Moving from a pandemic to an endemic disease

World Health Organisation’s (WHO) deputy director-general Sowmya Viswanathan had hinted at the fact earlier this year that COVID-19 or SARS-CoV-2 would transform from being a pandemic into an endemic disease. Other medical experts, especially from Western countries, are talking about it now. As the outbreak of COVID-19 in December 2019 is now racing towards the two-year milestone – there have been many who continue to suspect that it had surfaced as early as November, 2019 in China and that Beijing had made it public in December 2020 when it persisted and the numbers grew – when China and the WHO took note of the outbreak, and though WHO declared it a pandemic only at the end of January 2020, medical researchers and epidemiologists are taking the long-term view. Call it COVID-19 fatigue. The medical experts however feel that there would be a winter surge, especially in the West, but that in the course of 2022, COVID-19 would settle down as an endemic, seasonal fever. They also feel that the third booster shot of the COVID-19 now being recommended could soon become an annual shot, akin to the flu shot.

The fear is there in the minds of the Western experts that if the flu and COVID-19 were to occur in the winter either this time or from the end of next year onward then the health systems could be under great pressure. It had become evident how frail the health care systems in the rich Western countries have turned out to be at the peak of COVID-19 in 2020 and in the earlier part of this year.  The experts are however certain that the reason that the tide of COVID-19 has been pushed back is due to the vaccines that had emerged last December in a record short period of less than a year, and as vaccination had proceeded at a brisk pace, the greater spread of the pandemic had been prevented.

The damage had been immense with the death of five million people worldwide in the last two years, and the resurgence of the second waves in these two years. There has been a surge in COVID-19 despite vaccination in countries like China and Singapore, and in countries like Russia and Romania due to inadequate vaccinations. The surge in the United States has been mainly confined to populations that had resisted vaccination. The doctors and the researchers are now convinced that the Delta variation of COVID-19 has been dealt with. But they are not sure whether the existing vaccines would be effective if there are further mutations of the coronavirus, and whether this would necessitate changes in the COVID-19 vaccines as is being done now in the case of the flu shots.

This would require constant monitoring of the virus and the constant updating of the vaccines. What is now an indubitable fact is that the coronavirus is here to stay and there cannot be any talk of wiping it out. We must keep pace with its mutations and produce the vaccines as required.

Two issues have slightly receded into the background. First, it is becoming increasingly clear that it is becoming more difficult than ever to trace the origins of COVID-19 unless Chinese authorities share more information. Second, the outbreak of new viruses cannot be ruled out as it had happened in the case of SARS-CoV-1 around 2003 and SARS-CoV-2 in 2019, and that this is the medical challenge of the 21st century as tuberculosis had been in the 19th and early 20th centuries, and polio in later 20th century. There has been speculation about the emergence of viruses like the corona due to environmental degradation and deforestation. But until clear evidence is established, it will remain a speculative question.