How do we know a pandemic's over?

[xjx388]

Epidemic is when a new disease (or one that is not endemic to an area) spreads in a certain small area.

Pandemic is when the new disease spreads over a larger area.

Endemic is when a disease is widespread in or native to an area and spreads at predictable rates.

I think COVID is still considered a pandemic because it hasn’t stabilized into predictable patterns. New variants keep popping up and we haven’t reached a sufficient level of immunity in the population. But it will be endemic at some point, which, to my mind, doesn’t really change anything about how we should deal with it.

The more germane question is: At what point do we stop treating COVID as a public health emergency that requires government intervention? That’s a political question and will vary by jurisdiction.

 

[Chanakya]

Solid, informative posts, as usual, Skeptic Ginger. They reinforce my own opinion, that it isn't quite time to ease off (personal) protocols. Soon, hopefully. But we're not there yet.

 

[Chanakya]

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



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.

Amen to that, to the end being "nigh".

Not quite there yet, though? Soon, hopefully.

 

[The Atheist]

Amen to that, to the end being "nigh".

Not quite there yet, though? Soon, hopefully.

Very, I think. The current BA2 wave will subside as quickly as it began and the fat lady will be signing.

I can see the pandemic being over for all practical purposes by the end of April, and officially by WHO statement some time in June. China's the only place that might continue to have issues, which is ironically appropriate.

 

[Chanakya]

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

There were clear-cut announcements, back then, from WHO for one. And instructions/guidelines, initially somewhat conflicting, on what to do and what not.

I personally look at government mandates as the legal requirement everyone MUST follow, the bare minimum as it were, because those measures are often decided by weighing other concerns, including the economic and the political. If one has the wherewithal, then it's wise, IMV at least, to treat that as the floor. Actual observance per more conservative (that is, more careful) health authority guidelines, including from WHO.

Like Puppycow suggested upthread, they rang it in, so no doubt they'll ring it out, at some point, WHO I mean to say. Meanwhile, though? Disturbingly large numbers of people are pre-empting the end of the pandemic, and letting it all hang out, at least other than when in public in large numbers. Disturbingly large numbers are starting to take it easy, as far as masks and distancing, inside offices and (others') homes and restaurants and private parties and gatherings. Disturbing, because the numbers are large enough that one questions if one is right -- as opposed to getting unduly paranoid -- in not following their lead, and in waiting, instead, for more definitive easing-off instructions/guidance from health authorities, including at the global level from WHO.

(I meant that last literally, not rhetorically. That "question" is what this thread is.)

 

[xjx388]

I think April-June is way too optimistic to call the pandemic “over.” I think it will stretch on, especially in certain pockets of the world, until next year.

And even if the pandemic is “over,” what does that mean? It means that COVID moves to endemic status. Yay? We screwed the pooch on eliminating it or controlling it. So I’m not sure that “the pandemic is over,” really means much in a “we don’t have to worry anymore,” sense.

 

[Chanakya]

Epidemic is when a new disease (or one that is not endemic to an area) spreads in a certain small area.

Pandemic is when the new disease spreads over a larger area.

Endemic is when a disease is widespread in or native to an area and spreads at predictable rates.

I think COVID is still considered a pandemic because it hasn’t stabilized into predictable patterns. New variants keep popping up and we haven’t reached a sufficient level of immunity in the population. But it will be endemic at some point, which, to my mind, doesn’t really change anything about how we should deal with it.

Agreed, fully.

That said, I was wondering if there might be protocol-driven basis for that opinion. While I agree, fully, and am happy to hear you voice that sane opinion, I'm wondering if we might base that opinion on something more structured than merely what appeals to us personally.

The more germane question is: At what point do we stop treating COVID as a public health emergency that requires government intervention? That’s a political question and will vary by jurisdiction.

Oh sure, but it's "more" important only if you take the earlier question, about the appropriate personal level of precaution, as already answered. While personally in full agreement with your answer, that is the question I wanted to focus on here, in this thread.

 

[Chanakya]

Very, I think. The current BA2 wave will subside as quickly as it began and the fat lady will be signing.

I can see the pandemic being over for all practical purposes by the end of April, and officially by WHO statement some time in June. China's the only place that might continue to have issues, which is ironically appropriate.

Let's hope you're right. It would be wonderful if that's how it actually happens.


China? I find that worrying. Given the far lower efficacy with Omicron, which lessens the effective difference between their Sino-whatsisname-vaccine and more mainstream vaccines, surely what's happening there may well happen elsewhere? One hopes it won't, naturally. But I'm not sure I see any reason to be sure it won't.

