When will this pandemic end?
All of us have asked this question countless times since March 2020 when the World Health Organization declared COVID-19 disease a pandemic. Now after two years, a growing number of experts say the disease might soon cease to be a pandemic – at least in parts of the world. It is likely to enter the endemic stage.
What do ‘pandemic’, ‘epidemic’, and ‘endemic’ mean?
The words pandemic, epidemic, and endemic describe the prevalence of a disease. The usage of one of these words for a disease depends on how widespread it is.
A pandemic is broadly believed to occur when a disease spreads across countries or continents, often at a very fast speed in a way that new infections are reported daily.
There are six stages of the development of a pandemic, according to WHO.
- A virus circulates among animals not known to spread the disease to humans.
- The virus is found in animals known to have spread diseases to humans.
- Animal-to-human contact causes a human to develop the disease.
- Human-to-human contact makes it clear a community outbreak could happen.
- Human-to-human spread happens in at least two countries in the same region.
- Community level outbreaks happen in a third country in another region.
The sixth phase means that a pandemic is occurring, according to WHO.
An epidemic means a disease is unexpectedly and quickly spreading across a geographical area. Its prevalence is lower than that of a pandemic, which means that if a disease is spreading across South Asia, or in India, it will be an epidemic, but if it’s spreading in the larger Asia region or the world at large, it will be considered a pandemic.
Please refer to this graphic by the non-profit Wellcome Trust to understand it.
An endemic disease is one that is constantly present in a region or a population. Its spread is limited to this region or population and the larger region or the world at large is not affected by it. The examples include malaria and cholera that continue to be there in some parts of the world but are not found in several other parts of the world and are not a concern there.
What does it mean for COVID-19 to become ‘endemic’?
As more and more people gain immunity against the virus, either through recovery from an infection or through a vaccine, the hold of the virus over those people and regions will wane.
This means that people and places with higher vaccination and better healthcare – the developed world and the better-off developing world – would be the first to exit the pandemic stage of COVID-19. For example, it has been said in the United Kingdom for months that the end of the pandemic is in sight.
Julian Hiscox of University of Liverpool told BBC in January, "We are almost there. It is now the beginning of the end, at least in the UK. I think life in 2022 will be almost back to before the pandemic."
The endemic stage would mean living with COVID-19 just like any other disease such as flu, malaria, or dengue. This endemic disease would be consistent and within predictable levels, unlike what BBC calls “boom and bust” coronavirus waves that we have seen in the last two years.
Endemic COVID-19 would not necessarily make lives easier
A disease does not become more or less severe with its classification as a pandemic or endemic. These words only refer to how widespread it is, not how severe it is.
Malaria is an endemic disease and yet it kills around 6 lakh people a year, according to estimates.
Moreover, COVID-19 is believed to become endemic to lesser developed regions and poorer communities who have improper access to healthcare and vaccines, as the developed world and better-off communities would be the first to exit the pandemic stage with vaccination and better healthcare availability.
This prolonged prevalence of COVID-19 in poorer sections would increase their hardships as they already face multiple endemic diseases such as malaria and dengue.
For them, the classification to endemic stage would bring little relief. Moreover, some experts have said as coronavirus becomes endemic, flu seasons even in the developed world are likely to become COVID seasons and such phases would have to be carefully dealt with.