The pandemic is not over: We ignore it at our own risk
In a September interview, U.S. President Joe Biden stated: “The pandemic is over.” This comment, while not without controversy, echoed what so many want to believe, that the COVID-19 pandemic is behind us and that it is time to return to “normal.”
Clearly, the COVID-19 pandemic in the United States today is vastly different from where we were in 2020 and even during 2021. The number of new cases has substantially decreased and, thankfully, hospitalizations and deaths have also dropped. These very real improvements are due to remarkable scientific progress in prevention and treatment innovations combined with sustained efforts of individuals and communities to do their part. This includes the wide availability and utilization of testing — particularly rapid self-testing — access to vaccination booster doses offering protection against newer variants, the development of effective treatments to reduce the severity of illness, and other preventive measures such as effective masking and distancing during times of surging transmission.
Thanks to these public health interventions, it has been increasingly possible to return to a pre-pandemic norm for many people in this country. However, even as we acknowledge the progress, we must keep in mind the current reality, the tenuous status of the global pandemic and the implications of shedding all caution at this point in time.
First, our society continues to experience nearly 400 COVID-19-related deaths a day. On an annual basis, that is more than two times higher than influenza deaths in the U.S. during a severe influenza season. That is a tremendous tragedy. Additionally, certain subsets of the population continue to bear the brunt of COVID-19 in terms of the severity of illness and longer-term consequences. Older individuals, those with underlying health conditions, and those who have not been vaccinated continue to be most vulnerable to negative outcomes. Inequities continue to exacerbate vulnerabilities, including lagging access to vaccines and treatment for COVID-19 for certain racial and ethnic groups, resulting in the disparate burden of severe illness.
Second, we must not forget that COVID-19 can be particularly treacherous for immunocompromised adults, a group whose number in the U.S. is estimated at around 7 million. Studies have shown that COVID-19 vaccines offer only limited protection in this population due to the inability of such persons to generate an effective immune response. In addition, while hospitalizations and deaths from COVID are currently on the downswing in the U.S, the risk of post-COVID-19 debilitating symptoms — what has been called “Long COVID” — remains of real concern. For the safety of these vulnerable populations and to prevent chronic symptoms, there remains a collective responsibility to do everything possible to minimize virus transmission in our communities.
Third, not all countries and communities are experiencing the improving trends seen in the U.S. As the northern hemisphere heads toward winter, a number of countries around the world are currently experiencing an increase in case rates, a situation that does not bode well for what we may face in the coming weeks and months. In addition, vaccination coverage remains modest in many countries around the world. For example, as of July, only 21 percent of the population on the African continent had been fully vaccinated for COVID-19. We must remember that as long as this virus remains in circulation, whether in other countries or among communities in the United States, new variants may arise that could bypass the protection offered by currently available vaccines.
Marking with precision the exact end of a pandemic is not a simple matter. WHO Director-General Tedros Adhanom Ghebreyesus indicated as much in a statement: “We are not there yet. But the end is in sight.”
In fact, it is not realistic to anticipate that COVID-19 will switch off or disappear altogether. More likely, we will need to adjust to the presence of this virus for the foreseeable future, continue to be vigilant to its evolution, maintain momentum for the development of effective vaccines, and build capacity to rapidly detect surges in order to be able to mobilize resources quickly and effectively.
While there is much to celebrate in gains made to mitigate the severity of the pandemic and its wide-reaching negative impacts, COVID-19 remains and will remain a factor affecting the health and well-being of people across the world. Keeping this in mind, we must remain vigilant in our preparedness, cognizant of our collective responsibility to protect segments of our population that are most at-risk, and committed to reaching those who have traditionally experienced disparities in access to health and other services.
Wafaa El-Sadr, MD, MPH, MPA is the founder and director of ICAP at Columbia University, executive vice president for Columbia Global, and lead for New York City Pandemic Response Institute. Ayman El-Mohandes, MBBCh, MD, MPH, FAAP is the dean of the CUNY Graduate School of Public Health and Health Policy and lead for the New York City Pandemic Response Institute.