For Topol, that judgment must be based on the trajectory of the pandemic. “I look at where we were in the summer of 2021: we were down to 12,000 cases [diarios] in the US and deaths were just over 200,” he says. “If we stayed there,” Topol says, he would feel comfortable declaring the pandemic phase over. “But we’re nowhere near that.” Topol also fears the new variants may cause another wave of cases and hospitalizations that allow the pandemic to be prolonged.
For Lone Simonsen, an epidemiologist at the University of Roskilde (Denmark), the seasonality of the outbreaks, in addition to the lower number of deaths, could help indicate when the pandemic could end. If the number of cases spikes in the summer, when the virus has fewer chances to spread, “we’re still in the pandemic phase,” she says. That was the case in 2021, when cases were driven by the Delta variant, and this past summer with Omicron. So for Simonsen, wait and see.
But Denmark, Spain and other European countries with high vaccination levels lifted most pandemic mandates and restrictions months ago, as COVID-19 has not caused serious illness or overwhelmed hospitals. However, long-standing COVID remains a concern, Simonsen says. And no country has officially declared the end of the pandemic.
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Amesh Adalja, an infectious disease specialist at the Johns Hopkins University Center for Health Security, argues that the global pandemic phase is largely over, given that hundreds of millions of people have already been infected by the virus, that there are vaccines and treatments that can prevent severe disease and that COVID-19 is unlikely to completely disrupt the healthcare system as it once did. “It doesn’t mean that suddenly things go back to the way they were in 2019. It doesn’t mean that COVID-19 goes away and all the action stops,” she says. “It means that there is going to be a not very high reference number of cases, hospitalizations and deaths.”
What those acceptable levels of hospitalizations and deaths might be is a political decision, asks David Heymann, an infectious disease epidemiologist at the London School of Hygiene and Tropical Medicine in the United Kingdom and a former head of the WHO’s communicable diseases group.
Say it’s over when it’s not
Nuzzo and others worry that statements like the pandemic is over could be a disservice.
With the launch of a specific Omicron booster in the US, “I’m really concerned that this sends a signal to millions of Americans who are at risk of serious illness that they don’t need to be boosted,” says Nuzzo. “That’s very, very unfortunate.”
It is also concerned that these statements could lead to further reduction in access to free COVID-19 testing and treatment, especially for people without health insurance.
Topol is concerned that it could also undermine the motivation and funding to accelerate the development of better COVID-19 vaccines and treatments, endangering the health of millions of people who are immunocompromised or at risk of developing long-term COVID.
This is not the time to make bold claims about the end of the pandemic, he says. “But it is time to be bold to accelerate to a point where we can say: we’ve done it, we’ve done it.”