Covid Becoming Endemic


We’re learning new epidemiology terms. An epidemic is a sudden increase in the number of cases of a disease in a particular location. As Covid-19 began spreading in Wuhan, China, it became an epidemic.

An epidemic becomes a pandemic when that disease spreads across several countries and affects a large number of people. Covid-19 was declared a pandemic by the World Health Organization on March 11, 2020. They announced the number of cases outside China had increased 13-fold and the number of countries with cases had increased three-fold.

Lastly, a pandemic becomes endemic when a disease outbreak is consistently present, but limited to a particular region. For instance, malaria is considered an endemic in certain countries and regions, such as Africa. Influenza is endemic in the U.S., as well as the coronaviruses responsible for the common cold.

Could Covid-19 become endemic in the U.S. in the near future?

In an article published in Nature in January, almost 90% of infectious-disease researchers and virologists surveyed believed the Covid-19 virus will become endemic – meaning it will continue to circulate in pockets of the global population for years to come. “Eradicating this virus right now from the world is a lot like trying to plan the construction of a stepping-stone pathway to the Moon. It’s unrealistic,” says Michael Osterholm, an epidemiologist at the University of Minnesota in Minneapolis.

More than one third of the respondents to Nature’s survey thought that it would be possible to eliminate SARS-CoV-2 (Covid-19) from some regions while it continued to circulate in others. “The virus becoming endemic is likely, but the pattern that it will take is hard to predict,” says Angela Rasmussen, a virologist from Georgetown University.

This survey was taken in January, 2021, and published in February, 2021. What about today? In August, former Food and Drug Administration commissioner, Scott Gottlieb, M.D., said “We’re transitioning from this being a pandemic to being more of an endemic virus, at least here in the United States and other Western markets. This is going to become more of an endemic illness where you see sort of a persistent infection through the winter, but not at the levels that we’re experiencing certainly right now.” He said booster shots will play a role in getting the U.S. to that phase, as will the Delta variant.

What does this mean for those of us living in the U.S.?

Consider how we are living with other endemic diseases. For the common cold, we take essentially no precautions whatsoever, apart from possibly staying at home from work or school, when it is at its peak. Most people don’t even do that. The reason is the common cold is self-limited and causes essentially no lasting effects. Few people die from this disease, except for those with severely compromised pulmonary conditions or immune systems, who then contract fatal other diseases like pneumonia.

For influenza, which is significantly more life-threatening, few people take more precautions than the common cold. The rates of influenza vaccination are only about 40% in the general population and 60% in the vulnerable, high-risk population. However, about 40,000 Americans die of this disease in an average year. It is interesting to note that the number of influenza deaths in 2020 was significantly lower, possibly due to the precautions imposed upon the population in response to Covid-19, or possibly under-reporting of influenza fatalities in the hysteria over Covid-19.

If we are looking for a silver lining in this cloud, it may be that more Americans will realize the importance of vaccinations for both Covid-19 and influenza in the coming years and will therefore lower the incidence of both. If you fail to get vaccinated, you are accepting the risks of both of these diseases. But the government and society never required extreme measures such as mask mandates, closed schools, vaccination passports, and social distancing for these other endemics, and it’s time to stop them for Covid, too.

We have learned to live with influenza for many years and we can do the same with Covid-19. My advice is to get vaccinated for both if you are able – or take necessary precautions like extra attention to hand-washing, avoidance of crowds, and possibly masking in close quarters. But that’s necessary to protect you – not your neighbor. Let your neighbor get vaccinated, or take his own precautions. It’s time to get on with life before the Covid pandemic just like we used to do with influenza – only smarter.