Opinion: Will the COVID-19 pandemic become endemic?

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On July 22, Alberta Premier Jason Kenney tweeted that the province was “moving from a pandemic to an endemic state of COVID-19.”

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The analysis, which led to the lifting of nearly all public-health restrictions, was horribly wrong. It was based on two misconceptions: that case numbers would remain low and, even if they increased, there would be no serious illness and hospitalization.

Alberta reported 106 cases on July 22; Last Friday, the number of daily cases had risen to 1,473. The number of hospitalizations and intensive care admissions is also unattractive – 686 and 189 respectively – to the point where elective surgeries have been canceled because some hospitals are overwhelmed.

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Saskatchewan is, in many ways, worse than Alberta because Premier Scott Moe pretends to have no strategy other than to deny the reality that the pandemic is still a threat.

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Everyone wants the pandemic to end. It would be great to move from a pandemic state (where the coronavirus is spreading widely and sometimes out of control) to an endemic state (where the virus is spreading at a low level and under control).

But when you hear the word “endemic,” as you will increasingly do in the coming weeks, remember that status has to be earned. It cannot be achieved by wishful thinking or blissful ignorance.

Both Alberta and Saskatchewan worked to lift the ban prematurely, when vaccination rates were still very low, and this made resurgence easy and predictable.

There is a growing scientific consensus that COVID-19 is here to stay, that the virus cannot be eliminated or eliminated.

In practical terms, this means that SARS-CoV-2 (the official name for the coronavirus) is likely to become a seasonal visitor, like influenza.

But endemic is not a synonym for mild. The flu still kills thousands of Canadians a year, and COVID-19 will likely do so for many years to come.

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During the pandemic, due to measures such as wearing masks and physical distancing, the flu almost disappeared. But when we return to “normal” (or whatever the new normal becomes), the confluence of COVID-19 and influenza each fall and winter could pose a major public-health challenge.

The question becomes, inexplicably: How much sickness and death are we willing to accept as “normal”?

When we accept that a disease will be designated as endemic, it is a difficult question we have to answer. As with influenza-like infections, the dangers of which have grown and diminished over a century since the Great Influenza Pandemic of 1918-19, we never had that discussion. With COVID-19, we can quite clearly get it.

If we cannot get rid of the coronavirus, we can at least reduce its impact.

Vaccination is clearly the most effective tool for doing this. Having COVID-19 vaccines approved for children will go a long way toward that goal.

But while vaccination is important, it is not the be-all and end-all.

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In a world where COVID-19 is endemic, masks will still have a place. Why would we allow visitors to high-risk settings like hospitals and long-term care homes when this small gesture clearly helps limit the transmission of disease?

In the future, when we have sporadic outbreaks of COVID-19 – such as in schools or workplaces – the temporary mask mandate should become a reflex.

Our culture of going to sick work also needs to change, and so does better sick-leave policies.

So, too, is our accidental acceptance of school children as carriers of disease. To limit the risks of infectious diseases – COVID-19 and beyond – class sizes should be very small, and proper ventilation should be a priority.

After more than 18 months of COVID-19 gripping our lives in Canada – four waves and counting, and a depressing series of on-and-off lockdowns and restrictions – one of the most frequently asked questions is “is it divine? When will the pandemic end?”

The short, disappointing answer is: no time soon.

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Still, we have the tools to ease the pain and difficulty, at least at home.

Denmark offers a vivid example. The Nordic country lifted all COVID-19 restrictions and declared that the virus is no longer “socially significant” and can be considered a “ordinary dangerous disease”.

The new freedoms weren’t easily found: 548 days straight of pandemic restrictions (in contrast to Canada’s repeated, on-again approach), vaccinating more than 80 percent of eligible citizens and a commitment to shut down again if a flare-up occurs.

This is the spatial state we want to strive for in the short term – but it requires hard work, not self-destructive impatience or magical thinking.

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