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IS the pandemic over?

By September 23, 2022October 5th, 2022Blog

Friends— President Biden stirred up a small controversy last week when he said “the pandemic is over” in a 60 Minutes interview. In the next sentence, he clarified, “COVID is still a big problem, and we’re still doing a lot of work on it, but the pandemic is over.” Is Biden right? In this Endemic, we’ll discuss what it means for a pandemic to be “over” and what we can predict for COVID into the future.

📊 Washington’s COVID-19 Weekly Snapshot

COVID cases 😷

Title: 7-Day case rate per 100,000 population from 9/5/2022 to 9/12/2022. 16 of 39 counties have had 100+ cases per 100 thousand people. Counties that don’t fall into this category are Whatcom, Island, Snohomish, Skagit, Clallam, Pierce, Kitsap, Grays Harbor, Jefferson, Lewis, Thurston, Pierce, Cowlitz, Lincoln, Stevens, Adams, Pend Oreille, Ferry, Pacific, Klickitat, Clark, Asotin, Skamania, Whitman, Kittitas, Okanogan counties with 50 to 99.99 cases per 100,000 people, and Skamania, San Juan and Wahkiakum counties with 10 to 49.99 cases per 100,000 people.

Hospitalization rates 🏥

A line graph stemming from January 2020 to September 2022 that covers the weekly rate of new COVID-19 hospitalizations per 100,000 people. The highest spike was around February 2022, at above 25. There have also been 4 other spikes, at rates of approximately 18 (Nov. 2021), 8 (May 2021), 10 (April 2021), and 7 (March 2020). Since May 18th, 2022, the line again trends upward after a dip in hospitalization rates, and begins to plateau at the beginning of June, then rises at the end of June and begins to decrease in mid-July and continues to decrease in August, continuing into September. The latest data point is 4.7 hospitalizations per 100,000 people on September 10th.

Hospitalizations from COVID continue to drop which is welcome news. We’re down to 4.7 cases per 100,000 people, which is about half of what it was in July. But we need to keep up our guard, as the rate of spread is still considered moderate to high in most of the state. We continue to urge that you wear an N95 mask in crowded indoor areas and take precautions. And get those new and improved boosters.

Washington is also making news because state employees just negotiated a contract to receive $1,000 bonuses for getting boosted. Doesn’t sound bad at all—yet another reason why unions are great.

🤷‍♀️ When is a pandemic ‘over’?

In the first emails of our Endemic newsletter, we shared our viewpoint that we’re indeed still in a pandemic, but beginning to undergo a transition to an endemic phase, meaning the virus becomes a regular presence in human life, similar to the flu. There’s no official marker for when a virus transitions from a pandemic to endemic, but most scientists agree it’s when a virus becomes predictable.

The flu is a great example of a truly endemic virus: It has predictable seasonality and the deaths from it are generally stable from year to year. Let’s compare COVID to the flu on a couple of metrics.

A COVID infographic from the CDC with data as of September 20th. It shows 355 daily average deaths, and a line graph with a decreasing trend from August to September. It shows total deaths at 1,048,532. It shows 4,105 daily hospitalizations, with a similar downward trend from August to September. It shows in total, 23,639 current hospitalizations. Lastly, it shows that 34.9% of the population over age 5 has received a first booster dose, or 109,201,576 booster doses.

Deaths

The CDC estimates that an average of 36,000 people died of the flu each year over the past decade (10 years). If the current rate of COVID’s 355 daily deaths continued, we would see around 130,000 deaths a year.

When considering the official death toll from COVID, it’s also important to take into account how it’s counted. If you died principally from another disease, while also being sick with COVID, your death is counted as a COVID death. COVID often worsens other conditions, but the nuance is important.

Dr. Bob Wachter, the chair of the University of California San Francisco’s department of medicine, told NBC he thinks about half of all recent COVID deaths would fall under the “with” not “from” category.

So with that estimate, we’re closer to 70,000 deaths from COVID a year.

Some scientists believe that with current trends from COVID, it’s possible it will become more similar to the Flu’s 36,000 deaths a year. In another interview with NBC, Dr. Chris Murray, the director of the Institute for Health Metrics and Evaluation at UW, said, “It would not surprise me if we have a similar magnitude of deaths from COVID as we do from flu.”

Seasonality

For the most part, scientists agree that there has been no seasonal trend with COVID. Surges in the virus have been associated with when variants emerge as opposed to seasons.

Predictability

Usually, endemic viruses like the Flu do not have extreme surges in death or illness from year to year. While COVID has been on a plateau or slightly downward trend for the past month and a half, the virus is still unpredictable. There are already new variants of concern, such as Omicron’s BA.2.75.2 or BA.7 which can more strongly evade immunity.

We can’t say with certainty if these variants will cause large waves or a series of more predictable, smaller waves.

But together, we do have the ability to make the virus much more predictable. The higher the rate of the spread, the higher the rate of new mutations and variants. If we tamped down spread through nasal vaccines, robust ventilation, and masking in crowded indoor areas, we would see fewer new variants. Whether that’s enough for COVID to truly become “predictable” similar to the flu, is unknown.

The big picture

We disagree with Biden; The pandemic isn’t over because the virus isn’t predictable enough yet. The next few months will be very revealing: Will we see new variants surge or current trends continue?

At some level, COVID is also about the tradeoffs we as a society make around individual freedom and personal choices versus collective responsibility. The prospect of 36,000 deaths a year from COVID is awful. But for some perspective, the CDC estimates around 140,000 deaths a year from excessive alcohol use.

If COVID hawks want the public to adopt greater concern over COVID, it will have to be through smart and effective persuasion rather than shaming or ridiculing people. And it means listening to, and maybe compromising around, the real concerns and tradeoffs people have around COVID, whether it’s economic impacts or effects on our children’s education. It means listening to the many communities of color that have experienced systemic racism within the healthcare system and are rightly skeptical of it, and doing tangible things to respond such as investing in Community Health Workers.

We should even listen to the people who believe COVID is a plot by Bill Gates to make money from vaccines and Big Pharma. No really, in the sense, these ideas don’t come out of the void. In 2020, we saw around 70,000 deaths from the opioid epidemic. We know that Big Pharma colluded and bribed doctors to overprescribe addictive painkillers. People generally aren’t dumb—they understand that profit motives drive a huge amount of our healthcare system, and that corruption is common. It’s not too much of a leap from there to Bill Gates conspiracies.

At the end of the day, COVID is wound up in the broader problems our society faces. The labor organizer and author Jane McAlevey, titled one of her books, “No Shortcuts: Organizing for Power in the New Gilded Age”. We think that same philosophy applies to COVID. There aren’t any “easy shortcuts” to an effective, holistic response to COVID when a society becomes as distrustful, profit-centric, and fragmented as ours.

In her book, McAlevey makes the case that mobilizing a small cadre of activists is no substitute to real organizing, which is about bringing new people (especially when we may not hold all the same progressive beliefs) into a movement, a union, a community group, a campaign, and so on. We agree.

🙏 COVID-19 And Monkeypox Resources

Whether above or below, we’ll always keep this resource list around! Here’s what’s available:

The DOH has told the public that demand is likely to exceed supply for the first few weeks, so maybe take that into account. For example, if you’ve recently had COVID, then you have some recent natural immunity, and therefore could wait 2-4 weeks (conservatively) before getting your booster.

What do you think? Have any questions? Tweet us your thoughts @WACommAlliance.
Keep up on Washington’s latest COVID-19 trends, new research, and more through our Endemic newsletter.