Ellie Murray has a very good thread on the Twitter machine about the word ‘endemic’ and how it relates to COVID-19 ‘endgames.’ It is worth the read because it lays out very clear possible ‘endgames’ and how they are achieved. Murray also reminds people that we do have ‘good’ public health responses for other diseases, and that is, in part, because those responses are in line with the illness and death we are willing to accept. But this is the internet, so of course, objections must be raised.
One thing I disagree with is the idea that people don’t understand what the word endemic means. I think they do, it’s just there is significant disagreement over what is an acceptable COVID-19 public health burden. After all, there are too many awful Americans (yes, I judge) who think our current levels of American Carnage are acceptable. Others want something much less deadly and harmful.
For me, endemic would be around one case per day per 100,000 people. In a colonial territory like D.C. (population around 700,000), that might be a couple of hospitalizations per week, and, at most, a couple dozen deaths per year–the hospitalizations would probably be on par with influenza (probably lower), but more spread out throughout the year. The other part of ‘acceptable’ endemism is an R that is close to one, such that outbreaks are limited, and that we have time to respond through targeted measures and broader measures, such as returning to indoor mask wearing, are very limited and localized.
That’s where we want to be. There’s no way we get close to that without widespread vaccination, around 85% of the population. We likely also will need a third dose* that would protect the most vulnerable and limit spread further (unlike some, I am very cautiously very optimistic about a third dose; I don’t see credible evidence for pessimism at this point).
Yes, we will have to learn to live with COVID-19, but the choice is how we want to live. We have considerable say over that.
*Which is something the developers of the Moderna vaccine have argued all along, as well as people like Peter Hotez.