US President Joe Biden and WHO Director Tedros Adhanom Ghebreyesus both recently expressed optimism that the Covid-19 crisis may be drawing to an end. But is the pandemic really a thing of the past?
During an interview on the CBS channel’s “60 Minutes” programme on Sunday, US President Joe Biden offered a bold assessment of the coronavirus crisis, assuring audiences that the “Covid-19 pandemic is over.”
“We still have a problem with COVID. We’re still doing a lot of work on it. But the pandemic is over,” he said. “If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And so I think it’s changing.”
Biden’s statement came just a few days after Tedros Adhanom Ghebreyesus, director of the World Health Organisation (WHO), also offered an upbeat assessment on the end of the pandemic: “We are not there yet. But the end is in sight,” he told reporters at a virtual press conference on September 15.
The number of Covid-related deaths has been steadily falling worldwide. The WHO recorded 11,118 deaths in the week ending September 5, the lowest weekly count since mid-March 2020.
The US went from more than 3,000 deaths a day at the beginning of Biden’s term in January 2021 to about 400 in September, according to the CDC (Centres for Disease Control and Prevention, the US public health agency).
But this optimism may seem at odds with what is happening in other parts of the world.
“It can be disconcerting to hear about the end of the pandemic in Europe when several countries are re-launching an autumn vaccination campaign,” said Yves Coppieters, an epidemiologist at the Université Libre de Bruxelles.
Europe’s medicines watchdog said Tuesday that Covid-19 cases and death rates were falling, but warned the pandemic “is still ongoing” as it urged countries to roll out booster programmes before the winter. “… As autumn approaches, we need to prepare for a new wave of infections in line with the trend shown by the virus in the past two years,” Marco Cavaleri, the European Medicines Agency’s head of vaccine strategy, said at an EMA press conference on September 20, 2022.
In France the tone is far from triumphant, as Santé Publique France (France’s public health agency) has been warning of a rise in cases since the beginning of September.
China does not seem ready to claim victory in its fight against Covid-19 either. More than 30 cities in China are still imposing partial or total lockdowns on more than 60 million inhabitants.
Between the optimism of some and the caution of others, it is difficult to know where things stand. “Even among the scientific community, you would get really different answers. There is no one definition of what the end of the pandemic means,” said Rachael Piltch-Loeb, a public health policy specialist at Harvard University, in an interview with National Geographic on August 6, 2021.
The ball is in the WHO’s court
Officially, since it was the WHO that “declared the start of the pandemic, it is up to it to decide when the pandemic ends”, said Mircea Sofonea, an epidemiologist at the University of Montpellier.
The WHO has a committee of experts who have been giving their opinion every three months since January 2020 on whether the situation should continue to be classified as a pandemic. These experts were still in favour of designating it as such in their latest report, published on July 12. It is unclear whether they will share Biden and Ghebreyesus’ optimism in their upcoming report, expected in mid-October.
The epidemiologists seem to agree that there will be no definitive end to the Covid-19 crisis like there was with smallpox. In May 1980, the 33rd World Health Assembly confidently declared that smallpox had totally disappeared from all the world’s countries.
“We don’t have the means to aim for Sars-CoV-2’s total eradication,” said Sofonea.
In the case of Covid-19, the most scientific approach would be to “note when the main criterion for declaring a pandemic – that there are epidemics on at least three continents – no longer pertains to Covid-19”, said Coppieters.
Each country establishes a virus circulation threshold. If surpassed, the country is supposed to report to the WHO that it is experiencing an epidemic outbreak. For example, the “epidemic threshold” in France for Covid-19 is 98 cases per 100,000 inhabitants.
But having the most reliable data does not always guarantee unanimity. “WHO was criticised for declaring the start of the Covid-19 pandemic too late” in March 2020, said Sofonea.
The consequences of the end of the pandemic
Sofonea believes the only way to tell if we have reached the end of the pandemic is to “look at hospital saturation”. Thanks to widespread vaccination, more effective treatments and variants such as Omicron which seem to result in fewer hospitalisations, the impact of Covid-19 on national healthcare systems is much less severe than it was a year ago.
And simply declaring the end of the pandemic will not mean that Covid-19 has been eradicated, especially in regions – often less wealthy – where vaccination is progressing slowly.
This is why the epidemiologists do not believe the end of the pandemic will be announced any time soon.
“There’s not going to be a scientific threshold. There’s going to be an opinion-based consensus,” said Caroline Buckee, an epidemiologist at Harvard University, in an interview with the magazine Science on March 4, 2022.
The end of the pandemic and a return to “normal” will have certain consequences. Some pharmaceutical companies, such as the US company Moderna, have promised that they will not exercise their intellectual property rights over vaccine technology until the Covid-19 pandemic is over. Some emergency programmes, such as Covax – a worldwide initiative that aims to provide equitable access to vaccines – will also curtail their support once the pandemic ends, according to Science.
The declarations from Biden and Ghebreyesus are merely “political announcements”, said Coppieters, notably in the case of the WHO. “This contrasts with the organisation’s often very pessimistic tone since the beginning of the pandemic. I wouldn’t be surprised if the WHO meant that, amid all the other bad news (inflation, war in Ukraine, risk of recession), that the health situation, at least, is improving,” he said.