President Joe Biden set off a scramble this weekend when he told “60 Minutes” that the pandemic is over. “We still have a problem with covid,” he said. “We’re still doing a lotta work on it. But the pandemic is over.”
His comments sparked fierce condemnation from public health experts pointing to the hundreds still dying each day in the U.S. from the virus, along with semantic arguments over what constitutes a pandemic’s end, something that doesn’t have a clear definition.
Moreover, they say that asking whether the pandemic is over, or confidently declaring it finished, misses the point. The bigger question facing the nation is how we learn to live with covid without sacrificing so many Americans to the virus through death or disability, and without stressing hospitals to the breaking point and without disrupting key supply chains and services.
“A lot of people think of the pandemic as a hurricane: It has to be completely gone, blue skies,” said Amesh Adalja, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “That’s not the case. This is not an eradicable disease. It’s a fantasy world to think that the only criteria some of these individuals might have [for the pandemic being over] is, it’s 2019 again. That’s not going to be the case.”
In some ways, the country is undoubtedly in a better position than it was two years ago: Vaccines, over-the-counter covid tests and antiviral treatments have helped to lessen the virus’ toll. But scientists still barely understand the long-term consequences of covid infection, or how to treat the millions struggling with long covid.
Biden’s statement “was an unfortunate sound bite,” said Jennifer Nuzzo, an epidemiologist at Brown University. “My biggest worry is that in trying to put the pandemic behind us, we’re just going to completely move on and then find ourselves back in the same situation, or worse.”
Too many deaths and too little boosting
The highest daily death tolls in the U.S. — such as the period in summer 2021 when the delta variant was killing 3,000 people every day — are probably behind us, said Deepta Bhattacharya, an immunologist at the University of Arizona.
“I think it’s fair to say that the worst is over,” he said, with most people having some level of immunity now, from vaccination, infection or a combination of the two. “I don’t think we’re gonna go back to those terrible days.”
But covid is still a leading cause of death in the U.S. The country is losing 400 to 500 people each day to covid, nearly twice as high as the death rate last summer, before omicron hit. “That’s thousands of people each week,” said Nuzzo. “My career in public health changed dramatically after the events of Sept. 11, where the loss of 3,000 Americans on a single day changed our nation,” she said. “To me, it’s unbelievable that we have just kind of gotten numb to that level of loss.”
Vaccines are still the United States’ best bet to reduce deaths, but booster uptake is woefully behind compared with other countries, Nuzzo said. Less than 35 percent of eligible individuals have gotten their first booster, according to the Centers for Disease Control and Prevention, less than at least 70 other nations. Updated omicron boosters were authorized earlier this month, but confusion around the benefits and eligibility have hampered the rollout. At the same time, many states and companies are dropping their vaccine requirements, even in more covid-conscious areas like New York City.
“I worry most people are gonna hear [the pandemic is over] and not go get the boosters they’re authorized to get, particularly the elderly,” Nuzzo said.
That’s a problem on an individual and societal level alike. Experts say widespread boosting can also help keep hospitals from being overwhelmed during a possible fall or winter surge.
Hundreds of thousands of people are still getting infected each week, according to state and federal data, though the true number is likely much higher given the rise in at-home testing. While most people recover quickly and fully, some percentage — as many as 1 in 5 — will develop long covid, a potentially life-altering condition that has put as many as 4 million Americans out of work.
Scientists are only beginning to understand why some develop long covid, much less how to treat it. Even those who survive infection with little or no apparent complications may also be at greater risk for all sorts of diseases in the future, from diabetes to dementia.
Jeffrey Duchin, health officer for Seattle and King County Health Department, said that the U.S. won’t truly have learned how to live with the virus until scientists understand how to prevent and address long covid with better vaccines or treatments.
“Covid-19 is not going to disappear,” he wrote in an email to Grid. “And [with] the uncertainty with respect to the future course and severity of the pandemic, why are we not doing more to decrease the number of infections, deaths, hospitalizations, and complications, such as long Covid which currently remain unacceptably high?”
Developing those new tools, and maintaining the ones we already have, will take significant federal investment. But Congress hasn’t approved new covid funds since spring, and the president’s remarks only make that less likely. “That’s what’s going to be used by Congress to say, ‘No, you don’t need additional money,’” said Nuzzo.
Already, the government suspended the program that delivered free covid tests through the mail. And without more money, the program that covers the cost of vaccines or treatment for people without insurance could run dry early next year. Testing capacity could shrink, too, as manufacturers scale back production as public testing sites close and the government stops its bulk buys. Surveillance systems that track the coronavirus in wastewater or improve data collection could falter before they truly get off the ground.
That could be a recipe for disaster this fall and winter if a new variant pops up that’s more deadly or better able to evade the immune system. Even without a new variant, a colder-weather surge in covid and flu, of the sort that happened in 2020 and 2021, could stretch hospital systems that are worn out from more than two years of battling waves of infection.
“I keep making fire analogies, because you don’t just put out a fire in a city and think you never have to worry about the threat of fires again,” Nuzzo said. “You look at what happened and think, let’s make sure we’re never that vulnerable. Let’s use fire alarms, improve building codes, and staff a fire department every single day,” she added. “We need to have that same kind of thinking for pandemic threats, so that we’re not ever again blindsided in the way that we were.”
Thanks to Dave Tepps for copy editing this article.