This Word Endemic - What Could it Really Mean?

 After 2 years of this COVID pandemic and as people tire of various restrictions, closures and minor inconveniences, we hear the phrase "Learning to Live with the Virus".  People, many of who never heard the word "Endemic" before this year, are tossing it around as if it's exactly where we are and we just need to move on.  This scenario is apt:

Of course, from a biological perspective, endemic means far more than most people realize and it's not all sunshine and roses.

Note: Some of this post relies on a Nature.com podcast that appeared on February 4th, 2022, called:

Coronapod: What People Get Wrong About Endemic COVID

Which in turn relied on another Nature article posted January 24, 2022, called COVID-19 - Endemic Doesn't Mean Harmless.

First, some definitions:

The term endemic just means that rates of new cases of the virus are more or less static - not rising, not falling.  Many diseases are endemic, like the common colds and influenza.  So are malaria and polio (in some parts of the world) and so was smallpox, but vaccines managed to consign that one to the medical history books.

The thing to keep in mind is that many diseases can be endemic and relatively harmless (like the cold) and others can be endemic and deadly.  Malaria, for example, kills around 600,000 people each year (so far, COVID has killed around 6 million in 2 years).  TB killed 1.5 million people in 2020.  Just because something is endemic doesn't mean it like a case of the sniffles.

The other misconception is that viruses will evolve to become less virulent - less harmful.  I've seen many "Facebook PhDs" make that very claim in the past few months.

There is NO biological justification for making that claim.  With COVID, for example, most of the infection and transmission happens before symptoms appear.  There is NO reason for the virus to mutate and become more harmless.  Alpha and Delta were more virulent than the original Wuhan strain.  And now we have Omicron, which, while seemingly causing less severe disease, is FAR more transmissible, and we ought to know what THAT means by now.  More transmission means more replication and more possible mutations.  There is NO guarantee what those future mutations will bring.

So, what are we to do by way of any realistic response?

As the article points out, lazy optimism is NOT the answer.  We have tools - vaccines, antivirals, testing and several simple public health practices like masks, distancing and air ventilation.  And we need to engage these tools around the world.  Any remaining part of the world where the virus replicates unhindered is a danger to us all.  Remember, every variant we've come to know and love over the past 2 years was first identified in a different part of the world where uncontrolled replication and transmission was happening - the UK, India, South Africa.  They ALL ended up spreading around the globe.

And remember, while the enemy is at the gates, it doesn't matter if we're tired of it or not.