How do we know a pandemic's over?

[crackers]

I am immunocompromised, so I am quite happy to continue wearing a mask until I am the only person I see wearing one.

 

[dann]

Skyrocketed! Wow, must be really bad.

So let's have a look at that skyrocket, shall we?

I already gave people "a look at that skydrocket", but feel free to ignore it: ...the death toll skyrocketed... (Our World in Data)
But instead of looking at the actual numbers, The Atheist finds an article that was a lie even when it was published a couple of months ago since the numbers began to skyrocket in early November, not coincidentally six weeks after Denmark declared that Covid-19 was no longer a disease that threatened society, and 'living (i.e. dying) with Covid' began, The Atheist's favourite 'strategy': Daily new confirmed COVID-19 deaths per million people: Denmark (Our World in Data)

A majority of Danes believed that the change in attitude meant that the pandemic was over, but for some reason the death toll has never been higher than it is this month in spite of Denmark's level of vaccinations (Our World in Data). The numbers make it obvious that vaccinations and Omicron did not put an end to the pandemic. On the contrary! Used as an excuse to let it rip, they contributed to making the pandemic worse.

What's a good source? SSI maybe? The State Serum Institute of Denmark, the official body on the matter, has this to say: “typical misinformation about (Danish) Covid-19 numbers”
Specifically:
Bolding mine.

The State Serum Institute of Denmark used to be a reliable source of information about SARS-CoV-2 in Denmark. Unfortunately, that stopped when Denmark switched to the herd-immunity-by-(Omicron)-infection strategy. That was the point when it suddenly became awfully important to distinguish between with and of. And at this point, testing is being scaled down, which makes the number of hospitalizations and the death toll much more reliable than the number of new confirmed cases: Daily new confirmed COVID-19 cases per million people The numbers seem to be declining rapidly, but that is the Trumpian way: If you stop testing, the numbers go down! The percentage of positive cases today was 22.7.

That is priceless, you used Rebecca Watson as a source.

Legend.

I didn't use Rebecca Watson as a source of information about the pandemic strategy of Denmark or the current death toll from Covid-19, but I am not surprised that The Atheist, ISF's resident advocate of the idea that Omicron and vaccinations made the virus benevolent, seems to think so. And why look at the available data when one can google an old article that seems to confirm one's bias, right?
It's what he does.
Rebecca is a fountain of sensible advice and information in comparison to The Atheist.

But let's ask The Atheist a simple question: Does it look as if from week 1, 2022, mortality from Covid-19! has decreased in Denmark and now approaches the normal and expected level?
The current number of new Covid-19 infections and the death toll in Denmark are only 'normal' to people who don't give a damn about people's lives and health because their only worry is their stocks and bonds. Don't look up!

 

[dann]

A Danish epidemiologist, Lone Simonsen, celebrating Omicron infection as immunization:

Vaccineret + smittet = superimmunitet
Når en pandemi ender, betyder det altså ikke, at virus forsvinder. Det betyder, at immunitet bygger sig op. Det kan vi blandt andet se i den nuværende coronapandemi, fordi vaccinerne virker.
Det er første gang i en pandemi, at vi opbygger en masse immunitet via vacciner.
Nu har vi så en omikron-booster infektion oveni, så vi har betydelig og robust immunitet i den danske befolkning mod fremtidige varianter.
Den spanske syge er et pragteksempel på, hvordan pandemier ender (Videnskab.dk, March 14, 2022)

Vaccinated + infected = superimmunity
When a pandemic ends, it does not mean that the virus disappears. It means that immunity builds up. We can see this in the current corona pandemic, among other things, because the vaccines work.
This is the first time during a pandemic that we are building a lot of immunity through vaccines.
Now we have an Omicron booster infection on top, so we have significant and robust immunity in the Danish population against future variants.
The Spanish flu is a splendid example of how pandemics end

Notice that she entirely ignores the current post-vaccination death toll from Covid-19 along with sequelae. The more obvious it becomes that the vaccines don't prevent infection and don't prevent hospitalizations and death, the disease itself is treated as a vaccine. If only your faith is strong enough, the Omicron infection becomes something to look forward to - to the extent that health authorities feel compelled to warn people that 'Covid parties' may not be as good an idea as this particular ******* along with many others make it sound.

Not to mention the question: What exactly is this new Omicron-induced super immunity supposed to protect us from?! Wasn't it supposed to be over now?

 

[The Man]

I am immunocompromised, so I am quite happy to continue wearing a mask until I am the only person I see wearing one.

