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Are we there yet? Why the endemic might be two years away.

With the current global economic situation, political upheavals, and geopolitical conflicts, it can be easy to forget that the COVID-19 virus is still a concerning health issue. In fact, in Southeast Asia, two recent outbreaks in Singapore and Malaysia have highlighted the prevalence of the disease in our region.

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Channel News Asia reported that the COVID-19 outbreak in Singapore would be short and sharp, running from October and peaking in mid-November, while in Malaysia, the numbers were high in June – August 2022, with another spike happening in late September and mid-October this year. (Source: Facebook – Tan Sri Dato’ Seri Dr. Haji Noor Hisham Abdullah, Director-General of Health, Malaysia).

All this points to a call for more vigilance when it comes to mask-wearing, sanitizing, and practicing social distancing despite the fact that we are now two years on from the pandemic. As such, many people are now asking the question: are we truly in an endemic, or can we expect more outbreaks?

Yale University: The Endemic is Two Years Away

Researchers at Yale recently announced that the COVID-19 endemic stage could in fact be two years away. They used rats (a species that is also susceptible to coranviruses) as test subjects, and collected data on coronaviral reinfection rates which in turn allowed them to model the potential trajectory of COVID-19.

From their experiments, the researchers concluded that with natural infection, some people will develop better immunity than others; additionally, vaccines are still required, as they can generate predictable immunity. With both in hand, the population can accumulate broad immunity, which then pushes the virus toward the endemic stage.

The median time predicted by the model created by Yale is four years, so it could take humanity even longer than that to reach the endemic stage; it’s also important to remember the SARS-CoV-2 mutations that are periodically emerging could be more harmful, which could slow down the timeline even further. However, the researchers concluded that the more likely scenario is that the virus will continue to be transmitted easily between people, but will be less likely to cause severe illness.

While there are many types of coronaviruses, including SARS-CoV-2 which causes COVID19, the common factor in the spread of animal and human coronaviruses is their tendency to create non-sterilizing immunity. This means that fairly good immunity can be built up against viruses, but it also fades quickly.

The above explains what scientists have been seeing in humans: SARS-CoV-2 yields non-sterilizing immunity, so people who have been infected or vaccinated can still be reinfected. As such, they have concluded that it is unlikely that the COVID-19 virus will disappear any time soon.

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The difference between an endemic disease and a pandemic disease by AlJazeera.

What is an Endemic Virus, Anyway?

The study of epidemiology looks at the distribution and determinants of health-related events in specified populations, and determines at what stage or level a disease is at; these stages in turn measure how many people have gotten sick from a disease and how far it has spread – the endemic stage defines disease as having a constant presence or usual prevalence within a geographic era.

In April 2022, infectious disease specialist Stephen Parodi, MD., pointed out that when COVID-19 moves from pandemic to endemic levels, it will continue to be around but will not constantly disrupt peoples’ daily lives. To get the virus to the endemic stage requires a concerted effort around testing, vaccination, isolation, and quarantining; in many parts of the world, this effort has paid off, and life looks a lot more normalized than what the population has had to deal with over the past two years.

In terms of examples, HIV is one disease that has reached the endemic stage; while it has not disappeared, humans have come to terms with it and found therapies and prevention methods, and as a result HIV is not as feared by everyone as it was before. Malaria is another endemic disease that is a threat only in certain areas. It is prevalent in parts of Africa and Papua New Guinea, as well as warm regions close to the equator; in the case of malaria, prevention medications are available to stop its spread.

Preparing for the Best of Times

At the end of the day, while it may be comforting for the world’s population to believe that the threat of COVID-19 is over, there are still pockets of the planet that are dealing on a daily basis with the disease. The best way forward is to determine our personal level of risk, taking into consideration factors such as age, health status, and whether there are people in our lives that are vulnerable to the virus. In conclusion, the COVID-19 pandemic is still a pandemic, but it’s only a matter of time before it becomes an endemic.