How do we know a pandemic's over?

[dann]

Here is a little more from Maria Van Kerkhove's thread:

It’s marked by reduced impact compared to the peak of #COVID19 a few years ago, but it’s still a global health threat and it’s still a pandemic causing far too many (re)infections, hospitalisations, deaths and long covid when tools exist to prevent them.
COVID-19 Deaths - WHO COVID-19 dashboard
Maria Van Kerkhove (Twitter/X, Dec 31, 2023)

It’s marked by co-circulation of many other pathogens eg flu, mycoplasma, RSV, etc.
Cases and hospitalisations for #COVID19 have been on the rise for months. Hospitals in many countries are burdened and overwhelmed from COVID and other pathogens, and deaths are on the rise.
Maria Van Kerkhove (Twitter/X, Dec 31, 2023)

It’s marked by complacency. I will never accept that there is an “acceptable level of dearth” (something I’m asked) for #COVID19.
We are talking about people, parents, children, people who laugh, love, dream
I wrote this last March and this still applies

So where exactly are we now in the #COVID19 pandemic and where are we going?
Long thread
@DrTedros @DrMikeRyan @WHO
Maria Van Kerkhove (Twitter/X, Mar 11, 2023)

Maria Van Kerkhove (Twitter/X, Dec 31, 2023)

I recommend that you read the whole long thread, jt512!
I hope that it will help you understand not just what a pandemic is, but also what the current COVID-19 pandemic is!
I have explained it to you in the Science, Mathematics, Medicine, and Technology
thread, and I have explained it to you in this thread. Won't you at least listen to Maria Van Kerkhove, who has been put in charge of this by WHO?

 

[jt512]

I get the impression that you are just making it all up, all your claims and definitions, as you go along.

Well, I get the impression that you are a clueless, obsessed internet rando, so I guess we're even.

 

[dann]

Well, I get the impression that you are clueless, obsessed internet rando, so I guesw we're even.

I assume this means that jt512 won't answer my very simple question:

Where are those links and quotations to official representatives of those organizations stating "that Covid-19 is now endemic rather than pandemic"?

 

[jt512]

You're comparing hospitalisations to cases.

No. I am comparing hospitalizations to hospitalizations.

No they're not

The data you linked to showed that flu varies form year to year by a factor of 2. The data I linked to shoed that covid has varied by like 20 or 25% from this year to last. So, sorry, based on the available data, covid is actually more stable than flu.

The 2022 "summer" peak was mid-July. In 2023 in mid-July it was near a low point. The 2023 "summer" peak was in mid-September. That's not even summer.

I meant to write "late" summer, but left the word out. But regardless, the last time I checked, summer ends on September 21.

We're not done with this winter wave yet.

No, we are not. So either this winter wave will be on the same order of magnitude as the last two years, or it will exceed that. Given our current level of community immunity, I expect that this winter's wave will be on the order of magnitude of the last two winters'. If that prediction turns out to be wrong, I will be happy to admit I was wrong about covid being endemic. If it turns out to be right, what will your response be?

 

[Roboramma]

The definition offered by jt512 makes sense to me. Different diseases vary in their prevalence. It doesn't seem that "pandemic" refers to diseases that are high in prevalence, but diseases that are newly spreading through the world population. Once that spread is complete the number of cases may continue to rise and fall in waves within a certain range, but as long as they stay within that range, it doesn't make sense to continue to call the situation a pandemic, instead it's a new equilibrium situation. That's true regardless of the absolute value of the number of people infected by the disease at any one time.

Maybe it should be noted that this doesn't say anything specific about how much of a problem the disease is, what sort of interventions we should be investing in, etc. But the pre-equilibrium and post equilibrium situations seem different enough to be worth distinguishing, and that does seem to be what the terms pandemic and endemic disease do in this situation.

 

[icerat]

It doesn't seem that "pandemic" refers to diseases that are high in prevalence, but diseases that are newly spreading through the world population.

Then how have their been multiple influenza pandemics?

it doesn't make sense to continue to call the situation a pandemic, instead it's a new equilibrium situation.

What is in "equilibrium" here?

 

[dann]

I think there may be an equilibrium between, on the one hand, rising numbers of C19 hospitalizations and deaths, and on the other hand, a rising number of claims that this is perfectly normal and only goes to show that current pandemic policies are great and should remain in place unchanged.

 

[dann]

The definition offered by jt512 makes sense to me.

Pandemic: Definition.
We are now in the middle of the SARS-CoV-2, JN.1-variant, pandemic.

 

[dann]

Mask requirements are being reinstated. Long COVID studies and hearings are being arranged. Messages about clean air are being disseminated. All of this is a result of amazing grassroots advocacy, who have persistently pushed governments to do better for years. Advocacy works!
Dr. Lucky Tran (X, Jan 11, 2024)

Of course, nowhere near enough is being done. But it's important to note that progress is being made thanks to advocacy and activism. COVID is a long-term fight. And it's bigger than just COVID, this is about public health, and it's about equity and justice. Don't give up!
Dr. Lucky Tran (X, Jan 11, 2024)

Please get involved with a group doing grassroots advocacy work on COVID and Long COVID! Here's a great list to get started:

COVID Advocacy Initiative (Dec 31, 2023)
We started this list around a year and a half ago when people were reaching out to see how they could get involved in their area. It’s incredible to see the list has grown to 123 groups across the US and Canada!
http://bit.ly/covidadvocacygroups

Dr. Lucky Tran (X, Jan 11, 2024)

The thread mentions several places that are masking up again. And then there are all the usual disinformation trolls, of course.