Yep, same here, as is Moebob. I stopped in a fast food restaurant to get some lunch the other week. The counter person says to me (through her mask), "Oh, you don't have to wear a mask in here". I reply "But I like my mask, it's a nice mask" and she agreed (got a drawing of Guy Fawkes' features on it).

 

[bignickel]

When the fatality rate of Covid is the same, or less than, the flu, then I'll consider the Pandemic to be over.

 

[The Atheist]

I already gave people "a look at that skydrocket", but feel free to ignore it:

Covered in the piece I linked, and the only person ignoring anything is you ignoring the obvious. There are ~150 deaths a day in Denmark - that is the base rate. When you have very widespread infection, a lot of those people croaking will test positive for covid.

This is why the overall death rate is a lot more important than the covid number.

On the contrary! Used as an excuse to let it rip, they contributed to making the pandemic worse.

Thank christ nobody comes here any more, because you're propagating nonsense.

If the pandemic was "worse" more people would be dying in Denmark, and that isn't happening.

If you want to disagree, instead of blithering, show me where the baseline death rate for Denmark is higher now than usual.

The State Serum Institute of Denmark used to be a reliable source of information about SARS-CoV-2 in Denmark. Unfortunately, that stopped when...[\QUOTE]

They stopped agreeing with you?

That was the point when it suddenly became awfully important to distinguish between with and of.

Which, ironically, is the exact mistake you're making. You even point it out yourself, while completely missing the point. This:

The percentage of positive cases today was 22.7.

If 150 people are dying every day, and the positivity rate is 22.7%, that would be 34 people every day dying who have covid. 36 people died yesterday in Denmark who had tested positive within the past 30 days.

On those numbers, you are simply delusional if you think covid is killing a "skyrocketing" number of deaths.

But let's ask The Atheist a simple question: Does it look as if from week 1, 2022, mortality from Covid-19! has decreased in Denmark and now approaches the normal and expected level?

See above. Clearly it doesn't just look that way, it is that way.

Luckily, your government is a lot more sensible than you, because you'd be locking the country down on false premises.

 

[The Man]

As of Thursday the 17th masks will be optional (outside the clean room) at the site I work, for vaccinated workers.

ETA: Hey, just in time for St. Patrick's day. Wonder if there are any studies on the effects of green beer on viruses?

 

[Puppycow]

Whoa, wait a minute:

The more obvious it becomes that the vaccines don't prevent infection and don't prevent hospitalizations and death, the disease itself is treated as a vaccine.

Are you saying that vaccines don't prevent hospitalizations and death? Because I'm pretty sure they still do.

By "prevent" I mean "reduce the likelihood". Of course, there will still be some hospitalizations and some deaths among vaccinated people, but fewer than otherwise. Significantly fewer.

ETA, for evidence, just look at what is happening in Hong Kong right now, where many more elderly people are dying than in Denmark. This is because there is a low vaccination rate in Hong Kong among the elderly.

I made a post about it over in the science forum:
http://www.internationalskeptics.com/forums/showpost.php?p=13756960&postcount=1745

Here is the chart, I put Demark in for comparison. The difference you see is down to vaccination rates and prior immunity.

 

[8enotto]

Most of us are old enough to remember the aids epidemic. It's still out there and my little city has a quietly ignored record number of sex workers infected.
They still get enough business to keep on going. Those who don't partake of that never think about it.

CV has a similar story to play out. Most will drift back to business as usual sooner or later. With or without regards for government suggestions. Nobody talks of family dead of CV anymore so it must have slowed a lot.

In my semi rural home area nobody wears masks for the corner store trips. Nobody cares.
Go downtown and near everyone in Walmart has one. Even me.
No need to make a Karen situation with store staff. They have a policy to require it, roll with it.

A epidemic ends when the disease takes so few victims it blends in with every other disease in numbers. It just isn't notable anymore.
But, it's still with us probably in new varients for the rest of history to come.

 

[Chanakya]

Thanks for all of those inputs. Much appreciated.

My fundamental question, though, remains unaddressed, or at least, unresolved.

Sure, common sense is one way to go. That would be a function of local infection levels, and hospitalizations, and deaths, and what others are doing, and how susceptible one is (whether by temperament, or else by circumstance, professional or otherwise) to what others are doing.

But is that the way to go? I was wondering if those familiar with general pandemic protocols are aware if the WHO and/or national or regional equivalents are supposed to officially ring it out when appropriate, and if in the meantime it would be prudent to err on the side of caution, even if that comes across as dorky and/or germaphobic. (That's what I'm doing so far.)


---


The aids analogy is interesting. True, no one "rang it out". Arguably it's still " in". Although that isn't/wasn't full-blown pandemic, right? So maybe the comparison, while not unrelated, is less than fully apples to apples?

