Is the Pandemic Over? If Only It Were That Simple


September 21, 2022 – President Joe Biden says the pandemic is over. According to the World Health Organization, the end is in sight. Many of us prefer to talk about almost anything else, and even New York City has dropped most of its COVID protocols.

Biden’s claim (made to reporter Scott Pelley on Sunday) 60 minutes) has once again exploded the debate over COVID-19, even though he has twice now tried to soften it. It has awakened the already divided public, fueled extensive coverage on television news and led experts to take sides.

But for many, a pandemic cannot be declared “over” if the US alone has an average of more than 71,000 new cases and more than 400 deaths per day, and there are 500,000 cases and nearly 2,000 deaths per day around the world.

Biden’s comment has divided experts in medicine and public health. Some strongly disagree that the pandemic is over, pointing out that COVID-19 remains a public health emergency in the United States, the World Health Organization still considers it a global pandemic, and most importantly, the virus is yet to come. killing more than 400 people a day in the US

Others point out that most of the country is protected by vaccination, infection, or a combination, at least for now. They say the time is right to declare the end of the pandemic and recognize what much of society has already decided. Sentiment is perhaps best captured in a controversial new COVID health slogan in New York: “You Do You.”

In fact, a new poll by media site Axios and its partner, Ipsos, released Sept. 13. found that 46% of Americans say they have returned to their pre-pandemic lives – the highest percentage since the start of the pandemic. Meanwhile, 57% say they are still somewhat concerned about the virus.

A balancing act

“How can a country say the pandemic is over?” asked Eric Topol, MD, executive vice president of Scripps Research and editor-in-chief of Medscape (WebMD’s sister site for medical professionals).

According to Topol, it is far from over and there must be a balance between protecting public health and allowing individuals to decide how they want to live their lives based on risk tolerance.

“You can’t just let the public down and say, ‘It’s all up to you.'” He sees that approach as giving up on responsibility, potentially causing an already reluctant public to forget about the latest booster, the bivalent vaccine available. came to get. earlier this month.

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Topol coined the phrase “COVID capitulation” in May, when the US was in the midst of a spate of infections from the BA.2 variant of the coronavirus. He used the phrase again this month after the White House said COVID-19 vaccines would soon become an annual requirement, like the annual flu shot.

Topol now sees hope, tempered by recurring realities. “We’re on the way down, in terms of circulating virus,” he says. “We are going to have a few quiet months, but then we will cycle up again.” He and others are looking at emerging variants, including the BA.2.75.2 subvariant, namely: more transferable then BA.5.

The White House acknowledged that as early as May when it warned of up to 100 million infections this fall and the potential for a major increase in deaths. The University of Washington’s Institute for Health Metrics and Evaluation estimates that approximately 760,000 people in the US are now infected with COVID-19. That number will rise to more than 2.48 million by the end of the year, the group warns.

A new phase?

“From a public health perspective, we are clearly still in a pandemic,” said Katelyn Jetelina, PhD, a health policy expert who publishes Your Local Epidemiologist, a science newsletter for consumers. “The question is, ‘What phase of a pandemic are we in?’ It’s not an emergency where the navy rolls in the ships [as it did to help hospitals cope with the volume of COVID patients in 2020.]”

“The biggest problem with that comment [by Biden] is, are we normalizing all those deaths? Can we safely leave SARS-CoV-2 as the third leading cause of death? I was disappointed by that comment,” she says.

Even as people switch to an individual decision-making mode from a public health perspective, Jetelina says, most people still need to consider others when determining their COVID-19 precautions. In her personal life, she constantly considers how her activities affect the people around her. For example, she says, “We’re going to my grandpa, and everyone’s been taking antigen tests before.”

While younger, healthier people may be able to safely relax their safety measures, they should still be aware of those around them who are more at risk, Jetelina says. “We cannot place the full responsibility on the vulnerable. Our layers of protection are not perfect.”

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Like Topol, Jetelina suggests taking the circumstances into account. She recommends taking small steps to collectively reduce transmission and protect the vulnerable. “Get the mask” before entering a high-risk facility, and “get the antigen test before going to the nursing home.”

Worst behind us?

“The mission is not yet accomplished,” said William Schaffner, MD, an infectious disease expert and professor of preventive medicine at Vanderbilt University in Nashville. If he could rewrite Biden’s comments, he says, “He could have said something like ‘The worst is behind us,'” while citing the new vaccine to boost enthusiasm for it and promising to keep making progress.

Schaffner also admits that much of society has decided at some level that the pandemic is over. “The vast majority of people have taken off their masks, are going back to concerts and restaurants, and they want to function in society,” he says.

He understands that, but suggests reminding those who are particularly vulnerable, such as those over 65 and those with certain illnesses, to keep taking the extra steps, masking and distancing themselves, especially once flu season has set in. upwards.

And public health messages should remind others of the vulnerable members of the population, Schaffner says, so those who continue to wear masks won’t have a hard time with those who have given them up.

A focus on the most vulnerable

Biden’s statement “could have been better worded,” says Paul Offit, MD, an infectious disease expert and director of the Vaccine Education Center at Children’s Hospital in Philadelphia. But, he says, things are different now than they were in early 2020.

“We are in a different place. Now most of the population is protected from serious diseases [either by vaccination, infection, or a combination].”

The effect of that protection is already reflected in requirements, or the lack thereof, says Offit. At the start of the pandemic “we made the COVID vaccine mandatory in our hospital” [for employees]Now the hospital will not oblige the new bivalent vaccine.

He agrees that the focus should be on the most vulnerable forward. He goes on to say that people should make their own decisions based on individual circumstances and their risk tolerance.

An important and looming question, Offit says, is that scientists need to figure out how long people are protected by vaccination and/or previous infection. Protection from hospitalization and serious illness is the goal of vaccination, he says, and the only reasonable goal, he says, is not eradicating the virus.

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Biden ‘is right’

The opposing view is Leana Wen, MD, an emergency medicine physician, professor of health policy at George Washington University, and frequent media commentator, who says Biden shouldn’t backtrack on his statement that the pandemic is over. “He is right.”

She says the US has entered an endemic phase, as evidenced by social measures — many people are going back to school, work and travel — as well as policy measures, with many locations relaxing or removing mandates and other requirements.

There is disagreement, she says, about the scientific measures. Some say more than 400 deaths a day is still too high to call a pandemic endemic. “We are not going to eradicate the coronavirus; we have to live with it, just like HIV, hepatitis and the flu. Just because it’s not a pandemic [in her view] does not mean that the level of disease is acceptable or that COVID is no longer with us.”

We don’t see taking a public health perspective versus a personal perspective as an either-or health choice. “Just because something is no longer a pandemic doesn’t mean we don’t care about it anymore,” she says. But I think [many] people live in the real world. They see that family and friends have returned to play dates, go to restaurants and not wear a mask. COVID has become a risk, just like many other risks they face in their lives.”

The tension between public health and individual health is ongoing and will not go away, Wen says. And that goes for all health problems. The shift from broad public health concerns to individual decisions “is what we expect will and should happen.”

She also pointed to the costs of measures to combat COVID, including closed schools and businesses and their effect on mental health and the economy, plus another less-discussed cost: the effect on public health confidence.

Continuing to demand action against COVID-19 when cases dwindle, she says, could weaken trust in public health authorities even further. With New York State recently declaring a public health emergency after finding the polio virus in sewage samples, Wen wondered, “What happens if we say, ‘Have your child vaccinated against polio?'”



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