The end of the pandemic

Looking back, taking stock, summing up.

In an interview with 60 minutes, President Biden declared that “the pandemic is over”:

60 Minutes @60Minutes

“The pandemic is over. We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over,” President Biden tells 60 Minutes in an interview in Detroit. cbsn.ws/3DDT4D9

Anthony Fauci, when asked about the President’s comments, didn’t contradict them, though he did offer clarification:

“But we are not where we need to be if we’re going to be able to, quote, ‘live with the virus,’ because we know we’re not going to eradicate it. We only did that with one virus, which is smallpox, and that was very different because smallpox doesn’t change from year to year, or decade to decade, or even from century to century,” Fauci added.

“And we have vaccines and infection that imparts immunity that lasts for decades and possibly lifetime.” 

Now, Biden’s statement is, understandably, receiving a fair amount of pushback. After all, the U.S. is now experiencing around 400 deaths a day from the virus, a rate that would translate to about 150,000 a year:

But even though 400 a day is a lot, there was no big rise and fall in deaths like there was in previous waves. And this is despite a pretty substantial summer wave of cases due to highly infectious, immunity-resistant Omicron-type variants like BA.5 — a wave that’s probably understated due to the mildness of many cases and the ubiquity of at-home tests. In other words, a ton of people got Covid this summer, but not a ton of people died. Monica Gandhi, an infectious disease expert at UCSF, says that with the massive decrease in death rates, Covid is now no more dangerous than the flu for those who catch it. Epidemiological data showed the same thing in the UK back in the spring.

There are several obvious reasons for this. The main one is widespread vaccination — people who have gotten three shots are far less likely to die of Covid compared to people who haven’t gotten any:

There’s also the fact that most people in the U.S. have had Covid at least once. Those who survive the disease gain some immunity. (The pandemic has also killed many of the most vulnerable people.) In other words, through repeated vaccination and infection, Americans are building up layers of immunity to the virus, steadily reducing death rates.

Does this mean the pandemic is over, as Biden says? There’s no official, generally accepted, quantitative definition of when a disease is or isn’t a pandemic — the WHO decides when to declare a “public health emergency of international concern”, but this basically depends on the judgment of the people making the decision (as well as on politics, both internal and external to the organization). The CDC stopped recommending social distancing about a month ago — another judgment call. At some point, we simply collectively stop thinking of diseases as pandemics and start thinking of them as endemic — as diseases that are now simply present in our world rather than as special, unusual threats. At some point this happened for HIV, the other great pandemic of our times.

So it seems to me that Biden’s declaration that the pandemic is over is as good a place as any to bookmark this transition. As both he and Fauci stress, that doesn’t mean Covid is gone — it’s going to plague us (literally) for the rest of our lives. But a real line has been crossed, and most Americans can feel it. I thought this would be a good time to take stock — of how we beat the pandemic, of the stupid mistakes we made, and of how our world will be changed by Covid going forward.

Who gets credit for beating the pandemic?