As each COVID wave draws to a close, we have become accustomed to hearing from commentators and politicians that this time, the end of the pandemic might just be in reach. This line of argument is especially common in countries with high vaccination rates.
However, public health policy should not be based on wishful thinking, and unfortunately, the data tells us something entirely different. Not only does this epidemic appear to be a long way from petering out, but even when it does, the disease will likely remain, and millions of patients around the world will be forced to live with it or face the unfavorable alternative.
In the end, COVID will become an endemic disease akin to flu, with a stable prevalence and seasonality, though this might take decades. It will, however, continue to display much more serious potential consequences than flu, including higher rates of hospitalization and death.
Yet even when we reach the endemic stage, it does not mean we are out of the woods. COVID has much more serious implications than flu, with the rate of pneumonia five times higher among hospitalized COVID patients than those hospitalized with flu, while the risk of breathing failure is 50 percent higher.
Furthermore, contrary to popular belief, “an endemic disease does not necessarily mean a mild disease,” as recently reminded by leading public health expert William A. Haseltine. The flu is but one example of a pandemic disease turned endemic that, according to the WHO, is responsible for 290,000 to 650,000 deaths every year with an economic burden of over 11 billion dollars per year in the U.S. alone. Another conveniently forgotten endemic illness, malaria, afflicts 241 million people every year, taking the lives of around 627 thousand and serving as another reminder that public interest and media coverage is not always related to disease severity or its impact on society.
Analyzing the data at our disposal, it appears that even once the epidemic recedes, between five and 25 percent of the global population are expected to be infected with COVID, every year. Of them, around four percent will likely be hospitalized, while around 30% of those hospitalized will reach severe or critical condition. Between 10% and 20% of those in a severe or critical condition will die from the disease.
This forecast crystalizes the need to develop rapid and efficient treatments for patients at various stages of the illness. In addition to vaccines and treatments for mild-to-moderate COVID patients, living alongside COVID (whether in the pandemic or endemic scenarios) requires additional treatments for severe and critical COVID patients, whose impact on health system failures is the most significant.
Advanced treatments of this type, which can help in the rapid healing of pneumonia and quieting the cytokine storm among COVID patients, thus reducing lung damage and acute respiratory distress, are the key to saving lives and to returning to a normal routine.
As Winston Churchill famously said after the Battle of Alamein in World War II, “This is not the end, it is not even the beginning of the end. But it is, perhaps, the end of the beginning.”
For COVID, this is perhaps the end of the beginning, and we must use all the means available to win this great global battle too.