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Jul 15, 2023

COVID is endemic — so now what?

COVID is now seen as an endemic infection, similar to the way we think about other infectious diseases. This is supported by the recent summary of excess deaths from the Centers for Disease Control,

COVID is now seen as an endemic infection, similar to the way we think about other infectious diseases. This is supported by the recent summary of excess deaths from the Centers for Disease Control, noting that deaths from COVID make up 1% of the deaths per day in this country, despite a late summer surge in outbreaks. This is a significant milestone, and this success is due to our immunity to the virus either by vaccination or immunity via infection, or by both, and the development of an effective antiviral medication (Paxlovid).

The question now becomes: What do we do next? Do we brush aside the last three years of this public health challenge and no longer worry, or do we try to learn from this experience and attempt to improve our public health infrastructure?

The “Lessons from the COVID War: An Investigative Report” published this past April provides guidance on how to think about what went right and what went wrong during the COVID crisis. This book is an important study by the COVID Crisis Group, whose 34 members bring a broad perspective and a range of expertise to what happened over the past three years. These authors hoped there would be an official 9/11 type commission at the federal level to study the problem and make recommendations. This, apparently, is not going to happen.

The book details the politicization of the COVID crisis. The Trump administration failed to put together a functional organization and coherent message to manage the crisis, despite the presence of qualified health experts. It flirted with unproven treatments, helped to create distrust and almost mocked mask mandates at times. Donald Trump is considered to be a co-morbidity during this crisis. No doubt the asymptomatic transmission of this virus, and a lack of appropriate testing for the virus early on made things even more difficult. The Trump administration finally gave up trying and turned things over to the states, saying it was their problem to solve.

The Covid Crisis Group notes that in the past America was seen as the best in the world in dealing with a large crisis. We were not at our best during this crisis, but many people at the state and local level rose to the occasion. The best leaders provided the clearest information possible (remember Governor Hogan’s “Wear the damn mask” directive), and were able to recruit trusted partners to help encourage hesitant populations to get vaccinated.

One of the benefits of utilizing trusted partners is that people who were marginalized in our health system were able to find a medical home for other health issues. The federal government came through by supporting and financially backing the development of the COVID vaccines in record time. The distribution network was helped by the U.S. Army and recruiting the major pharmaceutical chains as partners, but vaccine hesitancy slowed the acceptance of the vaccine, costing between 120,000 to 350,000 lives. The strategic lessons stressed by COVID group emphasize preparedness on many levels including: stockpiles of critical supplies and medications, a world-wide warning system to help detect emerging threats, a better and timely way to collect data here in the U.S., building vaccine libraries for the known infectious diseases, and creating a command structure at the federal level to better coordinate actions of those institutions (the CDC, the Food and Drug Administration, the National Institutes of Health) directly related our public health.

Whether any of these goals can be achieved in the near future is difficult to say. With the 2024 election already looming, arguments against common sense public health measures are already being made by candidates for national office. Governor Ron DeSantis of Florida is taking pride in calling Florida a “Free State.” His disdain for masking and vaccine skepticism cost lives. Once the COVID vaccines were available, Florida’s deaths due to COVID significantly outpaced the rest of the country, due to vaccine hesitancy. Florida has 6.5% of this country’s population, yet 17% of the COVID deaths in the postvaccination period.

Robert F. Kennedy Jr., another vaccine skeptic, has blamed vaccines for all sorts of ailments. In 2019 he took advantage of a situation Samoa, where two deaths occurred due to improperly prepared measles vaccine. Kennedy traveled to Samoa to tout his antivaccine message, and the vaccine rate in Samoa plummeted. His message resulted in the deaths of 83 Samoans, most under 4 years old.

The bottom line: We need to elect leaders, who can help us to live together, safely, by providing the best public health information possible, not what benefits their political fortunes. Our elected officials should not be a comorbidity for either themselves or the people they serve.

Dr. George Delahunty ([email protected]) is professor emeritus at Goucher College and co-founder of the Post-Bac Premedical Program and Public Health Minor at Goucher.