The aggressive advance of the Omicron variant is the latest turning point in a disease that public health experts say is becoming endemic in the United States.

In other words, the Covid-19 pandemic will not have an end date. On the contrary, a crisis that engulfed the world a few months after the discovery of the coronavirus in China will dissipate in spurts and start into something that looks more normal over the years, according to infectious disease experts.

“I don’t think there will be a day when it all ends,” said Joshua Schiffer, associate professor in the division of vaccines and infectious diseases at the Fred Hutchinson Cancer Research Center.

How quickly an endemic and stable condition arrives and the degree of disruption of the virus will depend on the level of disease that officials and individuals decide to tolerate, the precautions they are prepared to take, and the course of the virus.

“It’s a standoff between society and the virus,” said Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco.

A line to receive free home rapid Covid-19 test kits at an immunization clinic run by the Philadelphia Department of Public Health on Tuesday.


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HANNAH BEIER / REUTERS

The Biden administration is preparing to deploy doctors and nurses to hospitals overloaded with Covid-19.


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Jeff Kowalsky / Agence France-Presse / Getty Images

Omicron shows how vulnerable society remains, even in countries with relatively high population immunity. The variant accounted for 73% of new infections in the United States in the week through December 18, according to estimates by the Centers for Disease Control and Prevention, up from 13% the week before. Hospitalizations and deaths were already on the rise in the United States before Omicron’s identification, and officials said they expected its rapid spread to put more strain on the healthcare system.

With the rise of a new wave, people and institutions are making decisions that reflect changing attitudes towards the threat posed by Covid-19. The Biden administration is preparing to distribute 500 million free home rapid tests from January, increase immunization capacity and deploy doctors and nurses to overcrowded hospitals, but has not called for broad closures .

Federal authorities are encouraging people to get vaccinated and boosted, wear masks in indoor public places, and get tested before meeting with friends and family for the holidays. Some cities and states are reinstating indoor mask policies or requiring proof of vaccination to enter indoor public spaces.

Meanwhile, individuals and businesses have had mixed reactions to Omicron. Some are cutting back on vacation plans, while others are pushing forward. After two years, many people are tired of the disruption of the pandemic and the precautions taken to combat it. Some advancements since last winter, including vaccines and rapid tests, may help people during this wave to maintain activities that were suspended last winter, public health experts have said.

China has edged the United States in shipping its Covid-19 vaccines around the world, but the Biden administration said it donated more doses. WSJ examines how Omicron challenges the two as they push for global influence. Photo: Rodrigo Sura / Esteban Biba / Shutterstock

“We know we have all the tools to use so that we can continue the operations that are important, like keeping the kids in school,” said Charity Dean, former deputy director of the California Department of Public Health and co-founder of the Public Health Company. Group Inc. “We just need to be proactive and put them in place now. ”

New Antiviral Treatments from Merck & Co. and Pfizer Inc.

should also help ease the burden of Covid-19 on society. Regarding vaccine outlook, early lab tests point to third or booster dose of Moderna’s vaccines Inc.

and Pfizer Inc. and its partner BioNTech SE could protect against Omicron. Public health testing and surveillance are also essential.

“Once we integrate them really well, we’ll be ready to go where Covid no longer disrupts our society,” said Ali Khan, dean of the College of Public Health at the University of Nebraska Medical Center.

Dr Noah Greenspan has been treating Covid-19 long-haul New Yorkers since the start of the pandemic.


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Lung well-being

Even then, Covid-19 and its effects will not go away. Physiotherapist Noah Greenspan opened a rehabilitation clinic in New York on Monday for patients with persistent symptoms of Covid-19, or long Covid. It had been offering online services and a smaller temporary clinic since October 2020.

“We plan as if Covid will never go away,” said Dr Greenspan.

Other companies are also adapting to life with Covid-19.

Joey and Yana Cabell have set up temperature scanners at their Chart House restaurant in Waikiki, Honolulu, and staff are checking patrons’ vaccination cards at the entrance. They have reduced the number of tables they have set up to keep them 6 feet apart, but have been operating at full capacity for the past few weeks since the restrictions were relaxed. They have musicians to play live every day. Ms Cabell said Omicron doesn’t turn customers away.

“Our Covid reality is that we have now suffered the worst,” she said. “We have resumed our normal activities.”

With the rise of a new wave, people and institutions are making decisions that reflect changing attitudes towards the threat posed by Covid-19.


Photo:

Thalia Juarez for the Wall Street Journal

The CDC says a disease is endemic when it circulates continuously in an area at a baseline and in a predictable pattern. Another hallmark of an endemic disease is the absence of social disruption, some public health experts have said.

The question then becomes: what level of risk and how many deaths from Covid-19 will people and governments tolerate?

“That’s where the political and social will comes in,” said Lisa Lee, infectious disease epidemiologist and associate vice president at Virginia Tech. Without some sustained precautions, “we will remain vulnerable,” she said.

In a typical endemic condition, each infected person would infect only one other person, preventing an exponential and exponential spread, she said. By some estimates, each person infected with the Delta variant infected three to eight others. Omicron is believed to be more transmissible. Early evidence from places like South Africa suggests the variant may cause less severe illness than Delta. Public health experts warn that a slightly less virulent and more transmissible virus could still overwhelm health systems.

Visitors to a New York hospital get their temperature checked.


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Wang Ying / Zuma Press

Omicron shows how vulnerable society remains, even in countries with relatively high population immunity.


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Spencer Platt / Getty Images

The Covid-19 also remains a much deadlier adversary than the flu, an endemic disease that kills some 50,000 people in the United States in one bad season, according to the CDC.

New strains of influenza can trigger epidemics or pandemics, if cases exceed expected levels.

In the United States, more than 1,200 people die from Covid-19 every day. But even at death and transmission levels far higher than typical of influenza, public health experts say the spread of Covid-19 will likely set in in a sufficiently predictable pattern to be considered endemic.

How the virus continues to mutate, the durability of the immune response from a previous infection and vaccination, and how governments proactively tackle Covid-19 will all influence society’s enduring relationship with the virus, public health experts said.

Andrew Noymer, epidemiologist and infectious disease demographer at the University of California at Irvine, who studies the 1918 influenza pandemic, said he expects waves of variant-driven Covid-19 to hit periodically the United States for decades, especially in winter. Mortality will likely decrease over time as the immunity of the population increases, he said. The price will likely be more illness and death among those most vulnerable to the virus.

“Covid is part of the woodwork now,” he said. “It’s part of the furniture.

Visitors in front of the Rockefeller Center Christmas tree in New York.


Photo:

Thalia Juarez for the Wall Street Journal

Write to Brianna Abbott at [email protected] and Daniela Hernandez at [email protected]

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