What Does an Endemic COVID Really Mean?

Key Points:

• In today’s Recommendations for Industry, we discuss the ebbing of Omicron and what a shift to an endemic COVID would really mean. Read more below.
• The FDA is limiting the use of the following two monoclonal antibodies – (a) bamlanivimad and etesevimab and (b) REGEN-COV – to treat COVID-19 as they are “highly unlikely to be active against the Omicron variant.” And as the Omicron variant now accounts for 99% of all cases in the U.S., these two treatments are not to be used [FDA].
• Although COVID-19 cases are ebbing, hospititalizations and deaths remain seemingly high [CIDRAP].
• Pfizer is starting its clinical trial for an Omicron-specific vaccine (CNN).
• The CDC has designated 15 destinations, including “popular Carribbean travel destinations [like] Dominican Republic, Guadeloupe, Jamaica, Saint Barthelemy, and Saint Martin” to the Level 4 Very High Risk list (UPI).
• There seems to be a new version of the Omicron variant, designated BA.2. However, there is no need to panic. There is currently not much information specific to it, and TAG will keep you updated on it as things evolve. Find more in the news at Washington Post or CBS. 
• Nature has released a discussion on what it means for something to be endemic. Just because a disease is endemic does not make it harmless or even less deadly.

Influenza:

• Influenza cases in the U.S. are still high; however, there has been a drop over the past week. The majority of influenza cases are Influenza A; this year’s influenza vaccine tracks similarly to the specific H3N2 virus. This is good news.
• Globally, “influenza activity remains low but continued to increase especially in the temperate zones of the northern hemisphere. In several countries, influenza activity reached the levels seen this time of year in pre-COVID-19 period.”

Recommendations for Industry

What Does an Endemic COVID Really Mean?

We are continuing to see an ebbing of Omicron case rates as the variant moves across the country, so even with some news of the emergence of an Omicron subvariant, TAG is holding guarded optimism for a continued decline in the pandemic and gradual shift to COVID as an endemic disease, similar to influenza. Variants are likely to continue to emerge – just as they do with the flu – but we are not seeing anything to indicate an increase in severity. We also would not expect a new spike as those who have had the initial Omicron variant (BA. 1) are likely immune to the subvariant (BA. 2).

So what, exactly, is the difference between an endemic and a pandemic – and what does it mean to your business management? As defined by Oxford Languages, an endemic disease is one that is “regularly found among particular people or in a certain area”; but, as discussed in Nature, the “overall rates are static — not rising, not falling.” So it does not mean it will end or even necessarily become milder. While the common cold is endemic, so are malaria and polio. “A disease can be endemic and both widespread and deadly,” so endemic does not mean that life simply will return to a pre-pandemic norm. Rather, as the Nature article states, “Stating that an infection will become endemic says nothing about how long it might take to reach stasis, what the case rates, morbidity levels or death rates will be or, crucially, how much of a population — and which sectors — will be susceptible. Nor does it suggest guaranteed stability: there can still be disruptive waves from endemic infections, as seen with the US measles outbreak in 2019.”

So we need to accept that COVID will be a factor of our lives, perhaps forever. Like the flu, people will get sick, be off work, have minor or severe symptoms, and some will even die. It is a fact of life we will need to accept – and that we will need to continue to prevent, most likely through (again, like the flu) annual vaccinations, personal hygiene, staying home when ill, and, yes, re-masking when the need arises.

In case you missed it

• In last Thursday’s Recommendations for Industry, we discussed Omicron’s path across the US. Read more here.
• U.S. hospitals have been inundated with Omicron cases; yet, as the vaccine mandate for healthcare workers becomes effective March 15, there is increasing fear that hospital systems may lose some workers.  Additionally, despite signs that Omicron causes milder disease on average, cases are still surging in many states, so vulnerable people are still becoming severely ill.
• Reflected in this, the CDC Nowcast reports that the Omicron variant accounts for 99.5% of all new COVID-19 case in the U.S. with almost 1 million pediatric COVID-19 cases reported between Jan 06 – Jan 13. (CIDRAP).
• The White House will soon offer 400 million free N95s to Americans. This goes hand-in-hand with the 4 free at-home rapid COVID-19 tests that each U.S. household can also acquire. For the latter, input your information into USPS at this link.
• The Omicron variant is surging globally, hitting record highs in Europe (including Germany, Czech Republic, and Bulgaria) and in the Southern American Hemisphere with Caribbean countries deeply impacted with a drastic rise in cases. 
• A recent study has found that there is no evidence of live SARS-COV-2 virus in breast milk of mothers who have COVID-19 (CIDRAP).

Public Health & Food Safety:

• The FDA released its 2021 “Year-In-Review” covering topics of response to COVID-19, diversity and equity in public health, safer food, protecting public, and consumer safety and protection topics. Download the document here.
• Texas A&M AgriLife Research is focusing on supporting onion producers (through research) to solve the problem of Salmonella contamination of bulb onions.