The writer is an Adjunct Professor of Epidemiology at the University of Nebraska and has worked for the US Centers for Disease Control and Prevention. He can be reached at jasghar@gmail.com

Endemic Covid-19? Another false god

Many are openly hoping that through the Omicron variant, most of the world population will acquire “herd immunity”.


Dr Rana Jawad Asghar February 01, 2022

When Covid-19 pandemic started in early 2020, many epidemiology terms were thrown on to us by those who were newly inspired by the discipline. One of these terms was endemicity. How quickly Covid-19 could be moved from a pandemic status to an endemic stage? This was a favourite question for highest decision-makers and alongside they were quietly hoping that quickly a majority of the population gets infected with the disease and then countries could have “herd immunity” and move forward. That is why there was a huge demand for prevalence surveys even though at that time diagnostic tests were still in infancy and accuracy of these surveys was very limited. But resources were poured in across the globe to find some false assurances. But now two years into the pandemic we have seen the highest ever number of cases in many countries. Fortunately, deaths have not risen proportionally in most countries. Biggest exception is the USA where deaths have risen to a historic level too.

Covid-19 endemicity is becoming once again a news headline. Many are openly hoping that through the Omicron variant, most of the world population will be infected and then we will acquire “herd immunity” and then disease will becomes endemic. Once disease becomes endemic the life will return to normal and the pre-pandemic party will restart. This is mostly coming from the developed world, and they are hoping that the way TB, HIV/AIDS and other infectious diseases have been controlled in the West, Covid-19 could be controlled too. But leaders are forgetting that these diseases are still killing hundreds of thousands in poor countries every single year. TB kills nearly 1.5 million people every year. Malaria still kills 600,000 and HIV/AIDS kills another million every year. Nearly all of those who are dying of these diseases are dying in developing countries. So, if you see anyone talking about Covid-19 endemic situation, they may be hoping that the above situation happens again in case of coronavirus too and they could be safe while the rest of the world could take a hike.

That is why people in developed countries are moving toward the fourth dose while one-third of the world population is still waiting for their first dose. Even the US president could not persuade giant pharmaceutical companies to share technology of mRNA vaccines with poor countries so that vaccination could be maximised. What they are forgetting is that Covid-19 is not like TB, HIV/AIDS or Malaria. Coronavirus pandemic cannot be pushed down and contained in the south the same way. It is highly infectious and airborne with many spreading while they are without any symptoms. This makes it close to impossible to control the disease working exclusively inside your national borders. As I wrote last year “Rich countries cannot build a wall of vaccinations around their borders as if transmission is happening somewhere else, eventually a new variant will breach these walls and make these populations vulnerable again.”

The recent Omicron variant has made it abundantly clear that we all are in this boat together. Secondly, prior infection is no guarantee against reinfection. Vaccinations are still saving lives but do not provide the same protection against reinfection. To really protect ourselves we need to hold each other’s hand and work together. Working together in a meaningful way and only then with global effort and a gameplan could we bring the transmission down and put a hold on new variants. For that, the World Health Organization has to step up and provide leadership based on science and collaboration. For those who are thinking that they could protect their countries on their own, I will ask them to leave this false god of Covid-19 endemicity. The only way we could “live with virus” is by first universally controlling it. Covid-19 will never be TB.

Published in The Express Tribune, February 1st, 2022.

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