From Pandemic to Endemic: Post-COVID-19 Era Might Have Already Arrived

All signs point to finally throwing off the dictatorship of the little spiky ball.

The public thinks so. The stock market thinks so. Many experts think so. They’re welcoming the post-COVID-19 world. In fact, many believe that we’ve already reached a place where COVID-19 stops being a pandemic that kills and becomes endemic, erupting in waves here and there—not deadly waves—but more like influenza and common cold waves. The sort of nuisances that aren’t going to kill you. (It must quickly be added that influenza does indeed kill, but not with the ferocity of COVID-19.)

More and more, the consensus seems to be building toward what author Jason Tetro told Infection Control Today® in a Q&A on October 22. “Moving forward, I think we’re going to be going into this idea of seasonality, or as I like to say, cold, flu and COVID-19 seasons.” And the so-called “monster variant,” of COVID-19—a variant that would be immune to antibodies whether they’re produced by vaccines or prior infection? We’ve already been hit with the monster variant, Tetro said. It’s called the Delta variant and it’s burning itself out because it's not immune to the vaccines.

“That is our monster variant,” Tetro told ICT®. “We have seen other variants come out since Delta has taken over. They’re not doing anything. There’s even something called Delta plus that really isn’t doing much. In that light, I think we might be at the worst when it comes to what COVID-19 can offer.”

Scott Gottlieb, MD, the former commissioner of the Food and Drug Administration, certainly agrees with that assessment. On Face the Nation Sunday, Gottlieb said that “we’re going to enter a more endemic phase and as things improve, cases may pick up. ... But that doesn't mean that we’re entering into another wave of infection.”

Gottlieb said that we can finally put this nightmare behind us thanks to the creation of a vaccine for children as young as 5 and pills in the pipeline, from Pfizer and Merck, that would allow people to treat COVID-19 at home.

“We’ve always said that two of the events that would demarcate the end of this pandemic was being able to vaccinate our children,” Gottlieb told Face the Nation. “We’re now able to do that down to age five. And also having a widely available or orally accessible drug that could treat coronavirus at home to prevent people from being hospitalized or dying.”

All of which gives credence to a prediction made by Monica Gandhi, MD, MPH, an infectious disease expert and a professor at the University of California, San Francisco. She predicted in a Q&A with ICT® in October 2020—that’s right, October 2020—that the “old normal” will return by January 2022.

“I think we’ll be going to movies,” Gandhi told ICT®. “That people will be going to the theater. People will be going to sports events. Will hug each other. Will hang out. We’re going to get back to normal, but it’s going to take a year and a half. January 2022. It’s so hard to say. But I do think it’s going to take until January 2022. We need to get the community transmission down. We need to get a vaccine. We will vaccinate the whole populace and then it will stop because it can’t go anywhere because we have immunity and we will get there.”

A good portion of the public in the United States thinks that we’re already there, according to the Axios/Ipsos Coronavirus Index.

“A majority of Americans (55%) believe returning to their normal pre-coronavirus life right now is a small risk or no risk to their health,” according to the Index, a marked increase since the “Delta driven, late-August low of 40%.”

The stock market certainly agrees, according to Axios—it’s “exploding.”

“Stocks move for all types of reasons,” Axios reports. “But the declines reflect a shift that’s sticking: At-home workouts and remote learning are out. Travel and gyms are in.”

Ross Klein, a fund manager at Changebridge Capital, which is invested in gym chain Planet Fitness, told Axios that “Folks are saying, ‘Hey you know, I’m going back to the office two days a week, perhaps I should go back to my old gym routine.’”

Still, a word of caution.

Infection prevention and control expert Saskia v. Popescu, PhD, MPH, MA, CIC, a member of ICT®’s Editorial Advisory Board, wrote recently that “giving thought to this rather unknown holiday season—now is the time to have conversations with staff about what can increase or decrease risk of COVID-19 during the holidays. These are especially important as more are getting boosters but may not necessarily realize that doesn’t suddenly make them Superman.”