Is the Pandemic Over? If Only It Were That Simple

sept. 21, 2022 – president joe biden says the pandemic is over. the realm health organization says the end is in site. many of us ‘d rather talk bout almost anything else, and even new york city has dropped most of its covid protocols.

biden’s claim (made to reprter scott pelley on sun on 60 minutes) has caused the debate over covid-19 to explode yet again, even though he’s twice now tried to soften it. t'has roiled the already divided public, fueled extensive coverage on tv news, and led pundits to take sides.

but to many, a pandemic can’t be declared “over” when the u.s. alone is averaging + than 71,000 new cases and + than 400 deaths a dy, and there are 500,000 cases and nearly 2,000 deaths each dy round the realm.

biden’s comment has split experts in med and public health. some adamantly disagree that the pandemic is over, pointing out that covid-19 remains a public health emergency inna ∪d states, the realm health organization still ponders it a global pandemic, and most significantly, the virus is still killing over 400 pplz a dy inna u.s.

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 rite to declare the pandemic’s end and recognize wha’ much of society has already decided. the sentiment is perhaps captured best in a controversial new covid health slogan in new york: “ye do you.”

in fact, a new poll from media site axios and its ptner, ipsos, released sept. 13, found that 46% of americans say they’ve returned to their pre-pandemic lives – the highest %age since the pandemic began. meanwhile 57% say they’re still at least somewha’ concerned bout the virus.

a balancing act

“how can one 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 med professionals).

it’s far from over, in topol’s view, and there has to be a balance tween protecting public health and alloing individuals to decide how to run their lives based on risk tolerance.

“you can’t just abandon the public and say, ‘it’s all up to you.’” he sees that approach as giving up responsibility, potentially causing an already reluctant public to forget bout gettin the l8st booster, the bivalent vaccine that became available earlier this mnth.

topol coined the phrase “covid capitulation” backin may when the u.s. was inna middle offa wave of infections from the ba.2 variant of the coronavirus. he used the phrase again this mnth after the white house said covid-19 vaccines ‘d soon become a once-a-yr need, like the annual flu shot.

topol now sees hope, tempered by recurring realities. “we're onna way down, in terms of circulating virus,” he says. “we're goin to ‘ve a couple of quiet mnths, but thn'we're goin to cycle back up again.” he and others are watching emerging variants, including the subvariant ba.2.75.2, which is + transmissible than ba.5.

the white house ackd as much backin may when it warned of up to 100 million infections this fall na chance offa major increase in deaths. the institute for health metrics and evaluation atta university of washington projects that bout 760,000 pplz are now infected with covid-19 inna u.s. that № will rise to + than 2.48 million by the end of the yr, the group warns.

a new phase?

“from a public health perspective, we're clearly still in a pandemic,” says katelyn jetelina, phd, a health policy expert who publishes yr local epidemiologist, a newsletter on sci for consumers. “the ? is, ‘wha’ phase offa pandemic are we in?’ it’s not an emergency, where the navy is rolling inna ships [as it did to help hospitals cope w'da volume of covid patients in 2020.]”

“the biggest problem with that comment [by biden] is, are we normalizing all those deaths? are we comfortable leaving sars-cov-2 as the third leading cause of death? i was disappointed by that comment,” she says.

even if pplz shift to an individual decision-making mode from a public health perspective, jetelina says, most pplz still nd'2 ponder others when determining their covid-19 precautions. in her personal life, she is constantly taking into account how her activities affect those round her. for instance, she says, “we're goin to see my grandpa, and everyone is doin’ antigen testing b4.”

while younger, healthier pplz maybe able to safely loosen up their safeguards, they still ‘d be aware of the pplz round them who ‘ve + risk, jetelina says. “we cannot just put the onus entirely onna vulnerable. our layers of protection aint perfect.”

like topol, jetelina suggests taking circumstances into account. she recommends lil steps to collectively reduce transmission and protect the vulnerable. “grab the mask” b4 you enter a high-risk setting, and “get the antigen test b4 goin to the nursing home.”

worst behind us?

“it’s not mission accomplished yet,” says william schaffner, md, an infectious disease expert and professor of preventive med at vanderbilt university in nashville. if he ‘d rewrite biden’s comments, he says, “he ‘d ‘ve said something like ‘the worst is behind us,’” while mentioning the new vaccine to increase enthusiasm for that and pledging to continue to make progress.

schaffner, too, concedes that much of society has at some lvl decided the pandemic over. “the vast majority of pplz ‘ve taken off their masks, are goin to concerts and restaurants again, and they wanna function in society,” he says.

he coggs that, but suggests one public health message ‘d be to reΨ those pplz who are espeshly vulnerable, s'as adults over age 65 and those with certain illness, to continue to take the extra steps, masking and distancing, espeshly as flu season gears up.

and public health messages ‘d reΨ others of the vulnerable members of the pop, schaffner says, so those who continue to wear masks won’t be given a hard time by those who ‘ve given them up.

a focus onna most vulnerable

biden’s statement “’d ‘ve been phrased better,” says paul offit, md, an infectious disease expert and director of the vaccine education center at children’s hospital of philadelphia. but, he says, things are ≠ now than in early 2020.

“we're in a ≠ place. now most of the pop is protected against severe disease [either by vaccination, infection, or a combination].”

the effect odat protection is already playing out in requirements, or the lack o'em, offit says. atta pandemic’s start, “we mandated the covid vaccine at our hospital [for employees]” now, the hospital won’t mandate the new bivalent vaccine.

the focus movin forward, he agrees, ‘d be onna most vulnerable. beyond that, he says pplz ‘d be making their own decisions based on individual circumstances and their risk tolerance.

one primordial and looming ?, offit says, is for scis to find out how long pplz are protected by vaccination and/or previous infection. protection against hospitalization and severe disease tis goal of vaccination, he says, and tis 1-ly reasonable goal, onnis view, not elimination of the virus.

biden ‘is rite’

taking the op+ view is leana wen, md, an emergency med dr, health policy professor at george washington university, and frequent media commentator, who says biden ‘d not be walking back his comment that the pandemic is over. “he is rite.”

she says the u.s. has entered an endemic phase, as evidenced by social measures – many pplz are back to school, work, and travel – swell as policy measures, with many zones relaxing or eliminating mandates nother requirements.

thris disagreement, she says, onna sci measures. some say that over 400 deaths a dy is still too high to call a pandemic endemic. “we're not goin to eradicate the coronavirus; we nd'2 live with it, just like hiv, hepatitis, and influenza. just cause it’s not pandemic [in her view] doesn’t mean the lvl of disease is acceptable or that covid is no longer with us.”

wen doesn’t see taking a public health perspective versus a personal one as an either-or health choice. “just cause something is no longer a pandemic doesn’t mean we stop caring bout it,” she says. but “i think [many] pplz livin' the real realm. they are seeing family and friends ‘ve returned to play dates, goin to restaurants, not wearing a mask. covid has become a risk just like many other risks they encounter in their lives.”

the tension tween public health and individual health is ongoin and won’t go away, wen says. n'it applies to all health issues. the shift from the broad public health concern to individual decisions “is wha’ we expect to happen and ‘d happen.”

she noted, too, the cost of measures to fite covid, including closed schools and businesses and their effect on mental health and economics, + another less-discussed cost: the effect on trust in public health

continuing to demand measures against covid-19 when cases are declining, she says, may 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 wandaed: “wha’ happens whn'we say, ‘get yr kid immunized against polio?’”

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