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Planning for covid-19 as an endemic disease

Do governments need to start planning for covid-19 as an endemic disease? Unfortunately, based on several factors, it seems that the only viable solution is to plan for covid-19 as an endemic disease.

Before we go into details about this matter, let us look at some key definitions to better understand what we are talking about. On the 11th of March 2020 World Health Organization (WHO) declared covid-19 as a pandemic (link). Wikipedia defines pandemic as:

A pandemic (from Greek πᾶν, pan, "all" and δῆμος, demos, "local people" the 'crowd') is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of people.

At that time there were more than 118.000 cases in 114 countries reported. Death tolls were 4,291, if we can trust the accuracy of the reporting. The immediately result from WHO declaring covid-19 as a pandemic disease, was the countless lockdown of countries around the world. We have since then seen a tremendous increase in covid-19 cases as well as deaths. According to Center for Systems Science and Engineering (CSSE) at John Hopkins University (JHU), the covid-19 numbers as of 21st of March 2021 are 123 040 456 total cases globally and 2 712 656 million people have died.

So, what happens after covid-19 no longer is a pandemic? Well, that is not an easy question to answer. A year ago, we started out with basically one strain of the virus (the novel corona virus). Today we are fighting several new strains of the virus. When viruses spread and replicates itself, there will always be mutations and new strains developing. Strains with improved properties, will survive and spread further. Today we can often read about the South Africa variant (B.1.351), the Brazilian variant (P.1), the UK variant (B.1.1.7) and in US there are two variants spreading (CAL.20C). These variants have one thing in common, they spread more easily than the novel variant.

A vital measurement for stopping the spread of covid-19 and somehow get control over the pandemic, is to vaccinate people. We have until now only had tools for trying to physically stop the spreading of the virus. That is why we have physical distance between us, that we are limiting number of people that can be gathered, that we are using facial masks etc. On a broader scale we have limited travel, both domestic and international, and some countries have tried to physically close the whole country. New Zealand have tried the latter. There are virtually now people coming in or out of New Zealand, and the result is that there are only 25 cases of fatality caused by covid-19. However, this is not a sustainable policy. Sooner or later New Zealand must interact with other counties if the economy is to be saved.

Embrace for the future

The best tool that we have in our toolbox to fight covid-19, is the vaccinees. Only vaccination by large scale, can enable the world to get control over the pandemic. This might look doable and not that hard. However, this is more complicated than what meets the eye. There are several reasons for this:

  • We need to produce vaccines for 7,8 billion people

  • These vaccines needs to be distributed around the world, to every part of the world

  • Vaccines that must be stored in ultra-freezers, cannot be distributed in e.g., Africa or South America. There is no infrastructure to support the transportation chain

  • The distribution of the vaccinees in the arms, needs to be in place for the whole world

  • In some countries there are widely distrust in the government and vaccinees

  • As long as the virus can spread and mutate, there is a serious risk that new variants may withstand current vaccines

  • Vaccinees are not yet licensed for children. They can contract and spread mutations

What is an endemic disease?

As we can see, there are several factors indicating that we must plan for covid-19 pandemic to become an endemic disease. Wikipedia defines endemic disease as:

In epidemiology, an infection is said to be endemic (from Greek ἐν en "in, within" and δῆμος demos "people") in a population when that infection is constantly maintained at a baseline level in a geographic area without external inputs.

This will undoubtedly be extremely hard. Three factors are key in handling an endemic:

1. Medical Development

The medical part of handling an endemic disease is perhaps not the most difficult part. Vaccinees will be developed and distributed more efficiently, as time goes by. New treatments e.g., using monoclonal antibodies will be developed and contribute to a better treatment of covid-19 patients. Best practises will be consolidated and likely make covid-19 treatment to become highly efficient (at least in developed countries).

2. Individual Responsibility

We might likely see that handling the endemic covid-19 disease, will have to involve and relay heavily on individual responsibility. People might have to wear masks in certain situations, restrictions on crowded spaces could become mandatory, vaccinee passports also might become mandatory and used in many situations (like going to the theatre, enter an amusement park with your family, travelling abroad etc.).

3. National and International Policymaking

The real problem starts when politicians both nationally and internationally shall try to develop common policies for how local and international business and interaction shall be conducted. Very few countries, if anyone, are independent from interacting with other countries. This means that countries need to find common ground and develop policies that works for all parties. We can just start to imagine how difficult this will be!

We know that the last chapter of the covid-19 pandemic is not going to be closed by the distribution of the vaccinee. A core value for Provida Medical AS, is that “Every Life Matters !”. We will continue offering covid-19 rapid test kits, covid-19 vaccinee and hopefully soon a covid-19 treatment. We feel confident that our knowledge combined with our product and service offering – will save lives!

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