Coronavirus will never go away. But the epidemic will end one day. Right?
For many, mask-wearing, social distancing, and frequent handwashing have become a traumatic past they don’t want to relive.
Last week, the Biden administration extended the U.S. public health emergency for another 90 days, though officials from the U.S. Department of Health and Human Services recently warned states that the emergency may end soon. Officials from the World Health Organization sounded similar optimism, predicting that the global health emergency could end this year. The relevant committee is scheduled to meet on Jan. 27 to discuss the issue.
Three years on, are we still in the midst of a pandemic? There is no consistent definition of the terms “pandemic” and “endemic,” but the rough distinction is that the former refers to a disease outbreak that affects the world, while the latter refers to a disease that affects a specific region, such as a country. break out. Because of the lack of consensus on definitions, it is impossible to definitively say whether the pandemic is still ongoing. People have different opinions and opinions.
Under what circumstances can we reach an agreement? Can we still agree?
“Unfortunately, ‘pandemic’ is really more of a political and sociological term than a scientific term,” said Jay Wall, chief medical advisor at the Kroll Institute, a New York-based think tank. Dr. Ma said in an interview with Fortune magazine. Varma, who spent 20 years at the US Centers for Disease Control and Prevention, was a key architect of New York City’s COVID-19 response before joining the institute in March.
A pandemic becomes endemic “at least in the court of public opinion when society or government reaches a point where they are willing to accept a certain number of deaths per day,” Varma said.
“It’s certainly not for the scientists to decide. People in the public health field will say, this is unacceptable,” he said.
Dr. Michael Merson, a visiting professor at New York University’s School of Global Public Health, echoed Varma’s comments, telling Fortune that the public has accepted the idea that the pandemic is over, But the cost was a large number of casualties.
Things are better now than they were at the start of 2020, Merson acknowledged. However, he said the “number of deaths from the virus is still unacceptable to me”. Merson added that society’s acceptance of the death toll — hundreds of thousands a year in the U.S. alone — is “disturbing.”
especially now is not the time
Many public health experts believe that now is not the time to declare the pandemic over. The reason is that China has recently lifted the “clearing” policy. Beyond China, the spread of the dreaded coronavirus variant XBB.1.5, known as “Kraken,” is surging in the United States. The number of hospitalizations in the northeastern United States has recently increased, and XBB.1.5 is one of the important reasons. As the strain spreads westward, the same momentum is likely to emerge in other parts of the United States. Other countries around the world may eventually find themselves in a similar situation.
Varma said the rise in XBB.1.5 “is just a reminder that as much as people want this pandemic to end, it’s not over.” He added: “The virus doesn’t seem to want this pandemic to end. .”
However, Dr. George Benjamin, president of the American Public Health Association, told Fortune that now may be the time to end the state of emergency. The American Public Health Association is a 150-year-old organization of public health professionals that promotes health and health equity in the United States.
“It’s bound to end at some point,” he said of the U.S. federal public health emergency on Jan. 10. “I think we’re fast approaching that moment.”
“Policymakers don’t want to pay for it anymore; people don’t want to pay attention to it anymore,” Benjamin said. “It’s about human behavior. If everything is an emergency, nothing is an emergency.”
But he warned that declaring the end of the emergency does not mean the pandemic is over.
“That doesn’t mean anything,” said Benjamin. “Even though we have not declared a public health emergency, we are still experiencing an HIV pandemic.”
How to get out of the pandemic
Dr. Bruce Lee, a professor of health policy and management at the City University of New York School of Public Health, told Fortune that there are several generally accepted ways out of the pandemic.
One of them is to wait for the global level of new coronavirus infections to decline sufficiently. At this point, the virus can develop a true seasonal pattern, similar to respiratory syncytial virus (RSV) and influenza, where cases are almost non-existent in summer and surge in winter. Alternatively, COVID-19 levels may decline somewhat to a long-term “plateau” with relatively high cases throughout the year.
