against COVID, which increases the chances of a more serious disease among them. Low levels of vaccination in many countries also make the emergence of a new option more likely, which could frustrate attempts to treat COVID as endemic.
What does endemic mean?
The United States Centers for Disease Control and Prevention (CDC) defines endemic “as the persistent presence and / or normal spread of a disease or infectious agent in a population within a geographic area.”
Dr Ebere Okereke, senior technical adviser at the Tony Blair Institute for Global Change and honorary senior public health adviser at the African CDC, said one key factor was “predictability and stability”.
“In public health [during endemicity] we have an expected and an expected number of cases over a period of time in a given geographical region. “
Mike Ryan, executive director of the WHO Health Emergency Program, recently noted: “Endemic in itself does not mean ‘good.’ Endemic simply means “it’s here forever.”
An epidemic is defined as a disease that affects a large number of people within a community, population and region. A pandemic is an epidemic that has spread to many countries or continents.
When authorities decide to switch to an endemic disease, it sometimes affects measures that were previously applied during the pandemic phase.
“If something is a pandemic or an epidemic, we need to take certain precautions against it to limit its spread. And in the case of endemics, these same measures are not necessary or mandatory, “Dr. Anna Blakeney, an assistant at Michael Smith’s labs and the School of Biomedical Engineering at the University of British Columbia, told Al Jazeera.
In the case of COVID, Blackney said that could mean that governments are starting to hint that they would like to do “less to control restrictions on testing, testing, masking or any of the measures to which have been shown to work against COVID. “
Is COVID-19 becoming endemic?
Each potential transition will vary from country to country, depending on several factors, such as how widespread the disease is across national borders and the level of immunity among the population.
According to the UN, two out of three people have been vaccinated with at least one dose in high-income countries. In low-income countries, one in nine people has been vaccinated with at least one dose as of January 19.
“When you say it’s a disease [has] “From epidemic to endemic, there are no hard and fast rules to determine that,” Dr. Amesh Adalya, a senior scientist at the Johns Hopkins Health Security Center, told Al Jazeera.
However, he said a marker could be when you don’t see the disease undermining hospital capacity.
“Once COVID-19 loses this ability due to sufficient immunity… I think the world will become endemic, but it will be in different timelines depending on where you are,” he added.
According to Adalja, endemicity is inevitable in the case of COVID.
“I think from the first day of the COVID-19 pandemic, it would always have become an endemic respiratory virus,” Adalya said.
He added that the main priority is to get more tools, such as vaccines, antivirals and monoclonal antibodies, to help reduce the strain on hospitals and health systems.
“Omicron has accelerated this process – we are essentially on the brink of endemicity, and it may be that once Omicron’s leap reaches countries around the world, we will obviously be in an endemic phase,” Adalia added.
How close is the world to coming out of the pandemic phase?
Hans Kluge, director of the WHO for Europe, said on Sunday that the Omicron strain had moved Europe to a different stage of the pandemic.
“The region is likely to be on the verge of an end to the pandemic,” Kluge told AFP in an interview, adding that Omicron could infect 60 percent of Europeans by March.
He said Europe could expect months of global immunity once the current wave falls due to vaccines or infection.
“We expect a period of calm before COVID-19 returns at the end of the year, but the pandemic does not necessarily return,” Kluge said.
But the next day, WHO Director-General Tedros Adanom Gebrejesus seems to have taken down Kluge’s comments.
“It is dangerous to assume that Omicron will be the last option or that we are at the end of the game … worldwide, the conditions are ideal for more options to emerge,” he said.
Okereke shares a similar perspective, noting the lack of knowledge about the coronavirus, which is needed for the world to predict the behavior of new strains and become endemic.
“I don’t believe we know enough about SARS-Cov-2 to say that if a new variant comes out, it will behave that way, or to say that new variants will not appear, we don’t know,” he said. Okereke.
“The key to reducing the emergence of new options is to ensure that we optimize vaccination programs worldwide.
“Until we do that, we risk having new options, the behavior of which we cannot currently predict,” she added.
COVID-19 vaccination rates remain low in Africa, with about 8 percent of the continent’s population fully vaccinated against the disease.
“In Africa, we don’t have the luxury of immunizing large sections of our population enough to start saying we have this, we’re in the final game of a pandemic,” Okereke said.
Experts warn that there is still not enough information to know exactly what is coming, especially with the new strains.
“If the virus starts to turn into a lighter virus, we’ll be fine,” Blackney said. “But if it suddenly becomes really contagious and deadly, then we won’t be in the right place.”
What do early data tell us about the Omicron pandemic variant?
Omicron was first discovered in South Africa in late November, and early research found that the strain appeared to be highly transmitted. The symptoms of the infection appear to be less severe than in other variants, while early studies have shown that the symptoms experienced by vaccinated patients appear to be milder than in unvaccinated patients.
Its high permeability also proved to be a challenge. Its spread has caused significant tensions in health systems, with many countries struggling with an influx of patients.
“Omicron is so widespread that we are still seeing a jump in hospitalizations and deaths,” Blackney said.
“The current situation tells us that while there is a risk of significant transmission and the emergence of new options, we must be vigilant,” Okereke said.
“This tells us that although our vaccines may not be the ideal solution … they have a significant role to play in reducing the severity of the disease in those vaccinated.
“The Omicron version also shows us that we cannot lower our vigilance, we must continue to improve the tools we have in our portfolio to manage this pandemic,” she added.
How can the world emerge from the pandemic?
There is a consensus among most health experts that the way to end this pandemic is by providing vaccines and treatments worldwide.
“Vaccinations are key,” Blackney said.
“We need to keep making new vaccines and find out how long this immunity lasts. We also need to increase the production of every tool we have, antivirals, tests, monoclonal antibodies and make sure they are widely available.
“We have the tools, it’s just a matter of making them available to people around the world,” she added.