An endemic state is when infection rates become more stable and predictable over time.person getting a vaccine with mask on

When we reach an endemic state, we’ll see COVID cases stabilize. But it might not always be stable—there can still be outbreaks and waves of infection. For example, seasonal influenza could be called endemic because it is stable most of the year, and then there is usually a surge during the winter months.

Endemic doesn’t mean less infectious or less deadly.

We hope that COVID evolves to be less deadly, but that isn’t always the case. Diseases can be endemic but also cause a lot of disease and severe outcomes, like malaria or tuberculosis. Endemic is about the stability of cases, not the severity.

Reaching endemic COVID is a global effort.

Even if Wisconsin or the U.S. reaches a place of stability, that stability can be disturbed when new variants emerge in different parts of the world and spread globally. While over 82 percent of Dane County has received one dose of COVID vaccine, only 58 percent of the world has received one dose of COVID vaccine, and only 11 percent of people in low-income countries have received one dose of vaccine, leading to global inequities in vaccine coverage. Vaccines are an important tool in helping us reach an endemic state. As more people become up-to-date on their vaccines COVID has less of an opportunity to mutate and spread quickly, causing outbreaks and disrupting our normal activities.

COVID is not yet endemic.

The world is still experiencing repeated outbreaks of COVID that cause waves of severe outcomes, like hospitalization and death. Cases haven’t yet stabilized in a predictable state that would suggest COVID is endemic.

COVID will likely become endemic at some point, but we don’t know when or how.

We can’t predict when or how COVID will become endemic. Omicron might be the last major wave, or it might not be. We all respond in the moment to new and changing circumstances during this pandemic.

Of course, we hear and see that many of us individually are tired of COVID and ready to stop thinking about it. We are all already weighing risks of COVID in our lives, and for those of us who are up to date on our COVID vaccines, we might find that COVID isn’t posing as major of a risk as it once was. But from a healthcare systems and public health systems level, COVID isn’t done with us yet—it’s still straining our hospitals and affecting our society, which means we are still having to respond (such as with vaccines and testing) to mitigate those effects. We also need to be prepared for potential future variants and surges, because COVID is still very unpredictable.

We don’t know what our endemic future will look like. But we know we’ll be balancing risks of COVID with the tools we have to reduce risk for a long time.

Most activities in our lives will not have zero COVID risk. We have medical tools to manage that risk—vaccines and new treatments like antivirals—and also non-medical tools such as masks, ventilation, social distancing, and getting tested and staying home when you’re sick. Just like other endemic diseases, we will likely always have some public health response, like vaccination education and outreach, so that we can minimize spread and manage risk. But any public health response when we are in an endemic state will look very different from now.

We are all hoping for a day when we never have to think or talk about COVID again. Unfortunately, COVID is here to stay. But we can use the tools we have to minimize COVID’s effect on our daily lives, and we will adapt to living with COVID as it stabilizes into an endemic state at some point in the future.

This content is free for use with credit to the City of Madison - Public Health Madison & Dane County and a link back to the original post.