THE DOCTOR IS IN / OP-ED BY DR. ADIL MANZOOR
Every time there is a health emergency, scientists always come up with technical names to qualify them. We all know that the WHO declared the coronavirus a pandemic in 2020. Now, there are talks of it being endemic. It gets difficult to catch up to what these terms really mean at times. Let me start by breaking that down.
There are typically three terms that describe how widespread a disease is, which usually offers a good indication of how seriously it should be taken. The first is epidemic. According to the CDC, an epidemic is an unexpected increase in the number of disease cases in a specific geographical area. The disease doesn’t even have to be contagious. An example is the Ebola virus that terrorized some regions of Africa some years back.
The next on the list is pandemic. You must be familiar with this, considering the coronavirus is one. WHO declares a pandemic when a disease’s growth is exponential, and the virus covers a wide area, affecting several countries and populations. COVID is a perfect example of what a pandemic looks like.
Finally, an endemic – the whole point of this article. An endemic occurs when a disease is consistently present but limited to a particular region, like the flu. Health experts can predict the patterns of spread of the disease and the rate with which it spreads. Note that the difference between these three isn’t the severity but the degree of spread. Usually, however, when a disease occurs in several different locations at a time, it requires the utmost level of attention.
With that out of the way, will there be an endemic stage of the coronavirus? If you were expecting a simple answer, you’re going to be disappointed. Scientists cannot seem to agree on whether the coronavirus pandemic will ever become endemic. Many experts have predicted for the coronavirus a similar path as the seasonal flu. While there is no crystal-clear cut definition of an endemic, a disease will be regarded as one when it doesn’t disrupt everyday life to the same degree as epidemics and pandemics. Also, when the disease’s spread pattern and rate is predictable, it is classified as endemic.
Some health experts believe this will be the eventual fate of the coronavirus, especially in light of the increasing immunity, either through vaccination or previous infection. Then, scientists on the other side of the spectrum believe the coronavirus will always be an epidemic virus, not an endemic one. This assertion is informed by trends the virus has displayed over the last few months.
There’s a formula biosecurity scientists use to assess how quickly a disease is spreading – R0. If a disease’s R0 is greater than 1, growth is exponential. And if growth remains exponential, the disease will hover around the epidemic range with recurrent epidemic waves. Considering the coronavirus is around this range, it is plausible to imagine it will remain this way for a very long while.
I think I mentioned waning immunity already as one of the important factors in play, but at least that can be controlled. What we have no real say in is the emergence of new variants. Omicron made a mockery of double vaccinations. And the WHO has warned the next variant of the virus will be even more contagious than Omicron.
Both schools of thought are valid, and I cannot really say for sure which is better, although I am more inclined towards it eventually being endemic. In any case, note that endemic doesn’t mean good – not at all. People will still die. Cases will still be occurring. If anything, it means it will be here with us forever. However, that’s still the best-case scenario for the coronavirus.
In the middle of all the uncertainties, one sure thing is that vaccines are our way out. We may even need a fourth dose soon, but that’s a story for another day. Stay safe.
This article was written by Dr Adil Manzoor DO, a Board Certified Internist & Board Eligible Pediatrician, who works as a Hospitalist, and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his unique medical practice Mobile Medicine NJ.
References
- https://www.cnbc.com/amp/2022/02/02/covid-will-never-become-an-endemic-virus-scientist-warns.html
- https://www.today.com/today/amp/rcna15315
- https://www.cnbc.com/amp/2022/02/24/moderna-says-covid-is-entering-an-endemic-phase-but-annual-vaccines-will-be-needed.html
- https://www.publichealth.columbia.edu/public-health-now/news/epidemic-endemic-pandemic-what-are-differences
