The Omicron variant is causing the virus to spread fast, and experts say that could speed up the timeline for COVID-19 to shift from a major health crisis to something we live with on a regular basis.
The concept is known as “endemicity,” and it refers to a time when a circulating virus no longer has the steep waves of outbreaks that hammer hospital capacity and force society to adapt, according to doctors. Instead, an endemic virus continues to circulate through our population — but in a way we can handle, like the flu.
“COVID won’t leave this planet. This thing is here to stay for a prolonged period of time,” said Dr. Peter Jüni, scientific director of Ontario’s COVID-19 Science Advisory Table.
“It’s here to stay, but with us developing more and more immunity, it will become more and more manageable over time.”
Here’s what we know about how — and when — COVID will become more manageable.
COVID’s shift into endemicity won’t be like flipping a switch, Jüni said. Rather, there “will be a transition phase.”
As Canadians await that transition phase, there are some signals of endemicity we can watch for, according to infectious disease specialist Dr. Gerald Evans.
“It won’t be a black-and-white thing, but what we’re going to see is…that these pandemic waves tend to disappear,” Evans said.
“We don’t see these large, huge rises in cases in the population, and instead we just see some activity, which may be seasonal.”
If there aren’t large swaths of hospitalizations and deaths when cases do rise, that’s another sign of endemicity, Evans said. That means the health-care system would be able to handle the outbreaks and provide adequate care to the Canadians who are impacted.
“We will see some infectious waves going on. These waves should not be likely…to overwhelm the health-care system,” Jüni said.
“That’s the most important part.”
Endemicity is achieved in a variety of ways, but overall, a virus is considered endemic when “enough of the population has immunity that we see (a) moderation in numbers of cases,” said Dr. Matthew Miller, assistant dean at McMaster University’s department of biochemistry and biomedical sciences.
Endemicity occurs when there are “fewer and fewer” of what Miller called “naïve individuals” — meaning people who haven’t been exposed to a virus — and, as a result of that, there is “lower virulence,” which means the virus is less severe.
That means the rampant transmissibility of Omicron could have an upside.
“After this wave, nearly everybody will have experienced some sort of exposition to the virus and therefore will have developed some sort of immunity — that’s what is changing,” said Jüni.
Omicron is especially good at conferring that immunity for two reasons, according to Dr. Evans. First, it’s very, very transmissible.
“It transmits incredibly easily,” Evans said.
That means it can “outcompete the other viruses,” like the more-deadly Delta strain. By replicating much faster in a host, Omicron gives people a more mild strain of COVID while conferring some measure of immunity against the more dangerous strains, according to Evans.
That’s the second part of the recipe for endemicity: Omicron “produces a milder form of illness,” he explained.
“For any virus to become endemic, it cannot be killing off the population of hosts that it infects,” Evans said.
“Omicron…(is) rapidly increasing the amount of immunity we see around the world when combined, especially, with vaccination.”
That doesn’t mean the few unvaccinated or partially-vaccinated Canadians should not get their next dose, or simply wait for the Omicron wave to wash over them, the doctors warned.
“If you would like us to reach an endemic state in another 10 or 20 years, don’t get vaccinated,” Evans said. “If you’d like this to end in the next year or two, get vaccinated.”
Evans explained that getting vaccinated “speeds up” the process of a pandemic becoming endemic by giving the vaccinated a higher degree of immunity shortly after they get their jab.
If you wait to get infected, it will take longer, put the health-care system at risk, and could have serious outcomes, Miller warned.
“If you don’t live through the infection, then it doesn’t matter what natural immunity you developed — or if you have really long-term negative consequences,” he said.
“Vaccines are a safe and really natural, frankly, way of gaining immunity.”
Once you’ve been vaccinated, you can benefit “again” from immunity you might get from a breakthrough infection, Miller explained. But, he warned, “that doesn’t mean that we should let Omicron run willy-nilly uncontrolled through the population.”
Jüni echoed Miller’s comment.
“This doesn’t mean that people should try to get infected,” he said.
“Why? Right now, the situation we’re in, you know, with strained health-care system, means if you’re unlucky and are one of the few people who is vaccinated who still experiences serious outcomes, you won’t get optimal care anymore.”
When the COVID pandemic finally becomes endemic, Evans said that while the virus won’t totally be gone, it will “disappear out of our conscious mind.”
“We won’t be thinking about it quite as much and it’ll get blended in with a lot of these other respiratory infections we see every winter,” he said.
“It (will be) just like every other cold that we have: it’s a nuisance. You feel unwell and probably don’t want to go to work or school, but you get over them.”
He warned that “periodically,” COVID will “cause some serious illness and in older people and people with significant other illnesses,” but, “that’s what the endemic virus will look like.”
Both Evans and Juni suggested we could see this become our new normal as soon as this fall — but, Evans added, you never really know.
“Omicron is really kind of ideal. It is highly transmissible and less virulent. That’s the perfect mix,” Evans said.
“It’s got the right mix at the moment, and we just have to hope we don’t get another variant come out that (is) still highly transmissible, but now more deadly again.”
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