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From Pandemic to Endemic: How COVID-19 testing will keep us safe over the long haul.

June 3, 2021

According to a poll in the journal Nature, 89% of scientists surveyed believe that COVID-19 is either “very likely” or “likely” to become an endemic virus -- in other words, that it will continue to circulate in communities across the globe in a manner not unlike influenza or the common cold. Finding our way back to a “normal” that protects us from the disease without requiring the drastic measures we’ve seen over the past year is now poised to become our next great pandemic response challenge. 

It can be strange to think about a world in which we live alongside COVID-19. What things will return to normal? Which will have to change, and to what extent? To better understand the issue, it’s helpful to explore what endemic COVID-19 may look like and what potential risks there might be going forward. 

First things first: while endemic COVID-19 seems likely, we can’t yet know precisely what form that will take, and for good reason. For starters, it’s just too early. The major vaccines in circulation have proven effective at stopping severe illness, but we don’t yet know for how long they confer immunity, how effectively they block transmission to those without immunity, whether they will need to be reformulated frequently, and so on, all of which have significant implications for how endemic COVID-19 may circulate. 

One possible path here is for COVID-19 to follow in the footsteps of the four other known endemic coronaviruses (OC43, 229E, NL63, and HKU1). These viruses typically strike children by the age of 6, causing mild symptoms, but in the process training their immune systems such that exposure during adulthood doesn’t cause illness. This would be a great outcome, but it’s too early to celebrate; emerging data on newer COVID-19 variants suggest that “immune escape” remains a real possibility despite our best efforts.

If endemic COVID-19 does mutate fast enough to frustrate our vaccines and immune systems, we may be faced with seasonal infection patterns and frequent vaccine reformulations like those we see with the flu. Inconvenient as that may sound, however, there’s a silver lining to the extent that previous infections and vaccine distribution will likely be able to blunt the worst effects of new endemic variants provided they’re caught in time.

Irrespective of the path the disease takes, the transition from pandemic to endemic status won’t happen overnight, nor will it be without risk. The key to mitigating those risks -- not to mention proactively identifying new variants threatening immune escape -- without sacrificing our freedom to work, move around, or socialize is to integrate COVID-19 testing deeply into everyday life. Going forward, baseline testing for all sick people should become a routine thing, and it should be available at home or in-office without the need to make an appointment with a healthcare provider. From a public health perspective, that’s the least invasive, most responsible adaptation that we can make.

Uneven global pandemic response -- including limited access to vaccines and accurate, rapid testing -- has created a strong likelihood that COVID-19 is here to stay, but ongoing, integrated testing will be what prevents us from enduring another year of lockdown. At Wellstand, we’re proud to be a driving force behind those broad testing efforts. If you want to know more about how we can help you do your part and protect your employees, contact us.

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