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Analysis

What covid-19 becoming

‘endemic’ really means
Clare Wilson

5-to-11-year-olds after the Food and There have been many mentions on external forces being placed in of cases caused by the omicron
Drug Administration authorised of covid-19 becoming “endemic” order to maintain that stability.” variant, it seems hard to argue
the use of the Pfizer/BioNTech in recent weeks. But the term Among infectious disease that covid-19 is currently
vaccine for that age group in has no single agreed definition specialists, endemic may be used endemic. “I don’t think we’re
October 2021. Ireland also recently and the virus becoming endemic in contrast to the term epidemic. actually anywhere near
announced it would offer that wouldn’t necessarily mean that An epidemic of a disease means endemic,” says Lawrence
vaccine to 5-to-11-year-olds. it is safe to stop measures such there is a surge in cases, perhaps Young at the University of
But in the UK, while the Pfizer/ as mask wearing. Warwick, UK. “I think a lot of
BioNTech vaccine for 5-to-11-year- On 11 January, Marco Cavaleri “We’re not actually it is wishful thinking.”
olds has been approved, the Joint at the European Medicines anywhere near What might endemic covid-19
Committee on Vaccination Agency told a press briefing that endemic. A lot of it look like? The coronaviruses that
and Immunisation has only “what we’re seeing is that we are is wishful thinking” cause common colds, such as
recommended that the vaccine moving towards the virus being OC43, seem to reinfect people
be offered to children in this age more endemic”. The previous because a pathogen has crossed every three to six years. As
group if they “are in a clinical risk day, Spain’s prime minister, over to a new species, as in the with covid-19, immunity to
group or who are a household Pedro Sánchez, said European case of covid-19. A pandemic reinfections doesn’t last long, but
contact of someone (of any age) officials should reclassify is an epidemic that has spread immunity to serious illness does.
who is immunosuppressed”. covid-19 as an endemic illness over several continents. If OC43 reinfections occur
due to falling death rates. UK If a disease is endemic, on every four years, that would
education minister Nadhim the other hand, the number mean about 45,000 infections
An evolving virus Zahawi recently said the of cases is broadly stable, a day in the UK. “That is a
The roll-out of vaccines to country is “witnessing the although there can be seasonal reasonable estimate of how
children in other countries follows transition of the virus from fluctuations. Measles is said to many covid-19 infections there
extensive and ongoing clinical pandemic to endemic”. be endemic in many countries. will be each day, averaged over
trials. In a November statement, But at a press conference on Malaria is endemic in some a few years, when we reach the
the WHO said the authorised 11 January, Catherine Smallwood regions, although cases may endemic equilibrium,” says Paul
vaccines were “safe and effective” at the World Health Organization rise in the rainy season. Hunter at the University of East
for children. The WHO also noted Europe said “we’re still a way off” Endemic diseases can still Anglia, UK. At the moment, the
that children who can’t attend endemicity. “Endemicity assumes cause serious illness and require UK is recording about 108,000
school, either because it is closed that there’s stable circulation of stringent measures. Malaria kills covid-19 cases a day and
or because they are ill with the virus, at predictable levels hundreds of thousands of people there will be many more going
covid-19, are missing out on with predictable waves of every year. Smallpox, too, was unconfirmed by testing.
education, and in some cases transmission… that doesn’t rely endemic before we eradicated The number of daily new
may struggle to go back. it, and it killed nearly a third of omicron cases in the UK recently
Meanwhile, the vaccines are Mask wearing at a those who caught it. started falling, as they previously
being tested, in smaller doses, in football match in Milan, Given that many countries did in South Africa, where the
even younger children. Pfizer and Italy, this month are experiencing a massive surge variant was first seen.
BioNTech have an ongoing trial in But another covid-19 variant
children aged 6 months to 5 years. may well emerge this year or
However, in December, the firms next to cause a further surge –
FABRIZIO CARABELLI/LIVEMEDIA/NURP​HOTO VIA GETTY IMAGES

announced that they were adding although it is possible that the

a third dose to the regimen, after a level of immunity in populations,
second dose didn’t provide enough caused by both vaccines and
protection. As a consequence, no infections, will continue to offer
results are available yet. increasing protection against
Similarly, Moderna says it severe illness.
expects data on its vaccine in So we may only be able to
2-to-5-year-olds by March. If the say when covid-19 has become
results are satisfactory, the endemic by looking backwards.
companies will seek approvals “Often you don’t know when that
to deliver the vaccines. transition has occurred, except in
Even as governments run their retrospect,” says Hunter.
vaccination programmes, the

14 | New Scientist | 22 January 2022