Endemic as a COVID-19 Endgame
What that means, and how we get there
Across the country the COVID-19 infection rate continues its up-and-down track. Currently, Illinois is experiencing an uptick in new cases, after several weeks of seeing a decrease. The Illinois Department of Public Health (IDPH) reported the seven-day statewide positivity rate from November 1 - November 7 was 2.6%, which is the highest seen since October 14. Michigan is also seeing an increase in cases.
According to Lori Grooms, the director of Infection Prevention and Control for OSF HealthCare, seasonal upticks like this are anticipated, but she doesn’t envision a surge like we experienced in the fall of 2020, when the statewide average in Illinois exceeded 13% in mid-November.
“We have seen spikes. We've seen a couple of waves, really about three major waves with coronavirus. And we'll see fewer and fewer of those, and we won't see the large numbers that we were experiencing,” Grooms said.
Grooms pins this prediction directly on the availability of COVID-19 vaccines and boosters. If the current trends continue, the next phase we can expect, she says, is downgrading the COVID-19 pandemic to endemic status with occasional scattered epidemics. But what does that mean, exactly?
“Endemic means that it is normally circulating and something you would expect to see in that area or that population,” she explained. “Epidemic is when it is at a higher than normal (range), or it is increasing and it generally is tied to one area or a smaller group of areas. A pandemic is an epidemic at the highest proportions, meaning that it's traveling the globe.”
A disease is considered endemic when it is manageable, or not causing an extreme burden on the health care system. An endemic disease allows a community to go back to normal activities, however it is unlikely to be eliminated and will exist within the population. Grooms compares our COVID-19 present to a pandemic of the past;
“The easiest way to explain it is to look at the flu of 1918,” she said. “That really took about two years before it became a normal circulating strain, and we’re coming up on two years. We are still seeing some new strains coming out, and that has to do with how fast the virus can change and replicate; how fast it can reproduce. So it will be about two years to two and a half years, and then we'll see it kind of calm down and become normal after enough people have been exposed.”
That exposure can come either through infection, also known as natural immunity, or can be achieved through vaccination. One is proving more effective than the other.
In fact, a recent study of COVID-19 infections among people who were previously infected with the virus shows that unvaccinated individuals are more than twice as likely to be reinfected with COVID-19 than those who were fully vaccinated after their first COVID infection. Grooms agrees with the findings, and says vaccination is the best way forward to slow down the spread through immunity and to reach an endemic stage of COVID-19.
“The more people we can have vaccinated, the faster we get that immunity in place. Also, vaccination tends to be a more a more effective immunity. It's five times stronger than natural immunity. Natural immunity tends to wane faster and is geared more towards the strain that the person was exposed to, whereas our vaccination is kind of a broader overall immunity looking for the spikes that are on the coronavirus,” said Grooms.
OSF HealthCare believes vaccination against COVID-19 is our greatest tool to help end the pandemic. For information about vaccination clinics for the 5-11 age group, or to schedule a COVID-19 vaccine or booster, visit osfhealthcare.org/vaccine.