The next year and beyond: implications of shifting from pandemic to endemic COVID


We’ve come a long way this year. Currently over 50% of Americans, close to 60% of Western Europeans, and 24% of the global population have been fully vaccinated against COVID. Every day around one in 200 people in the world receives a vaccination.

Of course this does not portend the end of COVID. This is underlined by recent data from Israel, where there are around 8000 cases daily, despite 78% of the population being double vaccinated.

Pandemic (from pan meaning ‘all’) is used to describe an epidemic that has spread across nations and sometimes the world. Endemic refers to diseases that may be widespread, but with relatively consistent numbers over extended periods.

As we move closer to the point where most of those who want to be vaccinated have been, for now just in developed countries, we will have to start considering ourselves past the pandemic phase, and into the endemic phase.

COVID isn’t going away

A recent survey of leading epidemiologists by the leading journal Nature suggests it is highly unlikely that coronavirus is ever completely vanquished, with almost 90% believing COVID will continue to circulate. A minority believe that it can be eliminated from some regions, but not across the world.

As the article explores in detail, there are substantial uncertainties in the current and long-term efficacy of our current vaccines, vaccine uptake, and other factors including contagion through animals, which has already been demonstrated.

Beyond lockdowns

Most countries in the developed world are living in various degrees of lockdown or restrictions. The impact on many businesses, not to mention the mental health of many, has been and continues to be brutal.

Clearly these measures cannot continue indefinitely. When we have done what we can by vaccinating most of the willing, we will have to consider the virus as endemic. There may still be pointed breakouts of the disease, but these will be punctuation marks in an ongoing state of living with COVID.

Disparate national responses and travel reopening

As we have already seen, there will continue to be a very wide spectrum of responses by governments, from laissez-faire to still continuing to go in and out of lockdowns as cases rise to minimize infections.

International travel will open up relatively freely between nations that have accepted that COVID is endemic, while some nations will long keep restrictions. Two weeks quarantine will minimize travel to some countries for a long time to come.

The divide between the vaccinated and the unvaccinated

Layering on top of the many deep political, economic, and social divides we are experiencing around the world, society will begin to be divided into those who are vaccinated and those who choose not to be.

In addition to the different levels of access to work, travel, entertainment and far more that many governments and some companies will mandate, the vaccinated will often not want to be around those who have not had the vaccine.

Divides within families and communities are already appearing and will often become more accentuated, with the potential for unfortunate escalation in division and conflict.

Evolving work and offices

The debates around whether and how to resume ‘normal’ office work and hours will continue.

Some companies will continue to strive to resume work as it was before, while others will soon establish relatively stable configurations of hybrid work between home, office, and third spaces that can adjust depending on the current degree of restrictions and caution.

Regular vaccinations

Scientists are still gathering data, however the latest evidence from Israel suggests that vaccines will need to be renewed, either because their efficacy degrades, or because new variants make them less effective.

Many have compared COVID in its possible endemic form to flu: highly transmissible, never eradicated, and evolving from season. A key difference is in its severity and mortality rate, and potential long-lasting effects.

The need for human touch

Humans are highly social animals, who need to be around others, and benefit immensely from the touch of others, be it in a handshake, cheek kiss, hug, or on occasion more.

There is a danger that in a world of endemic COVID some, or even many, will allow their fears of infection to limit their social engagement, particularly with strangers. We may need to develop new behaviors that allow us contact while minimizing risk.

Learning to live with COVID

Almost everyone has been impacted by COVID, some with deaths in the family, many with businesses or livelihoods lost, others with the emotional impact of isolation and lack of certainty.

Acknowledging COVID as a likely ongoing factor in our lives will require still more adjustment. The shape of life amid endemic COVID is not yet clear, but we can begin to get some sense of what it will be like. We will need to learn to live our lives to the fullest within its constraints.