Yesterday on 60 minutesin an interview at the auto show in Detroit, Michigan, President Biden stated: “The pandemic is over. We’re still having issues with COVID. We’re still doing a lot of work on it. But the pandemic is over.” His statement attracted the US public health community, and even some administrative officials, caught off guard. In the hours that followed, scientific commentators were trying to understand the basis for his conclusion that there was no longer a pandemic.
To be fair, as Boghuma Kabisen Titanji, infectious disease physician at Emory, speak, “The epidemiology and public health books don’t really say how to determine when a pandemic is over.” The end of a pandemic is not like an off light switch. It is not a discrete moment in time, but a process — a process that can chaotic and highly competitive. What President Biden’s statement suggests is that the “outcome” of the pandemic is not determined solely by science or public health data, but involves social and political considerations.
Classic Define of a pandemic, from John Last’s A Dictionary of Epidemiology, arguably the “biblical” of public health terminology, is: “an epidemic that occurs worldwide, or over a very wide area, that crosses international boundaries and typically affects several large number of people”. By this definition, it would be difficult to conclude that the COVID-19 pandemic is over.
Yesterday, 481,326 new cases and 1,789 deaths were report all around the world. The World Health Organization still classifies COVID-19 as a pandemic, although its Director-General, Tedros Adhanom Ghebreyesus, speak last week that “the end is in sight,” noting that the worldwide daily death toll is at its lowest since the pandemic began.
Perhaps President Biden is referring specifically to the US? However, one analysis last week by CBS News found that US COVID-19 deaths averaged 478 per day, “higher than July 2021 when the average was 168 deaths per day, and also higher than May 6 2022 when the average is 258 deaths per day.”
Average about 400-500 daily deaths Not indicates the end of the pandemic phase in the US. Like me Debate Previously, the US was unable to eliminate COVID-19 (removal means there will be no new cases within our borders). Nor can we push the death toll to zero, because there will always be vulnerable people, especially among older Americans, and while our scientific tools to prevent deaths – vaccines, antiviral drugs and monoclonal antibodies – are highly effective, but they are not 100% effective. But we are sure maybe achieve “low endemicity” – in which there are low levels of severe illness, hospitalizations and deaths, perhaps with seasonal peaks. This scenario is similar to influenza, which we try to keep low, including with flu shots. (CDC estimate That flu epidemic killed 12,000-52,000 people a year between 2010 and 2020, something we can further reduce by expanding access to an annual flu vaccine.)
Determining when the United States has transitioned from the COVID-19 pandemic phase to the ideal “low endemic” phase will be done through a comprehensive, participatory process. Ole Norheim and colleagues at the University of Bergen, Norway have Debate that such a process — such as hearings, town councils, and civics councils — “could contribute to more credible and legitimate decisions on difficult ethical questions.” ethics and political trade-offs in times of pandemic and beyond.” There will be less anxiety about President Biden 60 minutes interview if he brings scientists and the public into his discussion. It is unclear whether President Biden consulted his own management colleagueslet alone the wider community, with its determination that the pandemic is done.
But the main problem that the President says the pandemic is “over” is that it could hinder our efforts to achieve low circulation. For example, Congress is less likely to renew funding for COVID-19 measures if the pandemic is “over”. And the public can hear the announcement that COVID-19 is “completed” and less likely to receive a new divalent booster — the first vaccine tailored to virus variants. present. Current US burden of illness, hospitalization, death, and Long Covid can and should be reduced before declaring that “work done.” Have many ways in which we can achieve this, including addressing glaring inequalities in the United States and around the world in access to vaccines, boosters, and antiretroviral therapies like Paxlovid and Evesheld. Buying boosters for older Americans is an extremely high priority for preventing preventable deaths.
We’re not at low circulation yet — but we’ve got it. Only then can we declare the pandemic over. Until then, much work remains to be done.
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