Fri. May 20th, 2022

After the World Health Organization’s regional head for Europe last weekend expressed hope that the continent could move to a “pandemic endgame”, its WHO chiefs moving quickly to play off such optimism.

Director-General Tedros Adhanom Ghebreyesus explained Hans Kluge’s remarks the next day, insisting that it was “dangerous to adopt. . . we are in the final game ”of coronavirus while WHO Europe emphasized that the“ pandemic is not over yet ”.

The confused messages cut to the heart of a debate that is bubbling even before the Omicron variant caused a worldwide surge of infection: at what point does the world move away from the pandemic?

The different positions can be crystallized as “pandemic versus endemic”. On the one hand, the scientific community that views the constant threat of variants and patching up global vaccination coverage is proof that the pathogen has not been overcome.

On the other hand, there are those, often politicians, who are eager for the virus that hung around the world’s neck like a millstone for two years to be treated like any other problematic disease – a threat but one that can drive word.

Pedro Sánchez, Spain’s prime minister, made the case this month when he said “we are on the way to a endemic disease rdifferent from the pandemic it has been so far. ” Yet few health experts think the road to endemism will be simple.

Some countries, including England, have moved to lift Covid restrictions in an attempt to return to normal © Justin Tallis / AFP via Getty Images

Tim Colbourn, professor of global health epidemiology at University College London, said “many politicians do not know what endemic means”, even though “there is a case to be made saying the worst is over”.

“That does not mean the severity will decrease,” he said. “Endemic usually implies a steady state of equilibrium without large peaks, so we are not really there yet. You could argue that the politicians who say that are doing wishful thinking. ”

Marc Van Ranst, a professor of virology at the University of Leuven, accepted that endemic is a broad, poorly defined and often misunderstood term, but it was also too early to say that the world has reached such a place.

“As long as Omicron is still present in such numbers, it causes massive illness, no matter how relatively moderate, and as long as it overloads the healthcare sector. . . we can and should not call it an ‘endemic situation’. Not yet, ”he said.

Nevertheless, countries including Denmark and England have moved to lift Covid restrictions in a attempt to return to normal, as hospital pressure remained low.

Graph showing the Danish government lifting all Covid restrictions as cases deviate from more serious outcomes in its Omicron wave

Denmark has dropped restrictions despite rising infection rates, driven by the Omicron subtype BA. 2, which health authorities estimate could be 50 percent more contagious than the original Omicron. The end of measures in England this week coincided with a halt in the sharp drop in fall rates this year.

Even Thailand, which until last summer pursued a zero-covid policy, took a preliminary step on Friday to treat the virus as endemic, as health officials set out guidelines on how to treat it within six months to a year like the to start treating flu virus.

David Heymann, a professor at the London School of Hygiene and Tropical Medicine, said England, where population immunity to vaccines and previous infections was more than 95 per cent, had effectively treated the virus as endemic since the summer.

“They transferred the risk assessment from the government to individuals, they provided rapid diagnostic tests that we could use or we could wear masks,” he said.

Experts also point out that just because a disease is endemic, does not mean it is not fatal – tuberculosis, malaria and HIV / Aids are all endemic and have killed millions. On the other end of the scale, everyday diseases such as flu are also classified as endemic.

Graph showing that Covid has gradually become less lethal during the course of the pandemic, mainly due to immunity, but it remains on average more dangerous than flu

“Endemic diseases. . . is just a disease that resides in human populations and continues to transmit until measures are taken to prevent it from being transmitted, ”Heymann said. “Tuberculosis is endemic, HIV is endemic – all these infections that came from the animal kingdom have become endemic.”

Omicron may seem less virulent, but its significantly increased portability compared to previous variants poses a challenge in the large number of hospital admissions it can cause, especially among the unvaccinated.

The mere fact that it has spread so rapidly could also hasten the emergence of new troublesome variants, the WHO and others have warned.

The WHO, which started using the term pandemic in March 2020, is considering moving from an “acute pandemic response to long-term, sustained Covid-19 disease control”. But since the task of the health body is global, any guidance should take into account the situation around the world, rather than in just some countries.

Denmark has dropped restrictions despite rising infection rates driven by the Omicron subtype BA. 2 © via REUTERS

François Balloux, director of UCL Genetics Institute, said the root of the problem is an understandable desire of people to go back to life – and as such it was no surprise that many elected officials were eager for the good news. to deliver what their constituents desire.

“There was a pattern of over-promising. . . we are all guilty of it because we want to believe in things, ”he said, as if“ vaccines would prevent the relatively long-term transmission, which intellectually we knew would not happen in a certain way ”.

Nelson Lee, professor of public health at the University of Toronto, predicted that Covid would not “become a disease that occurs continuously in a community” and would rather rise once or twice a year, similar to the way the influenza virus occurs.

“It will be like an epidemic. “It will come and go, depending on the evolution of the virus towards the combined immunity of the population,” he said.

No matter how coronavirus plays out, scientists have agreed that the endgame will finally come. “It’s pretty important to give an idea that there’s light at the end of the tunnel and that pandemics don’t last forever,” Balloux said.

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