Year 2, Week 49: The Endemic Pandemic That’s Changing Our World

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Tuesday, Feb. 22, 2022

Endemic is the word of the week. You see it everywhere. Australia is opening up its borders, California has a new endemic policy. Denmark lifted all its COVID restrictions. Just yesterday, Britain removed all COVID restrictions.

Dr. Matshidiso Moeti, the head of WHO in Africa, announced that the continent is moving out of the pandemic phase into a phase of planned long-term management, “a kind of endemic living with the virus.” The Center for Strategic & International Studies stated that their Southeast Asia Data Tracker will close down on February 28, 2022, “as the regional governments embrace a new normal of living with Covid-19.”

Endemic is what we want the pandemic to become. COVID-19 is going to stick around, but hopefully it will soon meet the criteria in the definition above by becoming predictable and low frequency, at least in the sense of causing hospitalization and death. Perhaps by figuring out new, more sustainable ways to deal with the disease, we can go on with our lives in a more predictable, less disrupted manner. Right now countries and states are changing the ground rules–for schools, for concerts, for the office, for tourism. They aren’t consistent, and maybe they never will be.

Neither predictable nor low-frequency

But COVID is not endemic. We still cannot predict the rate of occurrence or death rate or the rise of new variants. Consider the graph above, which shows daily confirmed COVID deaths per million people. Two years ago, even as we were working on vaccines, we had no idea that a series of new more contagious variants would lead to a series of unpredictable non-seasonal surges. We are still in an era of uncertainty today.

I see two threads to watch going forward. One is the virus itself. How is it going to change? The second is the pandemic impact: How is the virus going to change our world?

Here are some outcomes we need to look out for:

1. How will the virus change itself? STAT recently published an article listing four directions the virus can take, and they are by no means mutually exclusive nor are they the only possibilities. Here they are, much shortened and oversimplified:
   1. Covid-19 may become milder and morph into one of the common cold coronaviruses (CCC).
   2. The virus may evolve to affect different organs and cells, leading to a disease that is worse. Or better.
   3. The virus may exchange DNA with coronaviruses that infect animals, leading to a new and different disease in humans.
   4. The virus may evolve to exploit our own immune system by using the antibodies we have developed from exposure as a gateway into cells with antibody receptors, in a process called “antibody-dependent enhancement.”

1. How will the virus change our world? Here, I must draw on issues I have observed, since there is no one article neatly spelling them out for me.
   1. Economic impact: supply chain disruptions, empty office buildings, global labor shortages. People have lost jobs, moved away, changed lifestyles.
   2. Health impact: Long COVID, other illnesses going untreated
   3. Environmental impact: increased use of disposable items: plastic shopping bags, test kits, gloves, masks, vaccination refuse (billions of syringes, gloves, glass vials).
   4. Psychological impact: on both adults and children, due to isolation, loss of jobs, being unable to hold a loved one’s hand even at their death, being kept from weddings and funerals, until the social glue that holds us together is gone.
   5. Organizational impact on churches, volunteer organizations, and organizations that rely on volunteers. People that once greeted each other with smiles and hugs feel unattached after two years of Zoom, if they stuck it out that long. I know I didn’t. The WSJ had an article this morning: “More Pulpits Empty in Difficult Times.”
   6. Social impact: Mandate wars, blaming each other for the decisions we’ve made in these unprecedented times.

The pandemic has changed our world, for the short term and for the long term. Think of it as you see news coverage about low inventories, labor shortages, and delayed treatment. The ripple effects will be with us for a long time.

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Infectious Waste

Labor shortages

Today’s Notable Headlines

“In warning to U.S., COVID rates soar after Denmark lifts all restrictions,” Yahoo!News, Feb. 16, 2022. https://news.yahoo.com/in-warning-to-us-covid-rates-soar-after-denmark-lifts-all-restrictions-183342093.html

“Britain drops last remaining COVID-19 restrictions, will treat it like the flu,” The Globe and Mail, Feb. 21, 2022. https://www.theglobeandmail.com/world/article-britain-drops-last-remaining-covid-19-restrictions-will-treat-it-like/

“Africa transitioning out of pandemic phase of COVID: WHO,” Aljazeera, Feb. 10, 2022. https://www.aljazeera.com/news/2022/2/10/africa-transitioning-out-of-pandemic-phase-of-covid-who

“COVID pandemic’s ‘acute phase’ could end by midyear: WHO,” Aljazeera, Feb. 11, 2022. https://www.aljazeera.com/news/2022/2/11/pandemics-acute-phase-could-end-by-midyear-who-chief-says

“Australia fully re-opens borders after two-year Covid-19 closure,” France 24, Feb. 21, 2022. https://www.france24.com/en/asia-pacific/20220221-australia-fully-re-opens-borders-after-two-year-covid-19-closure

“California adopts nation’s 1st ‘endemic’ COVID-19 policy; Could NY be next?” ABC7, Feb. 20, 2022. https://abc7ny.com/endemic-shift-california-new-york/11578301/

“Coronaviruses are ‘clever’: Evolutionary scenarios for the future of SARS-CoV-2,” STAT, Feb 16, 2022. https://www.statnews.com/2022/02/16/coronaviruses-are-clever-evolutionary-scenarios-for-the-future-of-sars-cov-2/

“COVID-19 has caused a surge in medical waste. Here’s what needs to be done,” World Economic Forum, Feb. 17, 2022. https://www.weforum.org/agenda/2022/02/medical-waste-plastic-environment-covid

Additional Sources

“Southeast Asia Covid-19 Tracker,” CSIS, https://www.csis.org/programs/southeast-asia-program/projects/southeast-asia-covid-19-tracker

Daily new confirmed COVID-19 deaths per million people, Feb. 20, 2022. https://ourworldindata.org/explorers/coronavirus-data-explorer

Why am I doing this?

The coronavirus pandemic will be written on our memories just as the 1918 Flu Pandemic, the Great Depression, or the Cold War left their mark on past generations. Since March 11, 2020, this blog has examined the modern pandemic experience both in the media and in everyday life, drawing on my experience as a medical technologist, a historian, and an ordinary person living through an extraordinary world crisis.