 

[Puppycow]

Let's hope you're right. It would be wonderful if that's how it actually happens.


China? I find that worrying. Given the far lower efficacy with Omicron, which lessens the effective difference between their Sino-whatsisname-vaccine and more mainstream vaccines, surely what's happening there may well happen elsewhere? One hopes it won't, naturally. But I'm not sure I see any reason to be sure it won't.

It's just Sinovac, a portmanteau of Sino for China, and vac for vaccine.

Unrelated, but I remember last summer when I got vaccinated and they gave me the certificate which said "Comirnaty" and I didn't know what that meant because I only ever heard it referred to as "the Pfizer vaccine" (or sometimes Pfizer/BioNTech). "Comirnaty" is the actual name of the vaccine, and it's a portmanteau of community and mRNA. Yes, mRNA is in the name if you look carefully.

 

[Skeptic Ginger]

I think April-June is way too optimistic to call the pandemic “over.” I think it will stretch on, especially in certain pockets of the world, until next year.

And even if the pandemic is “over,” what does that mean? It means that COVID moves to endemic status. Yay? We screwed the pooch on eliminating it or controlling it. So I’m not sure that “the pandemic is over,” really means much in a “we don’t have to worry anymore,” sense.

Watching what is happening in China right now, I don't think there were actions that could have stopped the pandemic by Dec 2019. China might have been able to nip it in the bud in Nov-Dec 2019, but that would have required perfect action and it's doubtful any country would have been perfect in predicting the significance in those first couple months.

And it's an issue in 'pockets' in the US as well as in other parts of the world.

 

[Skeptic Ginger]

...
China? I find that worrying. Given the far lower efficacy with Omicron, which lessens the effective difference between their Sino-whatsisname-vaccine and more mainstream vaccines, surely what's happening there may well happen elsewhere? One hopes it won't, naturally. But I'm not sure I see any reason to be sure it won't.

Might be more than vaccine failure.

ChinaDaily on vaccine uptake in Hong Kong

Hong Kong's vaccination rate is lower than that in the mainland, Singapore, Europe, and the United States, Lam said at a press conference.

She said Hong Kong's COVID-19 vaccine supply is ample and the HKSAR boasts a developed vaccination infrastructure, stressing efforts to urge more people to participate.

According to official data, 300,000 people aged 70 or older have not received their first dose of vaccine.

The vaccine uptake has increased dramatically now, but a couple of months ago it was relatively low.

 

[Puppycow]

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

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.

Just to pick out one sentence that caught my attention:

In previous waves, increases in Covid hospitalizations lagged behind jumps in cases by about 10 days to two weeks. Now, in the UK, cases and hospitalizations seem to be rising in tandem, something that has experts stumped.

When there's a consistent lag, it suggests a cause and effect relationship, but if they are rising in tandem it could just be that lots of new cases are being detected in people arriving at the hospital for other reasons.

 

[The Atheist]

I think April-June is way too optimistic to call the pandemic “over.” I think it will stretch on, especially in certain pockets of the world, until next year.

And even if the pandemic is “over,” what does that mean? It means that COVID moves to endemic status. Yay? We screwed the pooch on eliminating it or controlling it. So I’m not sure that “the pandemic is over,” really means much in a “we don’t have to worry anymore,” sense.

Fair points - and I don't mean that by the pandemic being over it will have gone away.

I think covid will be with us forever, but it's going to be like norovirus, colds, RSV and other diseases that harvest age-care homes every year and little else, although vaccines for it will likely be a part of life from now on.

 

[8enotto]

Vaccine campaigns in Mexico are very targeted and infrequent now. Not for a shortage of available vaccine. Outlaid areas ignored in early phases and age groups denied in heavier populated areas.

A mop up operation if you will, and I suspect a direct reflection of how those in charge see the pandemic evolving.

So, without stating directly how they feel actions do speak.
Maybe that is how we need to read the intentions of other nations. Everything is subject to change but it's a clue.

 

[attempt5001]

There have been some posts here about the effectiveness of vaccination for reducing transmission, hospitalization, and ICU admission. Ontario, Canada have tracked this data very nicely. This link shows the relative rates between vaccinated (at least two doses) and unvaccinated populations.
https://covid19-sciencetable.ca/wp-...al-and-ICU-Admission-with-2-Vaccine-Doses.png

 

[theprestige]

Well I realized today that after two years, it feels weird to walk around my building with no mask on. Every time I run into a fellow resident, I feel a twinge of guilt "oh, I'm not wearing a mask!" Which gives me two new ways to determine when the pandemic is over:

One, I could go back to wearing a mask. I'll know the pandemic is over when I start feeling guilty for being the only one wearing a mask.

