COVID-19 will now be an endemic pandemic

As COVID-19, the most widespread pandemic to have hit the planet, enters its fourth year, there is hope that we are nearing the end of this public health threat.

So far, we had deployed the Orwellian dictum of “ignorance is strength” to manufacture a delusional end to the outbreak. “The Mahabharata war was won in 18 days. The war that the whole country is now fighting against corona will take 21 days,” Prime Minister Narendra Modi said on March 25, 2020, a day after declaring the world’s most stringent national lockdown to curb the spread of COVID-19.

Then in September 2022, US President Joe Biden declared, “The pandemic is over.” In between these two statements, the virus killed more than 6.5 million people.

It is not done yet; in the week from November 7 to 13, some 2.3 million new cases were reported worldwide, with over 7,400 deaths. When will this end? By now, everyone wants a definitive answer to this question.

But what will the world feel like without the pandemic—will it bring sighs of relief or another unimagined situation?

Read Down To Earth’s 3-year coverage of COVID-19

One thing is for sure, the virus will not go away. And the science vouches for it. It will continue to do its duty of looking for hosts, even if it does not intend to kill them.

So, experts are now visualising another scenario: the pandemic will reach endemicity. This means COVID-19, with its ever-evolving strains and variants, will continue to hit a particular region and population groups in regular episodes. Such an endemic situation, as experts always say, is “manageable”.

We have been living with several disease-causing viruses that once triggered pandemics. But how much can one “manage” an infectious disease in this globalised world?

The ongoing pandemic is a living example of how quickly one virus can cause a global emergency. Given the geographical spread of COVID-19, even if the virus causes localised and seasonal outbreaks in an endemic scenario, it would be as widespread as the pandemic and cause a significant health emergency.

Countries would continue to report thousands of cases in periodic outbreaks as they report now, with occasional fear of the virus getting out of control. This would require the same level of healthcare attention that is being needed now, and countries would remain invested in managing this viral infection.

Local and community-level quarantines and lockdowns would continue. Significant population groups would remain in morbid condition, which would affect their work hours and lead to an overall loss of earnings.

Moreover, there would be many new strains and variants developing in endemic phases as well. This year, when Omicron led to a wave, there was a sense of relief that it was a mild one; it was highly infectious but did not kill many people. Latest data, however, shows that Omicron has already killed more people than the dreaded Delta variant.

The pandemic might end, but it will leave a trail of illnesses that are already turning out to be crippling: long COVID or symptoms continuing for months after recovery.

According to estimates, the world might have close to 200 million people with long COVID. This effect of the pandemic, which is not much understood, will show up even in endemic phases.

This means a vast population will be in a morbidity phase for a long time after they have recovered from COVID-19, which will affect overall well-being, livelihood earning capability and add to their healthcare expenses. Eventually, an endemic COVID-19 will add to the world's burden of diseases.

This was first published in the 1-15 December, 2022 edition of Down To Earth

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