Is it Over – From Pandemic to Endemic

It is a long road from a pandemic to an endemic, much like Nelson Mandela’s quote when he described peace. He said, “peace is not the absence of conflict but creating an environment where it can flourish.” The same is true when discussing Covid 19 becoming endemic versus a pandemic. Globally, there has only been one global disease, smallpox, eradicated. Smallpox, however, was transmitted with long exposure and through sharing of bodily fluids and or personal items such as bedsheets. Covid 19 and its mutations are easily spread in a shorter time. The latest mutation is more contagious than Polio.

So how could Covid and its mutations get to endemic status? Like all the other pandemic viruses that have moved to an endemic level, it is a combination of factors. Yes, one of them is some many people get infected, but the immunity gained from that does not last long. The way the top eleven infectious diseases have or are being controlled and maintaining their endemic status is through immunization and, in the case of HIV/AIDs through, retroviral drugs, condom usage, and pre-exposure medications. That means that continuous public health interventions, such as vaccinations, have to be done on a timetable, with flu being once a year and others done in childhood. In the case of HIV/AIDS, retroviral and pre-exposure medications have to be taken daily.

Thus, for an endemic to occur and be maintained, lots of people have to have timely access to life-saving vaccines and or medications. Outreach and adherence have to occur within all communities. This has to happen globally, as every disease is just a plane ride away from boomeranging back to the United States. The United Nations, through organizations such as Shot@Life, governmental organizations such as the United States PEPFAR program, and a combination of governmental and private organizations such as the Global Fund for HIV/AIDS, TB and Malaria, and GAVI have enabled a yearly global vaccine and medication distribution system that makes sure that previous pandemic illnesses can stay endemic.  Without this constant control and a global reach where everyone gets access to life-saving vaccines and drugs, the endemic does not stay endemic.