Two, I'll know the pandemic is over when I stop feeling guilty for not wearing a mask.

 

[Rolfe]

Masks are still required here. As they should be, because we have more virus in the place than ever before. It's just that masks alone aren't going to cut it and people need to start understanding about clean air.

I will not unmask indoors in company until something is done about this.

 

[Chanakya]

Well I realized today that after two years, it feels weird to walk around my building with no mask on. Every time I run into a fellow resident, I feel a twinge of guilt "oh, I'm not wearing a mask!" Which gives me two new ways to determine when the pandemic is over:

One, I could go back to wearing a mask. I'll know the pandemic is over when I start feeling guilty for being the only one wearing a mask.

Two, I'll know the pandemic is over when I stop feeling guilty for not wearing a mask.

I don't know if that's supposed to be a completely-free-of-substance joke. If it is, then fine, even though I don't quite get the funny part of it, but I appreciate your weighing in with some friendly humor. But if there's even the smallest smidgen of your actual POV, and of how you're actually viewing this question, in that flippantly worded comment, then I have to say I'm very surprised to find that argument presented in here of all places, and by you of all people. That's, like, as blatant an argumentum ad populum as you might find anywhere, and what's more applied to what is a very serious question, or should be. It's essentially saying that whatever the folks around me are doing is right, and what I must do is try to mimic them as best I can. That's, like, I don't know, entirely unexpected, coming from you. (Like I said, apologies if I'm running away with over-thinking a comment that was intended as no more than just a joke, and that does not touch on your actual POV at all.)

Sure, I can understand tailoring your reaction, to an extent, maybe even to a large extent, to local conditions as opposed to some global norm; but even if you're aiming to do that, even then trying to mirror what everyone around you is doing is hardly the best way of getting there, is it?

 

[Chanakya]

Masks are still required here. As they should be, because we have more virus in the place than ever before. It's just that masks alone aren't going to cut it and people need to start understanding about clean air.

I will not unmask indoors in company until something is done about this.

Do you mean clean air generally, and not necessarily linked with this Covid business? I agree, that's not a bad idea at all; but still, I guess that's kind of a separate issue.

Masking indoors is getting to be kind of troublesome these days. Socially I mean. An incident just yesterday ...on second thoughts, no need for personal details, but what I'm saying is, it's a bit like what it must have been like banishing smokers from your home in times past, when smoking, and specifically passive smoking, wasn't fully recognized as the health hazard we all now understand it is. I'm pretty thick skinned myself, and do what I feel is right without worrying overly much about how others take it; but when you see practically everyone around you letting it all hang, figuratively speaking, you start questioning whether it's they who're being weird, or whether it's you that needs a reality check. (By "you" I mean "me"!)

 

[Chanakya]

Anyway, while all of this is useful, as inputs as far as how people are individually dealing with this at this time, but it isn't quite what I was asking.

I spent a while searching online for some official position from WHO on this, both about the protocol in general terms of easing off of pandemics, as well as about what they advise at this point in time, and, while I found nothing generally applicable, I did come up with this. WHO's position, as of last week, seems to be that "...there are huge amounts of misinformation causing a lot of confusion among people...The misinformation that Omicron is mild, misinformation that the pandemic is over, misinformation that this is the last variant that we will have to deal with”..."

On the other hand, this was a comment that I needed to search for, and it was delivered by someone in WHO I've never heard of. Not that I'm some expert on who's who in WHO --- sounds weirdly punny, that, but I'm not going to go back and rephrase that! --- but my point is, it isn't the big guns at WHO proclaiming this as important headlines, but merely some functionary mumbling out something, something that does not leap out at one but something that one needs to actively search for in order to access. So that I wonder how much WHO itself is pushing this line of thought and action.

And in any case, I still haven't found whether they --- or respective national bodies --- go out and ring out the pandemic officially, in real time as it were. I guess I'm going to assume there is no such protocol, or at least none that those who might have devised them are taking very seriously, so that it is, indeed, a question of doing what appears best to you, individually, basis your local conditions. Which is not a bad idea, but yeah, that leaves it kind of an open question.