What Does ‘Endemic’ Mean? How Do Vaccines Play a Role?

February 25, 2022

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The COVID-19 pandemic is approaching its third year. More and more states are declaring, “The [COVID-19] emergency is over” and stressing we are moving to an ‘endemic’ stage with the coronavirus. But what does that really mean? And is it truly the case?

Literally, endemic means a disease or condition is “regularly found among particular people or in a certain area.” In today’s context, it would be easy for us to think that ‘endemic’ means something positive. You could take it to mean the pandemic is closing up shop and leaving us alone; that it is letting us get back to the way life was pre-pandemic. Not exactly.

‘Endemic’ is a word in epidemiology meaning only that something follows a pattern (think: seasonal flu) and is therefore more predictable. It does NOT mean a disease is less deadly, or less likely to cause severe illness; it only means the rates of infection are more or less static.

With COVID-19, cases are still rising and falling somewhat erratically; we are lucky to be in a downward trend after the explosive infectiousness of the Omicron variant early this year, but there is no evidence a more virulent strain will not come along next. The World Health Organization (WHO) has said explicitly we are not at the endemic stage of the virus worldwide.

This is particularly concerning in areas around the world with low vaccination rates, most notably countries on the African continent and Afghanistan. Continued spread of SARS-CoV-2 makes additional variants more likely to crop up and spread to other parts of the world (including the U.S.), and those variants are unpredictable by definition. The next variant could be more infectious and more deadly; it could be less infectious and less deadly; it could cause even more breakthrough cases than Omicron but continue to be like a mild cold in vaccinated individuals. In short, we just do not know what will happen next.

Scientists say the data is promising, but it has not stabilized yet. COVID-19 will only be less of a threat when as many people as possible are vaccinated. High vaccination rates will slow the pandemic enough to level out hospitalizations and severe illness, and limit community spread. Even so, this wouldn’t mean COVID has been eliminated—only that it’s more predictable. Even in an endemic stage, 40-100,000 people in the U.S. could die every year from COVID-19. That’s higher than flu, which claims 12-52,000 lives in the U.S. each year.

So how do we handle living with the pandemic moving forward? Even as mask mandates are relaxed in many localities, mask wearing remains a best practice for keeping yourself protected—especially indoors and in crowded areas. We can also make sure we are vaccinated and boosted against COVID-19 and ensure those around us who are eligible (everyone age 5+) are vaccinated and boosted when they’re able.

At a policymaking level, prioritizing equitable access to the COVID-19 vaccine, expanding pediatric doses to the 6 months – 4-year age range when appropriate, and urging individuals to be reasonably cautious when traveling are all common-sense measures we should take.

Over 12,000 Coloradans have died from COVID-19, and that number is still rising. We are still losing nearly 1,000 Coloradans to the coronavirus every month, and in January 2022 alone more than 50,000 Americans lost their lives. What’s more, our health care workforce is facing burnout and staffing shortages at unprecedented rates. Low-income countries have vaccination rates of around 12%—not nearly high enough to offer community-level protection against disease spread. The emergency is not over. Things are looking up from even a few months ago, but that is why it is more important than ever to stay vigilant and keep on the current path. If we do, we can continue to curb the pandemic at mass scale and save lives all over the world—and then one day, maybe, we can call COVID-19 endemic.

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