 

[dann]

San Diego COVID-19, Influenza and RSV Numbers

Earlier San Diego posts: 366, 377, 387, 389, 397, 403, 433, 444.

The first numbers here (post 377):

COVID-19: Cases 25,164, Deaths 143, Outbreaks 219.
Influenza: Cases 3,028, Deaths 6, Outbreaks 1.
RSV: Cases 1,944, Deaths 2, Outbreaks 3.

The latest (= last week's) numbers (post 433):

Jan 4, 2024:
COVID-19: Cases 32,528, Deaths 181, Outbreaks 291.
Influenza: Cases 9,041, Deaths 14, Outbreaks 8.
RSV: Cases 3,651, Deaths 6, Outbreaks 6.
San Diego County Respiratory Virus Surveillance Report (San Diego County, Dec 28, 2023)

This week's numbers:

Jan 11, 2024
COVID-19: Cases 33,292, Deaths 194, Outbreaks 307.
Influenza: Cases 10,280, Deaths 18, Outbreaks 13.
RSV: Cases 4,033, Deaths 9, Outbreaks 7.
San Diego County Respiratory Virus Surveillance Report

So this week 1,239 more flu cases vs. only 764 more C19 cases, but still almost twice the number of C19 deaths (13) than flu deaths (4) and RSV deaths (3) combined (7).
Notice that counting for all three infectious diseases started at the same time, so it is not as if COVID-19 started with an 'advantage'.
At this point, San Diego still has Scandinavian (early) summer temperatures.

 

[Lithrael]

Well, I get that outside air as the control would give you a baseline for how many infections are acquired outside of the air quality experiment, but it stll sems like you'd expect even the best filtration to perform no better than that. So when the metastudy shows no significantly better outcome for filtered air than for exchanged air, what does that prove? Wouldn't you want to compare it to what happens in a building with typical hvac? Or is gathering that data unethical? If so, how on earth do you reach a conclusion about how effective filtration is?

 

[jt512]

A WHO-sponsored international body, tasked with preparing an international agreement on pandemic prevention, preparedness and response has defined a pandemic as "the global spread of a pathogen or variant that infects human populations with limited or no immunity through sustained and high transmissibility from person to person, overwhelming health systems with severe morbidity and high mortality, and causing social and economic disruptions, all of which require effective national and global collaboration and coordination for its control".
Pandemic: Definition (Wikipedia)

I just took a look at the Wikipedia "Pandemic" article that you got the above quote from and I now understand why you are confused. You cherry-picked a non-standard definition of pandemic and ignored the standard, dictionary definition—"an epidemic occurring on a scale that crosses international boundaries, usually affecting people on a worldwide scale"—right above it, which defines a pandemic (as I do) in terms of an epidemic. If we then look up "epidemic" on Wikipedia, we get the standard definition: "Epidemic refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area."

That is exactly the definition I am using. The key point is that an epidemic is an above-normal level of a disease. Thus, whether we are still in a Covid-19 pandemic rests on whether the level of the disease we have observed over the past two seasons is now the normal level. I think it is for reasons I have repeatedly stated. Anyone who thinks we are still in a pandemic bears the burden of explaining why the current level of Covid is still elevated. As I have explained, I don't see anything short of the rollout of a sterilizing vaccine causing a future reduction in incidence, and a pandemic is not defined in terms of the lack of a sterilizing vaccine.

 

[dann]

I am not at all confused, but I can see why you would like to think so.
I can also see that you would like to make it seem as if the current pandemic didn't just exhibit a sudden increase "in the number of cases of a disease above what is normally expected in that population in that area." That area being the world, in this case.

The irony is that the people who are adamant that the SARS-CoV-2 pandemic is no longer a pandemic also tend to be the ones who were taken aback by the current increase in the number of cases and the ones who have been claiming that COVID-19 is no longer any worse than the flu.

Have you found those links and quotations I've been asking you about for several weeks now?
You know, the links to official representatives of the U.S. CDC, WHO and ECDC stating "that Covid-19 is now endemic rather than pandemic."
My question is very simple in order to avoid any confusion.
The answer should be just as simple: yes or no.

 

[icerat]

Thus, whether we are still in a Covid-19 pandemic rests on whether the level of the disease we have observed over the past two seasons is now the normal level.

Simply fact is, as I said earlier, that there is no clear definition of what a pandemic is, and when it ends.

But I will say, do you really think defining "normal" based on two data points (ie 2 "seasons") is a remotely robust approach?

 

[jt512]

Simply fact is, as I said earlier, that there is no clear definition of what a pandemic is, and when it ends.

