Will Covid stay here?What experts say about the transition from a pandemic to endemic

Seattle-In the early days of the pandemic, many were caught hoping that once the vaccine was launched, Covid-19 would stop on its track and be permanently buried.

But hopes for a Zerocovid country have long been confusing for most scientists.

“Everyone has stopped talking about getting rid of Covid,” said Dr. Elizabeth Haroran, an epidemiologist at the Fred Hutchinson Cancer Research Center in Seattle, about her fellow researchers. “It never goes away, and that means it will be endemic.”

Today, most scientists expect the virus to circulate indefinitely with fewer cases and a more predictable number of cases. This is a condition known as a fad. That way, the coronavirus will be like many other viruses that humanity has learned to deal with, such as the flu. However, it is unclear whether coronavirus maintains a greater health risk than other endemic respiratory viruses.

There are some signs that governments and public health authorities are already working with that idea in mind. The latest wave of Omicron variants not only reminded us that the coronavirus was mutating in an unexpected way, but also served as a guidepost. Relied on extreme measures such as local blockadeIs currently focused on reducing risk and taking precautions to enable vaccination and boosters to continue in a relatively normal life.

Given that Covid is expected to settle and how quickly Omicron variants spread, some infectious disease experts believe that most people can be infected for life. Some people have it.

Dr. Francis Riedo, an infectious disease specialist at Evergreen Health, a hospital system in Kirkland, Washington, said: “The real question is how serious the infection will be.”

Even if endemic Covid is inevitable, it doesn’t mean that people should stop taking precautions, experts say. Instead, they are beginning to consider a future in which Covid’s precautions, such as masking and occasional encouragement to social distance, may become somewhat common. Vaccination will continue to be central, as is precautions for vulnerable people.

And in the short term, it is important to try to avoid infecting people now, including those who have been vaccinated, when the pandemic is skyrocketing as the Omicron variants are infuriated.The medical system will soon be besieged, hospital workers will be exhausted, and monoclonal antibodies and Antiviral drug..

“The community is definitely responsible,” Riedo said. “Looking at this country, there are huge bands that have not been vaccinated and have not been infected yet, but they will be infected. And what can we do to help them?”

The virus becomes endemic as people increase their overall immunity to the disease through vaccination and infection. By weakening the immune system, it prevents the virus from being completely killed.

In the case of endemic disease, all infected people, on average, infect one additional person with the virus. However, it is a “dynamic equilibrium,” and the spread of the virus can increase or decrease depending on factors such as the season, Haroran said.

Sergei Maslov, a professor of bioengineering at the University of Illinois at Urbana-Champaign, said there is no model that can predict how quickly society can turn into an epidemic. Push them in the direction of endemic disease..

“At this point the mutations are pretty unpredictable and we don’t know what will happen after Omicron,” he said.

Alexei Tokachenko, a research partner at Maslov, a scientist at the Brookhaven National Laboratory in Long Island, New York, said it usually takes several years for a new viral pathogen to transition from a pandemic to endemic. ..

“Ultimately, yes, there are some repetitive patterns, average levels of epidemics,” Tkachenko said. “It can’t be so low that we don’t care.”

Pfizer executives this week They believe Covid will be endemic by 2024.. Dr. Anthony Fauci, director of the National Institute of Infectious Diseases, wrote with a colleague last week: The virus is unlikely to be eradicated And they expect “regular outbreaks and endemic species”. In a February survey of the journal Nature, Nearly 9 out of 10 researchers working on the coronavirus Covid thought he would get endemic.

Endemic often settles in a more predictable and stable pattern. Influenza, for example, surges to some extent in cold weather, as expected. However, researchers cannot say for sure how damaging Covid’s endemic levels can be.

“The question that is really open to me, or to public health and all of us, is how serious illness and death it causes when it becomes endemic and people are infected,” says Haroran. rice field.

The endemic version of Covid may be somewhat similar to influenza, according to the predictions of Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Center.

Bedford said he believes that endemic Covid means that most people get infected about every three years on average, and most of the time they are very mild.

The math behind Bedford’s napkins shows that 50,000 to 100,000 people die each year from endemic Covid in the United States, according to a presentation he shared this fall when the Delta variant was the major strain. Suggested that there is sex.Influenza for 10 years prior to Covid 12,000 to 52,000 deaths per yearAccording to the statistics of the Centers for Disease Control and Prevention.

Long Covid, a poorly understood disease that follows infection, can increase the social cost of endemic Covid.

Infectious disease specialist Reed said the comparison with the flu makes sense. Vaccination is the key to protecting vulnerable groups.

“With Covid, some people die, even if they are vaccinated. The average age of those people is in their 80s,” says Riedo. “They have multiple comorbidities. They cannot tolerate small perturbations of physiology.”

People who die from Covid without vaccination are on average 10 to 15 years younger and tend to have fewer health problems, Reed said, adding that the same is true for influenza.

Endemic Covid does not affect everyone equally. Immunosuppressed people may not benefit much from vaccination and may need additional protection to reduce the risk of endemic Covid.

Riedo outlines potential treatment plans for immunosuppressed patients, who make up 4% to 5% of the US population: , You start them with new drugs, “for example, drugs that help control the growth of the virus.

Even if the risk is more significant during the endemic Covid surge, layers of protection such as masks and distances can help prevent infection and manage the risk of particularly at-risk populations.

“Covid is not the first to have to think about two layers of protection, or how to protect himself during the plague and environment that endangers them,” microbiology said. Said Erin Sorrel, an assistant professor of immunology. Georgetown University, Washington, DC “Getting a cold, flu, flu, or something will be a problem for their health and safety.”

Not all viruses become endemic and do not remain intact.

Strict control of the first SARS virus, which was asymptomatic and did not spread, allowed health authorities to effectively eradicate it. The virus that causes smallpox has been eradicated by global vaccination efforts.

Some experts I still believe it is possible to eliminate the coronavirus on a country-by-country basisAlthough it requires a huge investment and the cost may not exceed the profit.

The other four coronaviruses circulate in humans and cause the common cold. Scientists suspect that they may have evolved from a pandemic before the severity diminished as people gained immunity.

However, this is the first time researchers have measured coronavirus on the road to endemic disease. More surprises may be waiting for you.

“Who thought of Omicron?” Haroran said. “Is it in your crystal ball?”