The point about Japan's super careful culture is well taken. Unfortunately most places have a very different culture and very different norms, so the path of least resistance isn't necessarily the most prudent.


---


eta: And I take your point, dann. What "authorities" proclaim itself isn't necessarily infallible. Clearly your conclusion, basis your national situation, is open to debate; but that broad point is worth keeping in mind. That perspective adds a further nuance, a further complication, to the question of "official announcements" that I hadn't considered.

 

[8enotto]

If anyone officially declares CV as a epidemic done, they are going to look really stupid with any outbreaks. Even a year later.

It's endemic. It's part of humanity now and just another disease we could get. It will mutate and evolve as we do to not get killed by it. We as a species didn't do what it would have taken to control it the first months.

If anyone wants to wear masks and carry alcohol gel for the rest of thier lives it's a choice. But immunized people are testing positive and vaccine resistant folks aren't getting dead for testing positive. Or aren't testing positive at all.
It's not a black and white situation. It's all gray areas based on factors nobody has fully noted or studied yet.

Do whatever gives you peace of mind and patronize places that share your ideas when possible. One slob coughing on your groceries doesn't help you keep calm.

 

[Chanakya]

If anyone officially declares CV as a epidemic done, they are going to look really stupid with any outbreaks. Even a year later.

Well, yes and no.

No, because situations evolve, and the scientific consensus evolves with it. For instance, if at first the consensus was "No masks", and afterwards it changed to something different, basis our changed understanding of a changing situation, then that isn't " stupid".

But yes, because that's how some/many perceive it, that inconsistency, even when valid, is "stupid". And politicians, at any rate, are certainly vulnerable to, and therefore mindful of, perception, even when the perception itself might be unreasonable.

It's endemic. It's part of humanity now and just another disease we could get.

Well that's one view. But is that the reasonable/consensus view, is what I'm asking.

After all there were folks saying that exact thing when the pandemic was raging full-on. They were wrong then.

Could be the situation's changed, and that's the right attitude now. But how do we know? Who decides? Does WHO, all caps? Is there a protocol for the easing off of a pandemic, or is it every man for himself, doing what seems right to him personally?

The answer to this obvious questions seems surprisingly difficult to arrive at. RL friends and acquaintances didn't know, although some pretended to. Google is coy about coughing out the answer, although like the Delphi I may not have asked it right, that's possible. I was wondering if a clear-cut answer might be forthcoming on here. Or even a clear-cut answer to whether a clear-cut answer is even a thing, in this situation. (Common sense suggests it ought to be. Common sense suggests it ought to be the WHO's job, and local health authorities's job, to present such --- Is it "So take it easy now", or isn't it? But of course, they don't consult me and my common sense when framing their protocols, so who knows? Does anyone, here, know I mean?)




eta: As far as specificity, look at China. Admittedly their indigenous vaccine was dodgy, but against the apparently mild Omicron apparently all vaccines have very low efficacy. And it seems the milquetoast Omicron is killing people in large numbers in those two cities in China. How sure can we reasonably be that we're at the " Meh" stage yet?

Sure, we all do what gives us peace of mind. That, always. But I was wondering what the objective, consensus view might be, about easing off; and if there are established protocols for quickly assessing that. Or must we necessarily work this out for ourselves, each of us, as best we can?

 

[dann]

But is that the way to go? I was wondering if those familiar with general pandemic protocols are aware if the WHO and/or national or regional equivalents are supposed to officially ring it out when appropriate, and if in the meantime it would be prudent to err on the side of caution, even if that comes across as dorky and/or germaphobic. (That's what I'm doing so far.)

When people's lives and health are at stake, it is usually wise to err on the side of caution. See Rebecca Watson's YouTube video.

The point about Japan's super careful culture is well taken. Unfortunately most places have a very different culture and very different norms, so the path of least resistance isn't necessarily the most prudent.

There is no doubt that norms and culture are important, but norms and culture are nurture, not nature, and thus easier to change, in particular when the change is as insignificant as wearing face masks when shopping and on public transport. Cuba and Japan don't have similar norms and cultures, and yet ...
Cuba & USA (Our World in Data)
When combined, vaccinations + face masks work! (Cuba's numbers would have been even more spectacular if the U.S. blockade hadn't delayed Cuban vaccine production, which accounts for Cuba's one and only real 'wave' in the summer and fall of 2021.)
Cuba, Japan, USA:
Daily new confirmed COVID-19 cases per million people. 7-day rolling average.
Daily new confirmed COVID-19 deaths per million people. 7-day rolling average.
Vaccinations:
Share of people vaccinated against COVID-19
COVID-19 vaccine doses administered per 100 people
Daily COVID-19 vaccine doses administered per 100 people. Rolling 7-day average.
CNN's Tracking Covid-19 vaccinations worldwide

