Opinion: The pandemic may be over, but the coronavirus is still with us

“We have never been in a better position to end the pandemic,” Tedros said on Wednesday. “We’re not there yet, but the end is in sight.”
I agree with him. Cases, hospitalizations and deaths are decreasing in most, if not all, countries. In addition, many in the world have received a vaccine, developed the disease, or both, and it gives reasonable hope that we will have herd protection.
But Tedros is right to be cautious. As we approach the end of the third pandemic year, the accuracy of most forecasts has been staggering. The coronavirus seems to be several steps ahead of our understanding despite our best attempts. Yes, at the moment, we seem to have the upper hand, especially given that there are no new variants of the virus that causes Covid-19 at a gallop, a break in the action that we haven’t experienced in a long time.
Also, the US Centers for Disease Control and Prevention recently determined how much progress has been made, at least against deadly diseases. It’s kind of like a good news-bad news update. The CDC described three post-vaccination phases: the dominant Delta variant (summer 2021), then the “early Omicron” period (winter 2022), and finally the “late Omicron” period (spring 2022).
The death rate for those sick enough to be hospitalized has dropped dramatically, from about 15% during the predominance of the Delta variant to less than 3% at the end of the Omicron phase over the past year, according to the CDC. These figures are good news from a trend perspective.
However, in the United States, hundreds of deaths from the disease continue every day, with 5 in 10 deaths in those at least 65 years old, especially those with other medical conditions at the same time.
In other words, even if we consider the pandemic “over”, we are not yet done with Covid-19. As President Joe Biden said in a CBS “60 Minutes” interview, “the pandemic is over. We still have a problem with Covid.”
Given the yes-no moment, I fear that the WHO leader’s statement may still cause premature celebration. Tedros used the metaphor of a race almost — but not quite — won. To me, this is very wrong to think about the future. It’s not race or war; there is no medal to wear on a bowed head or a belligerent to advance in surrender.

Rather, the enemy is an anarchic part of the RNA, wandering about without cause or concern, without direction or purpose. We are looking for a relatively peaceful coexistence with the virus, because total victory is out of reach. There won’t be a bang, but there won’t be a squeal either, just a change in pace and intensity that will periodically remind us that a new full-scale wave may be around the bend.

So how do we know when the pandemic is over? The WHO has a formal way of determining the beginning and end of any pandemic, which it calls a Public Health Emergency of International Concern, or PHEIC. In addition to Covid-19, since 2007 it has been done six times (influenza, polio, twice in the case of Ebola, Zika and monkey). National public health groups like the CDC defer to the WHO’s ruling.
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These decisions are made by an 18-member expert committee formed by the WHO. This group has fairly clear criteria when deciding to declare a public health emergency: The problem must be “severe, sudden, unusual, or unexpected,” likely to spread globally, and likely to require immediate international action, according to the journal Science.
However, the criteria for declaring the end of a pandemic are not so clear. Some hard data, such as a decline in the number of cases or an increase in vaccination rates, may help, but the final decision is based on social and political reasons rather than scientific ones, Caroline Buckee, an epidemiologist at the Harvard TH Chan School of Public Health, told Science. “There will be no scientific threshold,” he said. “There will be consensus based on opinions.”
This return to hands-on decision-making may at first seem like a disappointment. After all, we’ve muscled our way out of disaster using high-tech scientific techniques, mastering how to inject messenger RNA into a human cell with a confidence that would make the great science fiction writer Ray Bradbury cringe. Also with antibody treatments, antivirals and rapid home tests.
So why do we trust mental experts sitting around a table to advise us on the symbolic end of the pandemic, as if we will then resume normal life? Are human minds sophisticated enough to make important decisions in the face of a disease that has killed more than 6.5 million people worldwide and fooled the best experts every step of the way?

There was never going to be any way to see more than a day or two into the future, when a new pathogen was doing unexpected things in a population that wasn’t completely immune. However, with its ending. So yes, the 18 experts will gather and think and then worry and think some more. In the end, they will give light.

Because of the pandemic. Pandemic, however, is not synonymous with Covid-19. The risk of catching a bad case of a virus called SARS-CoV-2 will remain with us for the foreseeable future. And how well we manage its quieter version will determine how long we remain pandemic-free.