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Explained: Is Covid in India in endemic stage? | India News – Times of India

NEW DELHI: Covid-19 is already in an endemic stage in India, and citizens will now have to live with SARS-COV-2 without being forced to face irrational measures such as lockdowns and curfews, Dr Gangandeep Kang, one of India’s foremost virologist said in in an interview with Times of India.We decode the various stages of the virus and what Covid becoming an endemic means for you.
What does it mean for a disease to be an endemic as opposed to a pandemic?
Diseases are endemic when they occur regularly in certain areas based on established patterns, while a pandemic refers to a global outbreak that causes unpredictable waves of illness.
For example, illness outbreaks such as that of the seasonal flu, dengue are all considered to be endemics. This is also the stage the WHO and other health bodies refer to as the timeline when a given population learns to live with the virus.
In retrospect, a pandemic means something different. COVID-19, which was earlier declared as a pandemic in March 2020, measured the exponential, and wide spread of the disease on the global front, at the same time. When a disease outbreak spreads worldwide, or to larger areas, it is referred to as a pandemic. An endemic which spreads over a wide area, and ends up afflicting a lot of people at the same time is referred to as a pandemic.
Unlike a pandemic, an endemic is constant and localized to a particular area.
The WHO defines pandemics, epidemics, and endemics based on a disease’s rate of spread. The difference between an epidemic and a pandemic isn’t in the severity of the disease, but the degree to which it has spread.
A pandemic cuts across international boundaries, as opposed to regional epidemics. This wide geographical reach is what makes pandemics lead to large-scale social disruption, economic loss, and general hardship.
“Endemicity implies that the virus is and will continue to be present in the population. And that stage has been reached already. There will be cases and flare-ups, or waves, when new variants are introduced as we have seen with Omicron, which will require additional measures depending on the burden on the healthcare system. By this framing, SARS-CoV-2 is already endemic,” explains Kang.
However, for many countries, designating a disease as endemic means that fewer resources will be available to combat it, since it will likely no longer be considered a public health emergency.
The five stages of the pandemic, explained by Dr Fauci.
A pandemic has five stages and according to Dr. Anthony Fauci, the top medical adviser to President Biden, we are still in the first of five stages of the pandemic.
1. Pandemic. We are still in the pandemic stage “where the whole world is really very negatively impacted as we are right now,” Dr. Fauci said.
2. Deceleration. The next stage is deceleration, in which the world sees a slowdown in newly confirmed cases. According to Dr. Fauci it’s too soon to know whether natural immunity will cause new cases to fall and noted that a new variant could always prevent this drop off.
3. Control. The third phase is the control phase where COVID-19 would become an endemic disease. “Control means you have it present, but it is present at a level that does not disrupt society,” Fauci said. Fauci said that the US is still nowhere near the control phase, with hospitalizations and deaths at “unacceptable” levels.
4. Elimination. The fourth stage of a pandemic is elimination. This occurs when a virus still exists in the world but has been eradicated from certain regions or countries.
5. Eradication. The fifth and final stage is eradication, which entails global elimination of a virus. “That’s not going to happen with this virus,” Dr. Fauci said
But, who decides when Covid will be called an endemic?
Most wealthy countries will probably make that decision themselves depending on how the virus is circulating within their borders and on the potential for new cases to cause big outbreaks. The Covid-19 vaccines, medicines and other measures widely available in rich countries will likely help them curb outbreaks.
The WHO does not technically declare pandemics. Its highest alert level is a global health emergency, and Covid-19 has warranted that distinction since January 2020. The UN health agency has convened an expert committee every three months since then to reassess the situation. It’s likely the pandemic will be over when the WHO’s experts declare that Covid-19 no longer qualifies as a global emergency, but the criteria for that decision are not precisely defined.
Others argue that designating Covid-19 as endemic is arguably a political question rather than a scientific one, and it speaks to how much disease and death national authorities and their citizens are willing to tolerate.
What’s the way forward in the endemic stage?
According to Dr Kang, India needs to rationalise testing to be able to identify the proportion of symptomatic individuals, have a sense of what is happening in the community (for example, through environmental surveillance), and in some cohorts, conduct studies about the frequency of infection and its consequences. India also needs to monitor performance of the vaccines, to know if we need to switch or boost.
What about the efficacy of current vaccines?
“The vaccines are working. With Omicron, it does seem we need a third exposure to boost protection from severe disease. But that could come from vaccination via boosters as in the West, or from prior infection, as in Africa and India,” said Kang.
What about new variants and their impact on health infrastructure?
When RNA viruses replicate at high levels, they mutate. The consequences of those mutations are usually in the direction of better spread, whether from increased transmissibility or increased immune escape.
” We need to plan for different kinds or low- and high-threat scenarios so that contingency plans are in place,” said Kang.
“The UK has achieved a high level of vaccination and is now set to cover its young clinically vulnerable children. They are opening up and I think they are doing everything right, except that I would advise continued use of masks in schools or at public locations until cases decline. Europe does not have a single model, but high vaccination, good clinical management are features of every country’s response. And that approach is correct,” she added.
In Britain most coronavirus restrictions have been lifted, including mask mandates; Austria and the Netherlands have eased lockdown measures despite surge in cases. The European Union has now recommended that vaccinated residents are no longer required to undergo testing or quarantine when traveling between the 27 member states.
Spain proposal
Last month Spanish Prime Minister Pedro Sanchez said that falling death rates for Covid-19 suggest that it’s time for European officials to start considering whether the disease should be considered an endemic. That means Spanish officials would no longer need to record every Covid-19 infection and that people with symptoms would not necessarily be tested, but they would continue to be treated if they are sick. The proposal has been discussed with some EU officials, but no decisions have been made.
What has WHO said: The Work Health Organization (WHO) says that the continent of Europe may be able to end the COVID-19 emergency phase in 2022, mainly due to the highly transmissible Omicron variant, which has turned out to be less severe than the previously dominating COVID-19 variant, Delta.
With inputs from AP

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