Amid declarations by epidemiologists and public health experts that COVID-19 is shifting from a pandemic disease to an endemic one, Dartmouth professors and public health experts caution against this diagnosis due to the pandemic’s unpredictability.
In an email sent out to the community on Wednesday, interim provost David Kotz and executive vice president Rick Mills addressed the uncertainty of COVID-19’s long-term trajectory.
“Many epidemiologists and public health officials observe that we are moving from pandemic to endemic status, although it is still not certain how severe or disruptive the virus will become over time,” they wrote.
They added that this evolving approach to confronting the pandemic has translated to a shift in focus in federal guidance and local government policies from “containing the spread of the virus to reducing risk and making it easier for people who have been vaccinated and boosted to resume normal activities while taking precautionary measures.”
The term “endemic” describes something that is “constantly present or occurring frequently in a region or population,” infectious disease epidemiologist and Geisel School of Medicine professor Anne Hoen wrote in an email statement.
“In epidemiology, it can take on a more specific meaning, which is where a disease reaches something close to an endemic steady state in a population,” Hoen added. She contrasted an endemic with an epidemic spread, where introduction of a virus results in exponential spread through a population.
Because the omicron variant is causing “massive epidemics” in many regions of the world currently, categorizing the pandemic as an endemic is not fully correct, according to Hoen.
“It is clear at this time that COVID-19 will be here long-term,” Hoen wrote. “So in one sense of the word endemic, yes, that is where we are. But in the more specific epidemiologic sense, ‘endemic’ is not a good description of the current situation.”
Rockefeller Center for Public Policy policy fellow and public health practitioner Anne Sosin echoed Hoen, saying that there is “no basis for saying that this is an endemic at this point in time.”
“The U.S. is experiencing record cases, hospitalizations … and widespread disruption, so as much as we would like to be done … the desire to say we are finished is premature,” Sosin said.
According to Sosin, many are using the omicron variant as proof of COVID-19’s shift to an endemic presence in society.
“Many are saying right now that the omicron surge is the endemicity, but many also thought that about [the delta variant],” Sosin said. “So I think we need to recognize that new variants and the sudden surges that they drive are a hallmark of COVID-19, and we need to build the policy infrastructure to manage them.”
According to Hoen, the omicron variant has also caused less severe disease than previous variants. This can be attributed in part to increasing immunity due to more people receiving vaccinations and boosters, as well as the variant’s tendency to infect lung cells less easily, Hoen wrote.
“The next important variant could be less deadly or more deadly,” Hoen added.
Hanover deputy health officer Robert Houseman also commented on the volatile nature of the pandemic, as “every one of the COVID-19 variants thus far [has] been different.” As for the pandemic shifting to endemicity, he said that “we do not know what an endemic COVID-19 will look like until we are in it.”
According to Houseman, Hanover will most likely follow guidance from the Centers for Disease Control and Prevention.
Sosin emphasized the importance of implementing policy infrastructure to manage waves of new COVID-19 variants.
“I’ve been an advocate for data-driven mask policies as one tool to manage the pandemic,” Sosin said. “But we also need to have the infrastructure in place, if we see a more virulent variant emerge, to take more drastic measures.”
Hoen wrote that for the College, “prevention strategies are still very much needed.”
“I think Dartmouth needs to be finding ways to carry out its mission while doing its part to implement the strategies that we know can help to control [COVID-19],” Hoen wrote. “Despite the movement to treat [COVID-19] like other respiratory viruses, we need to acknowledge that it is still causing far more morbidity and mortality than respiratory viruses typically did prior to [COVID-19], and that it is a dynamic situation that will continue to take unexpected turns, at least for a while.”
