COVID has become endemic, CDC tells NPR : Shots

Four years after SARS-CoV2 caused a devastating global pandemic, U.S. health officials now consider COVID-19 to be endemic.

“At this point, we can say that COVID-19 is endemic around the world,” Alon Hall, deputy director for science in the CDC’s division of coronaviruses and other respiratory viruses, told NPR in an interview.

So essentially, COVID-19 is going to be here to stay in a predictable way.

The classification does not change any official recommendations or guidelines on how people should deal with the virus, but it acknowledges that the SARS-CoV2 virus that causes COVID-19 will continue to circulate and cause disease indefinitely, and emphasizes the importance of people getting vaccinated and taking other steps to reduce their risk for the foreseeable future.

“This is still a very significant problem, but it’s now one that can be managed against the backdrop of many public health threats, rather than as a single pandemic threat,” Hall said. “So the way we approach COVID-19 is very similar to how we approach other endemic diseases.”

Since the coronavirus began spreading explosively around the world, authorities have been calling COVID-19 a “pandemic,” which occurs when a dangerous new disease spreads widely across many countries.

The definition of “endemic” is vague, but it generally refers to a disease that has taken root in a place and people are forced to live with it, such as malaria, which is prevalent in many parts of Latin America and sub-Saharan Africa.

Though the coronavirus remains widespread, daily life has returned to normal for most people, even amid a surge in infections this summer. On Wednesday, Noah Lyles competed at the Olympics and won a bronze medal despite having COVID-19 symptoms. President Biden worked from home during his recent COVID-19 infection.

COVID seems to be becoming a part of life, so NPR reached out to the CDC and other experts to ask whether they think it’s time to call it endemic.

“Well, in terms of most people’s notion of endemic, that it’s just something that’s around and you have to continually manage it, certainly COVID is endemic in that sense,” said Dr. Ashish Jha, dean of Brown University’s School of Public Health and former White House COVID-19 response coordinator under President Biden.

But not everyone agrees. Some epidemiologists say COVID-19 may be on its way to becoming endemic, but the virus is still too unpredictable to reach that conclusion just yet. For example, the outbreak this summer has turned out to have started surprisingly early and spread much more rapidly than expected.

Nearly every state has high or very high levels of the virus in wastewater, according to the most recent data from the CDC.

“There’s still a lot about this virus that we can’t predict,” says Caitlin Jeterina, an epidemiologist who writes the popular newsletter Your Local Epidemiologist, “and many scientists, including myself, think it’s at least a decade away from SARS-CoV2 actually finding this really predictable pattern. The hope is that over time it will fade into the background, but we’re not there yet.”

Hall and Jha agree that COVID-19 remains unpredictable, but they argue that it has become predictable enough to be considered endemic.

“The best way to describe COVID-19 right now is as endemic, but with periodic outbreaks,” Hall said, “and these outbreaks can change in timing and magnitude, which is why continued vigilance and monitoring is so important.”

And even if COVID is endemic, that doesn’t mean it’s no longer a problem.

“Endemic doesn’t necessarily mean good,” says epidemiologist William Hanage of the Harvard T.H. Chan School of Public Health. “Tuberculosis is endemic in parts of the world. Malaria is endemic in parts of the world. Neither of those are good things.”

COVID still claims hundreds of lives each week, many of them elderly and people with other health problems. Although COVID is no longer the third leading cause of death, it still ranks as the 10th leading cause of death, according to a new CDC report. COVID is projected to kill nearly 50,000 people each year, according to the new report.

“I think we need to be very cautious about dismissing this as, ‘Oh, it’s just a mild infection.’ It’s not,” said Michael Osterholm of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It’s a big risk, especially for older people and people with underlying health conditions. Fortunately, for most people who are young and healthy, it’s probably just a flu-like infection.”

But even if people don’t get seriously ill and die, COVID-19 can make them very sick, keep them out of work or school, and can leave them with long-term COVID-19.

“I really hope that this doesn’t become the new normal for COVID-19,” said Samuel Scarpino, an infectious disease researcher at Northeastern University in Boston. “I got it a few weeks ago, and pretty much everyone I know has it. It would be a real shame if we got COVID in the summer, RSV in the fall, and then the flu, and basically we’re at risk for respiratory infections all year round.”

So whether or not COVID-19 is officially considered endemic, people will need to think about protecting themselves by getting vaccinated once or twice a year and considering wearing masks in risky situations or around high-risk people.

Many infectious disease experts say better treatments and new vaccines that can prevent the virus from spreading, as well as improved ventilation, would also help.

“I believe we still have to do more to control this virus,” Jha said. “This is a virus we have to deal with. We can’t ignore it. We can and should do better.”

Jha and other experts say it remains important to keep monitoring the spread of the virus and its evolution, especially to spot the emergence of new, more dangerous variants.

“We’re going to have to continue to live with COVID-19,” said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “It’s one more thing that people have to deal with. It’s one more reason for your kids to miss school, one more reason for you to miss work, one more thing to think about when planning gatherings. We’re in this together.”