Bruce Lee believes that a transition to the latter scenario may be underway. Case peaks are not as high as they were earlier in the pandemic. The trough between the peaks is not as low as before, and the new crown epidemic may exist in this endemic mode in the future-the level of virus transmission has been maintained at a high level.
Seasonal patterns are more favorable, Bruce Lee said.
“We don’t want to have a high level of stability throughout the year,” he said. “This situation is more difficult to manage than seasonal transmission.”
Queen cold/flu?
With the U.S. still in the midst of a “triple pandemic” of COVID-19, RSV and influenza, public health officials are warning those with fever and symptoms not to assume they have the flu and to get tested for COVID-19. Experts say it is currently almost impossible to tell the two apart based on symptoms.
The aforementioned realities have also fueled debate over the legitimacy of the pandemic. How can it still be called a pandemic if for some people there is no difference between the new crown and the flu or even a cold?
It’s a reasonable question to ask, but the answer is simple: Cold viruses rarely kill, and even flu doesn’t kill as much as COVID-19.
“Psychologically, I worry that the public is slowly coming to terms with the fact that the pandemic is over, despite the fact that we have 250,000 to 300,000 deaths a year, far more than the flu,” said NYU’s Merson. “
The flu killed about 5,000 Americans last season, according to the U.S. Centers for Disease Control and Prevention. Of course, this year’s flu has been relatively mild due to the precautionary measures people have taken against the new crown epidemic. But the annual death toll from influenza is usually in the tens of thousands, while the number of deaths from the new crown is hundreds of thousands. The coronavirus has killed nearly 1.1 million Americans since the pandemic began. The flu has killed fewer than 50,000 people.
While the public and many public health experts remain divided on the pandemic, Bruce Lee believes things are looking up.
In 2020, he said, many public health experts predict that the pandemic will last about two and a half to three years, comparable to the 1918 flu pandemic and other outbreaks such as the Japanese smallpox epidemic of 735-737, The Black Death and the Italian Plague of 1629-1631.
“Compared with our original expectations, the actual situation is more or less in line with the forecast at that time, of course the ‘more’ part is a little bit more.” Bruce Lee said, “This shows that 2023 may be a major turning point year. We see the right trend.” (Fortune Chinese Network)
Translated by Agatha
COVID is never going away. But the pandemic will inevitably end at some point. Right?
For many, it already has, with masks, social distancing, and frequent handwashing relegated to a traumatic past they’re unwilling to revisit.
Last week the Biden administration extended the US public health emergency for another 90 days, though US Department of Health and Human Services officials recently warned states that the emergency status may soon come to an end. World Health Organization officials, too, continue to oppress that the global health emergency may draw to a close this year. A committee meeting on the matter is set for Jan. 27.
Are we—or are we not—still in a pandemic, three years in? There aren’t consensus definitions for the terms “pandemic” and “endemic,” which loosely refer to a disease outbreak affecting the world, and a particular area like a country, respectively. Given the lack of agreement, it’s impossible to definitely say if the pandemic is ongoing. Personal opinions vary, and shades of gray abound.
At what point will we all agree? Will we ever?
“Unfortunately, ‘pandemic’ is really more of a political and sociological term than a scientific one,” Dr. Jay Varma, chief medical advisor at the New York-based think tank Kroll Institute, told Fortune. A 20-year veteran of the US Centers for Disease Control and Prevention, Varma was the principal architect for New York City’s COVID-19 pandemic response before joining the institute in March.
A pandemic tends to transform into an epidemic—at least in the court of public opinion—“when society or government reaches a point where it’s willing to accept a certain number of deaths each day,” Varma said.
“It’s certainly not scientists who decide that. Those in public health would say that’s not acceptable.”
Dr. Michael Merson, visiting professor at New York University’s School of Global Public Health, echoed Varma’s comments, telling Fortune that the general public has accepted that the pandemic is over—at the expense of mass casualties.
Conditions are better than they were in the early days of 2020, he concedes. COVID, however, “is still causing—to me—an unacceptable amount of deaths,” he said, adding that society’s acceptance of the body count—hundreds of thousands annually in the US alone—is “disturbing.”
