Covid will always be an epidemic virus — not an endemic one, scientist warns

According to a biosecurity expert, Covid-19 will never become an endemic illness and will always act as an epidemic virus.

Although the endemic disease can arise in large numbers, Raina MacIntyre, a professor of global biosecurity at the University of New South Wales in Sydney, said that the number of cases does not vary as quickly as the coronavirus.

"If case numbers do change [with an endemic disease], it does so slowly, usually over the years," she said. "On the other hand, epidemic diseases spread rapidly over days to weeks."

To measure how quickly a disease spreads, scientists use a mathematical equation known as the R naught (or R0). The R0 indicates how many people will get an infection from an infected person, with Imperial College London experts predicting the number to be higher than 3.

According to MacIntyre, if a disease's R0 is more than 1, its spread is exponential, indicating that the virus is spreading and the conditions for an epidemic are there.

"The public health goal is to keep the effective R below 1," she said. "The effective R is R0 adjusted by interventions such as vaccines, masks, or other mitigations." "However, we often find recurrent epidemic waves for respiratory transmitted epidemic infections if the R0 is greater than one."

According to MacIntyre, this is the pattern that has been seen with smallpox for centuries, and it is still seen with measles and influenza. It's also the pattern that's unfolding with Covid, which has had four large waves in the last two years.

"Covid will not magically turn into a malaria-like endemic illness with introduced in the early for long periods," she said. "It will continue to cause epidemic waves, driven by waning vaccine immunity, novel variants that escape vaccine protection, unvaccinated pockets, births, and migration," says the study.

"This is why we need a continual 'vaccine-plus' and ventilation plan to maintain R below 1, so we can live with the virus without major societal disruptions," MacIntyre said, adding that "additional variants will be coming."

The World Health Organization recently warned that the next Covid type would be even more contagious than omicron.

Covid will continue to "show the waxing and waning pattern of epidemic diseases," according to Global Biosecurity, a Twitter account representing a collective of UNSW research departments studying epidemics, pandemics, and epidemiology.

The organization said, "[Covid] will never be endemic." "It is and always will be an epidemic sickness." This means it will seek out unvaccinated or under-vaccinated individuals and spread quickly among them."

Pandemic, epidemic or endemic?

According to the Centers for Disease Control and Prevention in the United States, an epidemic happens when cases arise over what is usually expected, typically unexpected.

When a disease's growth is exponential and spreads globally, the WHO calls it a pandemic.

In a blog post last year, experts from Columbia University's Mailman School of Public Health explained that while an epidemic is large, it is also often contained or expected in its spread. However, a pandemic is international and out of control. "The difference between an epidemic and a pandemic is the degree to which the disease has spread, not the severity of the disease."

The United States Centers for Illness Control and Prevention (CDC) defines endemic disease as "the constant presence or normal prevalence of a disease or infectious agent in a population within a geographic area."

According to the American Lung Association, for Covid to become endemic, enough people must have immune protection against it, highlighting the need for vaccination in the virus's move away from pandemic status.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus stated that Covid might be declared a global health emergency this year if the proper steps are taken, including tackling vaccine and healthcare inequalities.

His comments come a week after another senior whom official warned that "we will never be successful in removing the virus" and that "endemic does not mean 'good,' it simply means 'here forever.'"

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