Insights: The journey from pandemic to endemic and what it signals

When it all began two years ago, few could have predicted or been prepared for how long Covid-19 would last. Governments worldwide were compelled to tread cautiously as their hopes for a speedy economic and travel recovery were dashed each time a new Covid-19 variant emerged, throwing the world back into uncertainty. But recent developments in the pandemic policies adopted by nations, particularly those in the European Union, have offered green shoots of hope, signalling a big step back towards normality.

Starting with the decision by the British government to drop all restrictions that have been in place since the start of the pandemic, a slew of countries in the region announced plans to lift Covid-19 curbs and reopen borders to enable travel to return once more. Although this announcement came at a time when the number of new Covid-19 cases in Europe was at an all-time high, the number of hospitalisations and deaths from the virus in many countries had dropped dramatically. It was indicative of a shift in the way the world thinks about the pandemic.

While the Omicron variant may be much more transmissible than many previous variants, it has revealed itself to be far less severe. Industry studies suggest that the risk of hospitalisation or need for emergency care with Omicron is about one-third that of the earlier Delta variant – pointing to the fact that Covid-19 may perhaps be turning from a pandemic, to simply becoming endemic.

Going back to the science
Scientific opinion around the world remains divided about the pandemic – every forecast for the future is accompanied by a parenthesis warning about the potential risks of emerging variants and their unknown effects on our ability to fight them. Where a section of the world is optimistic about the virus finally tapering into an endemic akin to the seasonal flu, there are equally those that continue to urge caution and believe it might be too soon to pronounce the endgame for Covid.

While eradicating Covid-19 might be the big dream, it is sadly unrealistic. In all of history, there has only ever been one human disease that was successfully eradicated: smallpox. Studies have shown that most causes of past pandemics are still around today, be it the plague or the deadly 1918 flu that was caused by the H1N1 virus. However, they are no longer as destructive as they once were; they have evolved into milder variants, have effective treatments, or can be prevented with vaccinations. In these ways, modern science has changed the landscape considerably – as has occurred with our fight against the Covid-19 virus – enabling high levels of protection and treatment against the effects of the virus.

In the same breadth, if we look at the strides of the vaccination programmes in the UAE, which has one of the highest vaccination rates in the world. The UAE government currently reports that 97 per cent of the population is fully vaccinated. The daily number of Covid-19 cases around the country are decreasing , fewer people are becoming unwell and needing hospitalisation. In other words, the link between infection and hospitalisation has been significantly broken. As long as the trend to vaccination continues, countries like the UAE have been  able to reduce their Covid restrictions, opening up and returning to some semblance of normality. As the UAE has eased restrictions across the country, the travel and tourism industry has seen a quick recovery. With major events like the Expo 2020 held in the country have helped boost the country’s travel industry’s performance.

Although it may be difficult to predict the exact timings until we reach endemic phase for Covid-19 we can anticipate what may occur once it does. Firstly, there will be more infectious Covid-19 mutations, but they will cause fewer symptoms because most of the community would have already been affected by a Covid strain in the past. Therefore, even though a new mutation will cause a sudden spike in cases, it shouldn’t hamper people from continuing their daily lives.

Transitioning towards an ‘Old Normal’
As nations continue to expedite their vaccine rollouts and ease restrictions, it is likely to provide a shot in the arm for the globe and lift the spirits of those who have been putting off their yearly vacations due to concerns around not only contracting the virus, but also being locked up in lengthy quarantine protocols when travelling. That said, it may still be a while before health measures across the globe become standardised due to many factors, including vaccine inequalities across different countries.

It’s no doubt that the criteria for travel will differ for each destination and there is no one-size-fits-all. However, slowly but surely, we are seeing the rules for quarantine and isolation changing. The UAE government has implemented new rules for close contacts of Covid-19 cases. Close contact no longer need to quarantine but they do have to take two PCR tests. Vaccines will continue being a mandatory requirement to undertake certain international travel. To that end, vaccine certificates (or proof of vaccination at least) may continue to be a requirement and stay so until such a time that the world’s immunity to Covid has risen so that the virus no longer poses a significant threat. For now, testing is here to stay for some destinations, but it will be gradually phased out as a precondition for travel. Countries will move away from community testing and instead require only symptomatic individuals to be tested, particularly as the virus variants become less potent.

Ultimately, as we look forward to enjoying the little luxuries we once had, such as travel with fewer restrictions, the local government regulations will play a critical role in sustaining the status quo and preserving the health of both individuals and the travel industry. While safety will remain the topmost priority worldwide, it will be equally important to ensure that life is not ruled by lockdowns if we are to achieve a simultaneous recovery of our economic and mental health.

With pent-up demand for all those family gatherings and far-flung holidays put on hold during the pandemic, the future that we are seeing today appears to be considerably brighter than it was six months ago. Green shoots of hope are emerging, and in some places, meadows already bloom.

Dr Simon Worrell is the global medical director, Collinson