Will It Ever Go Away? COVID-19 and Its Transition to an Endemic

COVID-19 was declared a pandemic two years ago, but the hospitalization and death rates have continued to drop recently and many believe the disease is transitioning to an endemic.

Pennsylvania has had a total of almost 3 million confirmed cases of COVID and more than 43,500 deaths since it was declared a pandemic two years ago. But recently, the number of cases has dropped, along with hospitalization and death rates.

Over the past two weeks, the COVID hospitalization rate in the state has dropped by 42%. The daily case count dropped 58% in the same time period.

It’s not the pandemic of 2020, but it’s also not over yet — if it’ll ever be.

“We are in transition,” said Dr. John Goldman, infectious disease specialist at UPMC Pinnacle in Harrisburg. “The CDC has estimated that by the spring 80% of people will have been exposed or immune to COVID.”

Transition into what?

Pandemic vs. Endemic

“WHO has been assessing this outbreak around the clock and we are deeply concerned both by the alarming levels of spread and severity, and by the alarming levels of inaction,” Dr Tedros Adhanom Ghebreyesus, World Health Organization director-general, said in a written statement March 11, 2020.

Citing the more than 118,000 cases in 114 countries, and 4,291 deaths, WHO officially declared COVID-19 a pandemic that day. 

A pandemic is the worldwide spread of a new disease or virus. 

“Because the virus is new, there is no immunity and everyone is at risk,” Goldman said. “With COVID, it spread very rapidly and there was a high hospitalization and high death rate.”

Pennsylvania’s new cases per day rate peaked at over 30,000 in December 2020 and the daily death rate saw its highest totals in January 2022, when the omicron variant spread, according to the state Department of Health.

Hospitalizations and deaths in the commonwealth related to COVID continue to decrease, Goldman said. 

In addition, the CDC shifted its guidance on masking recently. Most Pennsylvania counties no longer need to require mask indoors, according to the new recommendations, because they fall into the “low” or “medium” risk categories.

“Pennsylvania is prepared for a transition toward endemic,” Pennsylvania’s Acting Secretary of Health Keara Klinepeter said in a written statement. “Moving forward does not mean ignoring COVID-19. We have the knowledge and tools needed to make smart decisions guided by public health research to keep ourselves and our communities safer.”

When a virus becomes endemic, it means the disease is constantly present in a certain area and the spread is more predictable.

“It is still the same virus,” Goldman said, “but it has infected many more people and people have been vaccinated. So the virus spreads more slowly resulting in fewer hospitalizations and fewer deaths.”

Goldman said as time wears on and immunity builds, COVID will become like the flu.

“Each year we will have a COVID season,” Goldman said. “But the number of deaths and hospitalizations will continue to go down.”

While COVID has often been compared to the flu by some over the past two years, Goldman said COVID has always been more contagious than the flu. 

“With COVID, one out of every 200 people died,” Goldman said. “It’s one out of every 1,000 for the flu. That’s a big difference.”

When Will COVID Become an Endemic?

“This is going to be a gradual transition back to life,” Goldman said. “It will probably happen within the next six months.”

For COVID to become endemic, Goldman said, “We will need to see 80% with immunity or exposure.”

Since the Omicron virant started spreading, 90% of patients in the hospital are not vaccinated, Goldman said.

About 67% of the state’s population is fully vaccinated, according to the CDC. Almost 80% have had at least one dose.

“We’re in this together, to do the right things with calm and protect the citizens of the world,” Ghebreyesus said at the end of his statement on March 11, 2020. “It’s doable.”