Sure there is. It is the one I quoted. You admit as much here:

But I will say, do you really think defining "normal" based on two data points (ie 2 "seasons") is a remotely robust approach?

Well, once again: what, short of a sterilizing vaccine will cause the incidence to go down? Answer the damn question already; and, if you can't, consider that this is as good as it's going to get.

And, FWIW, I'm not the only voice saying that the pandemic is over. See, for instance, https://www.unc.edu/discover/covid-19-has-become-endemic/.

 

[dann]

Life expectancy across the UK has fallen to its lowest level in a decade, mainly owing to the impact of the coronavirus pandemic, data shows.
Boys born between 2020 and 2022 can expect to live to 78.6 years, a decrease of 38 weeks compared with the same measure between 2017 and 2019. For girls, the expectancy for the same period was 82.6 years, having also fallen by 23 weeks compared with 2017 and 2019
UK life expectancy falls to lowest level in a decade (TheGuardian, Jan 11, 2024)

38 weeks and 23 weeks! Astonishing, isn't it?
At least, it should astonish people who make claims like this:

Covid has only been killing people with a toe-tag already ordered for a couple of years now.

But maybe they order them years in advance in NZ.

I doubt that the lifespans of children exposed to repeated SARS-CoV-2 infections will be shortened by only a couple of years, but I guess we won't live to see it.

 

[jt512]

I am not at all confused, but I can see why you would like to think so.

You are deeply confused. So confused that you don't realize that the definition of pandemic that you are going by is non-standard, and that even by that definition, we are no longer in a pandemic. That's pretty confused.

I can also see that you would like to make it seem as if the current pandemic didn't just exhibit a sudden increase "in the number of cases of a disease above what is normally expected in that population in that area." That area being the world, in this case.

Well, I haven't seen that data, although, admittedly, I have been focused on the country I live in, the US. Did you have some data you wanted to share?

The irony is that the people who are adamant that the SARS-CoV-2 pandemic is no longer a pandemic also tend to be the ones who were taken aback by the current increase in the number of cases and the ones who have been claiming that COVID-19 is no longer any worse than the flu.

Whether that is true or not, it has nothing to do with whether or not we are still in a pandemic. Only the data the definition of pandemic do.

Have you found those links and quotations I've been asking you about for several weeks now?
You know, the links to official representatives of the U.S. CDC, WHO and ECDC stating "that Covid-19 is now endemic rather than pandemic."
My question is very simple in order to avoid any confusion.
The answer should be just as simple: yes or no.

I haven't looked, but I did, above, post a link to a UNC-Chapel Hill article titled "COVID-19 has become endemic," which, quoting Dr. David J. Weber, who is the associate chief medical officer and medical director of infection prevention at UNC Medical Center, the Charles Addison and Elizabeth Ann Sanders Distinguished Professor of Medicine and Pediatrics in the School of Medicine, and a professor of epidemiology in the Gillings School of Global Public Health, says, "We have passed the pandemic phase [of Covid-19], it’s safe to say, and entered what we call an endemic phase."

For your convenience, here, again, is the link: https://www.unc.edu/discover/covid-19-has-become-endemic/

 

[dann]

And, FWIW, I'm not the only voice saying that the pandemic is over. See, for instance, https://www.unc.edu/discover/covid-19-has-become-endemic/.

Nobody said that you were the only voice. There are far too many of those voices.
However, Dr. David J. Weber is far from being a minimizer:

COVID-19 is still having a big impact. Even with dramatic decreases in cases, we’re losing more than 100 people a day to this virus in the U.S. In the most recent week for which I have data, about 850 people died. You are more likely to die of COVID today than you are from a car crash or gun violence. You can’t watch a nighttime newscast without hearing about both of those, yet more people are dying of COVID. When was the last time you heard a story about that or the number on the news?

So kudos to the doctor for that!

But you are the one who claims that official representatives of the U.S. CDC, WHO and ECDC have stated "that Covid-19 is now endemic rather than pandemic."
Am I right in assuming that you post a link to The University of North Carolina at Chapel Hill because you are well aware that official representatives of the U.S. CDC, WHO and ECDC never said what you claimed they did?

 

[icerat]

Sure there is. It is the one I quoted. You admit as much here:

No, because there's no criteria to determine "normal"

Well, once again: what, short of a sterilizing vaccine will cause the incidence to go down? Answer the damn question already; and, if you can't, consider that this is as good as it's going to get.

So you define "normal" as, in effect, any level of incidence that's not close to eradicated?

And, FWIW, I'm not the only voice saying that the pandemic is over.

Never said you were. It's been getting declared over here in Sweden since July 2020.

 

[dann]

I haven't looked

Why do you even have to look?
You first claimed that the three organizations themselves had said that the pandemic was over and when I posted links to two of them saying the opposite and also couldn't find anything from the third organization saying that the pandemic was over, you doubled down and claimed that official representatives of the organizations had said that the pandemic was over. You should be able to just tell us where you heard them say so. It's a very simple request.

It isn't difficult to find somebody else saying it. I could easily find those myself.

What is so confusing about this?!