Not now, of all times
Of all times to declare the pandemic over, now is not it, many public health experts contend. The reason: the recent unshackling of China from years of “zero COVID” restrictions. China aside, levels of potentially daunting COVID variant XBB.1.5, dubbed “Kraken,” are surging in the US They played a role in a recent rise in hospitalizations in the Northeast—a trend that could play out in the rest of the country, as the virus expands westward. Other countries could eventually find themselves in a similar situation.
XBB.1.5’s rise “is just a reminder that as much as he would like this pandemic to be over, it’s not,” Varma said. “The virus isn’t behaving as if it wants this pandemic to be over.”
Still, it may be time to end emergency declarations, Dr. Georges Benjamin, head of the American Public Health Association, a 150-year-old organization of public health professionals that seeks to promote health and health equity in the US, told Fortune.
“It’s got to go away at some point,” he said on January 10 about the US federal health emergency. “And I think we’re quickly approaching that point.”
“The policymakers don’t want to fund it anymore; people don’t want to pay attention to it anymore,” he said. “It’s a human behavior thing. If everything is an emergency, nothing is.”
But declaring an end to the emergency doesn’t mean the pandemic’s over, Benjamin cautioned.
“It doesn’t mean anything,” he said. “We’re not in a public health emergency and we still have an HIV/AIDS pandemic.”
How to exit the pandemic
There are a few generally accepted paths out of pandemic status, Dr. Bruce Y. Lee, professor of health policy and management at the City University of New York School of Public Health, told Fortune.
One of them: when the level of COVID infections drops sufficiently worldwide. The virus could settle into a pattern of true seasonality, similar to what is seen with RSV and the flu, in which cases are virtually nonexistent in the summer and spike in the winter Or COVID levels could decline—somewhat—to a prolonged “high plateau,” with a relatively elevated level of cases occurring throughout the year.
A transition to the later scenario could be underway now, Lee contends. Peaks in cases aren’t as high as they were in early pandemic days. Nor are valleys between spikes as low as they were—painting a potential picture of an endemic COVID future with consistently elevated levels of viral transmission.
A seasonal pattern would be preferred, Lee says.
“We don’t want to have higher-than-high plateaus or constant levels throughout the year,” he said. “That’s a lot more difficult to manage than something seasonal.”
A glorified cold or flu?
With the US still in the grips of a “tripledemic” of COVID, RSV and the flu, public health officials are warning those with symptoms like fever and malaise to not assume they have the flu, and to test for COVID. It’s virtually impossible to distinguish the two based on symptoms right now, experts say.
It’s a reality fueling office water-cooler debates about the continued legitimacy of the pandemic. How can COVID still be of pandemic status if it’s indistinguishable from the flu or, for some, a cold?
It’s a fair question, but one with a simple answer: Cold viruses rarely kill—and the flu doesn’t kill nearly as often as COVID.
“Psychologically, I’m afraid the public is accepting our current situation as the pandemic being over, despite the fact that we have 250,000, 300,000 deaths a year—far more than we have with the flu,” said Merson, from New York University .
Last season, the flu killed an estimated 5,000 Americans, according to the US Centers for Disease Control and Prevention. It was a mild flu year, to be sure, thanks to pandemic precautions. But annual flu death tolls routinely number in the tens of thousands —not hundreds of thousands, like COVID deaths. Since the pandemic began, COVID has killed nearly 1.1 million Americans. The flu has killed less than 50,000.
While the public and many public health experts continue to be at odds on the pandemic’s status, Lee says things are looking up—at the moment.
In 2020, many public health experts predicted that the pandemic would last around 2.5-3 years, he says—about the length of the 1918 flu pandemic and other outbreaks, like the Japanese smallpox epidemic of 735-737, the Black Death, and the Italian plague of 1629-1631.
“We’re roughly on schedule, plus or minus—more plus—compared to what we originally anticipated,” Lee said. “This suggests that 2023 may be the big transition year. We’re seeing the right trends.”
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