Like Denmark, Iceland is a well-vaccinated Nordic country that dropped restrictions and face masks:
Daily new confirmed COVID-19 cases per million people
Daily new confirmed COVID-19 deaths per million people

By the way, there was no real opposition to the face-mask mandate in Denmark. It could have continued without any problems in the winter of 2021-22 if Denmark hadn't suddenly made a U-turn and gone full in on 'herd immunity by Omicron'.

eta: And I take your point, dann. What "authorities" proclaim itself isn't necessarily infallible. Clearly your conclusion, basis your national situation, is open to debate; but that broad point is worth keeping in mind. That perspective adds a further nuance, a further complication, to the question of "official announcements" that I hadn't considered.

As for what Danish authorities claim:

De sidste måneder af 2021 oplevede Danmark en overdødelighed i gruppen af ældre personer på 75 år og derover. Særligt fra uge 49 2021 til uge 1 2022 var denne overdødelighed betydelig og formodes at skyldes smittespredning med deltavarianten.
Dødeligheden i Danmark falder (Statens Serum Institut, Feb 3, 2022)

In the last months of 2021, Denmark experienced excess mortality in the group of elderly persons 75+. Especially from week 49 2021 to week 1 2022, this excess mortality was considerable and is presumed to be due to the spread of the Delta variant.


Week 49 was Dec 6-12.
However, the assumption that this was due to the Delta variant only seems to be wishful thinking:
Omikron er den dominerende variant (Danish Ministry of Health, Dec 21, 2021)
Omicron is the dominant variant

By Jan 21, the second Omicron variant was taking over ...

 

[dann]

Whoa, wait a minute:


Are you saying that vaccines don't prevent hospitalizations and death? Because I'm pretty sure they still do.

By "prevent" I mean "reduce the likelihood". Of course, there will still be some hospitalizations and some deaths among vaccinated people, but fewer than otherwise. Significantly fewer.

ETA, for evidence, just look at what is happening in Hong Kong right now, where many more elderly people are dying than in Denmark. This is because there is a low vaccination rate in Hong Kong among the elderly.

I made a post about it over in the science forum:
http://www.internationalskeptics.com/forums/showpost.php?p=13756960&postcount=1745

Here is the chart, I put Demark in for comparison. The difference you see is down to vaccination rates and prior immunity.

Vaccinations give you some protection, but not nearly enough to keep you out of the hospital:
Denmark:

Hospitalizations according to vaccination status
Hospitalized per 100, 000
Unvaccinated: 29,3
One shot: 22,2
Two shots: 21,7
Three shots: 29,5
Indlagte efter vaccinestatus (TV2.dk)

There is more to it than this, of course. For instance, the elderly are more likely to have had three shots than the very young, and people who can't be vaccinated are probably self-isolating.
See the numbers for Cuba, i.e. a country that is well-vaccinated and still masking up, in the post above.

 

[Chanakya]

I've followed your posts about the Danish situation, dann, and Sweden as well, in the past, at which point the authorities had clearly screwed up big time.

I "don't have an opinion" -- to use that forum meme! -- on the Danish situation at present, simply because of late I've not kept abreast with what's happening, and don't know enough to independently hold a view on this. You may well be right, dann, but, as this thread shows, your conclusion isn't the unanimous one -- although it could be it's right.

Like I said, the broader point you raise is concerning. I've been asking whether it's a matter of personally arriving at our own answer, or should one go by the what the authorities say (and carry on with the protocols until they do). But you rightly suggest that authorities, whoever they are, and no matter what they say, might be mistaken too; which kind of renders my question moot, and throws the ball back in our personal individual court. Like I said, that adds a nuance and a complexity I hadn't considered.

Personally I'm all for staying extra careful, even if it subsequently turns out one was overdoing it. Because simple risk weighing, right? But my elderly parents, for instance, have a lesser immunity to public perception and the peer pressure thing than I do, and unllke me they do give a damn what friends and kin say. Which is stupid, but it is what it is. Although touch wood they're healthy enough generally, but age itself puts them in the high risk category. I was wondering if I should keep raising unholy hell to keep having them toe my line, until there's an authoritative easing off announcement, or if I should let them be. That, in short, is at the heart of this thread.

Anyone else, anyone else at all, I'd let them do what they like, and take the consequences, whether good or bad or ugly. But I can hardly do that here. Nor do I feel right bulldozing my views on them -- not unless I've very good reason to, beyond just my personal, fallible judgement.

