“I think we’ve done a huge disservice using the word ‘endemic,’ frankly,” Michael Fraser, executive director of the US Association of State and Territorial Health Officials, told an audience of mostly public health officers during a panel discussion at the 2022 Preparedness Summit in Atlanta on Thursday.
“It’s not well-understood. It’s not precise,” he said. “There are endemic diseases that kill 400,000 people a year, like malaria … and there are endemic diseases like herpes or HSV-1 that are in half the population and maybe you get a cold sore.”
Endemic refers to the constant presence or “usual prevalence of a disease or infectious agent” among a population within a geographic area, according to the US Centers for Disease Control and Prevention.
But it might be too simplistic a term to apply to Covid right now.
“It doesn’t seem to fit,” Lori Tremmel Freeman, chief executive officer of the National Association of County and City Health Officials, told CNN at the event. “No term really can just be plugged and played.”
“We don’t have all the pieces to this puzzle of Covid,” she said. “It seems like a false narrative to talk about the end. We can plan for it, but we have to be ready to go back to measures if we see another variant or another wave.”
It’s a pressing discussion, given that the Western world is moving — albeit at different speeds — toward a pre-pandemic set of measures and rules.
European countries “brutally” ended their restrictions in the early part of this year, the World Health Organization said, and April has seen Germany scale back mask rules and the UK scrap all of its prevention measures.
The US, meanwhile, could let its mask mandate in airports and on flights lapse on Monday.
So what’s the answer, according to the experts? Instead of using “endemic,” Fraser said, public health leaders should focus on what “sustained management” of Covid-19 might look like.
That means exploring options like annual booster shots, keeping some prevention measures in reserve for future outbreaks — and constant monitoring of where, when and how the virus is spreading.
“We tend to think of endemic as really just an expected disease that’s out there circulating,” Janet Hamilton, executive director of the Council of State and Territorial Epidemiologists, said during the panel.
“That’s definitely what Covid is going to be — but the ‘expected’ part is still, I think, such a big question on the table,” she said.
CNN Health’s Jacqueline Howard contributed reporting.
YOU ASKED. WE ANSWERED.
Q: Will boosters be needed more than once a year?
A: It’s possible that some people will be offered frequent Covid-19 vaccine boosters, according to Dr. Leana Wen, CNN medical analyst and an emergency room physician. But there is “a lot we don’t know,” she said.
“Certain groups of people may need more frequent vaccines,” Wen said, referring to immunocompromised people. “It’s possible that, going forward, certain more vulnerable populations will be recommended to get vaccines at a higher frequency than the general population.”
Wen added that there would need to be contingencies in place so that if a new variant that evaded prior immunity arose, the option to develop, manufacture and distribute variant-specific vaccines would be available, which could bring vaccine frequency up for that particular time period.
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The United Kingdom, for example, has been at Level 4 since July 19, 2021.
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TOP TIP
Ventilated spaces help reduce the risk of transmission
We spend most of our days indoors — so the “air we breathe indoors has a massive impact on our health,” Joseph Allen, director of the Healthy Buildings Program at the Harvard T.H. Chan School of Public Health, told CNN.
A good rule of thumb, he advised, is to look at how well-ventilated a space might be. The better the ventilation, the more the air is diluted — similar to how it is outdoors.
But tasking people with assessing their own risk can be a challenge, so having the basics of vaccinations and knowing Covid-19 infection rates is important.