Which brings me back to the WHO protocol about formally shutting off measures. And local/national authorities as well.

 

[Skeptic Ginger]

For the record, it's quite impossible to use the HIV pandemic as an example for declaring COVID a pandemic* or when to declare it's now endemic and no longer a pandemic. Politics and stigma were and still are significantly involved. It makes idiots in the US attacking Asians look like fleas on a rug in comparison.

*The WHO mostly refers to it as an epidemic but sometimes as a pandemic. I don't believe they ever officially declared it a pandemic.


It's going to be difficult to declare the pandemic is over and endemic COVID has begun given the uneven rates of infection in different countries. And we are in no way at the point of long lasting vaccines and no or at least very rare new variants emerging.

It's safe to say the COVID pandemic is not over.

 

[ponderingturtle]

If anyone officially declares CV as a epidemic done, they are going to look really stupid with any outbreaks. Even a year later.

It's endemic. It's part of humanity now and just another disease we could get. It will mutate and evolve as we do to not get killed by it. We as a species didn't do what it would have taken to control it the first months.

The difference between it at pandemic levels vs endemic levels is about are you seeing huge spikes in infection or is there just a stable background level of infection. Given how big some outbreaks have been recently I don't think we are in the endemic stage yet.

This article has some good graphs that depict it

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461290/

 

[Skeptic Ginger]

The difference between it at pandemic levels vs endemic levels is about are you seeing huge spikes in infection or is there just a stable background level of infection. Given how big some outbreaks have been recently I don't think we are in the endemic stage yet.

This article has some good graphs that depict it

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8461290/

That's a good article explaining the transition.


RSV is endemic even though it has seasonal peaks above endemic levels.

Influenza is endemic though different strains are often treated as new pathogens. If the HPAI H5N1 starts spreading person to person it could very easily become a new pandemic.

Bottom line, I'm not sure we have a good checklist to tell us COVID has essentially shifted from pandemic to endemic. It's clear though that we are not there yet.

As for mutating to become milder, don't count on it. It's now recognized that not killing the host is not necessarily always naturally selected. HIV is an example (if we didn't have current meds and other interventions) of a virus that more readily spreads the more virus reproduction a host has. It takes ~2 years on average for that viremia to overwhelm the host's immune system. That's plenty of time to spread thus selection for more viral reproduction can naturally be selected. And considering the use of anti-retroviral meds, initially* that resulted in natural selection of drug resistant strains. Then if those meds were withdrawn, the earlier strains re-emerged.

*We are beyond this now with multiple anti-retrovirals and other interventions.

Other viruses have been around a very long time and have not mutated to become milder. Take the RSV example again, it spreads readily so that almost all children get the infection by the age of 2. The serious disease and fatalities occur in very young children, especially infants, and in the elderly. Nothing is naturally selecting milder strains.

CDC: RSV

RSV can be dangerous for some infants and young children. Each year in the United States, an estimated 58,000 children younger than 5 years old are hospitalized due to RSV infection. Those at greatest risk for severe illness from RSV include

Premature infants
Very young infants, especially those 6 months and younger
Children younger than 2 years old with chronic lung disease or congenital (present from birth) heart disease
Children with weakened immune systems
Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions ...

Virtually all children get an RSV infection by the time they are 2 years old. Most of the time RSV will cause a mild, cold-like illness, but it can also cause severe illness such as

Bronchiolitis (inflammation of the small airways in the lung)
Pneumonia (infection of the lungs)

In the US fatalities are low because of our interventions, not because the virus is now milder.

 

[The Atheist]

Yet again, the point is made that neither variety of omicron is causing the levels of harm as previous infections:

"The issue with hospitalization is a little bit more puzzling, because although the hospitalizations are going up, it is very clear their use of ICU beds has not increased," Fauci said. "So are the numbers of hospitalizations a real reflection of Covid cases, or is there a difficulty deciphering between people coming into the hospital with Covid or because of Covid?"

https://edition.cnn.com/2022/03/15/health/covid-rising-uk-us/index.html

This reflects exactly what doctors in South Africa said - a lower percentage in hospital, and those who did end up there needed a day or two on a CPAP machine and went home, with minimal impact on ICUs.

I think the end of the pandemic is nigh.

 

[theprestige]

Does the WHO, for globally, and/or local authorities (including national authorities, or states, or whatever) go out and announce "All clear, as you were, everyone stop being psychotic germaphobes!")? Or are people expected to read the equivalent into a gradual dwindling of panic messages as well as actual cases?

I mean, how did you know a pandemic's started?