Two years after it began, the COVID-19 pandemic may be evolving into an endemic, slowly retreating into the background but remaining a constant threat, according to a Mayo Clinic infectious disease specialist.
Because of the virus’s ongoing presence, vaccines will have a continuing role in people’s lives, said Dr. Jack O’Horo, who is based in Rochester, Minn. Mayo also has locations in Jacksonville and Phoenix.
Case numbers are declining “precipitously” in the United States and much of the world, he said. But the coronavirus likely will always be around, in the form of one variant or another, with occasional eruptions similar to the flu virus, he said during a recent virtual session with reporters.
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“An endemic refers to a disease that’s present at a certain level in the population either at certain times of year or year-round, but you expect a certain level of background activity,” he said.
One of the best examples, he said, is seasonal flu, with cases tending to rise during the winter. “There is a certain expected level of increase,” he said.
COVID-19 caused about 1 million deaths in the US and 6 million worldwide, what O’Horo called “grim milestones.” Despite declining case numbers, there are currently some global “hot spots” for variants of the virus, he said.
What kind of impact is the virus still having locally
But Jacksonville is not currently among them, according to hospital representatives.
Baptist Health, the largest area health system, on Wednesday reported it had 29 coronavirus patients at its five hospitals. At the peak point of last summer’s surge of the omicron variant on Aug. 11, 2021, Baptist hospitals had 569 COVID-19 patients.
Also as of Wednesday, Ascension St. Vincent’s had six patients at its three hospitals and there were 12 at UF Health Jacksonville’s two hospitals. Mayo Clinic Jacksonville, HCA Florida Memorial Hospital and HCA Florida Orange Park declined to provide case numbers.
But a Mayo spokesman said the clinic had a “relatively low number” of COVID-19 patients in recent weeks, compared to the caseload during surges earlier in the pandemic. An HCA Florida spokeswoman said the current caseloads at Memorial and Orange Park were “significantly lower than they were” during the omicron spike.
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“It’s difficult to predict what kind of variants to expect next,” O’Horo said. “Given that all viruses mutate, we can reasonably guess that there will be more variants. That’s where it’s going to require some continued vigilance from public health to help to isolate those cases as they arise and make sure we have adequate protections in place.”
Public health vigilance — monitoring and, as needed, requiring masks and other protective measures — will be required at the federal, state and local levels. The US Centers for Disease Control and Prevention’s risk guidance “goes down to a county level, which is an important way of looking at this. … keeping abreast of local conditions,” he said.
“Just because it’s safe to take off your mask three counties over in one setting doesn’t mean it’s safe to do the same in this county in a more vulnerable setting,” he said.
Also, periodic COVID-19 vaccinations will be needed to prevent spread, similar to annual flu shots. Currently about 63 percent of Duval County residents are fully vaccinated against the coronavirus, which limits their risk of hospitalization and death.
“That’s what keeps the disease in check, what keeps it manageable enough that we don’t overwhelm our hospitals and clinics like we have in the past two years of this pandemic and helps keep us in a more normal phase of life,” O’ Horo said.
“Vaccines will continue to be a very important part of this endemic,” he said. “This isn’t an end to the need for some of those precautions. Vaccines are probably the most important of these measures we can take.”
‘Lessons learned’ should help prevent future pandemics
O’Horo said he is hopeful that COVID-19 cases will continue to drop through the spring and summer and not surge as they did in summer 2021 when the omicron variant was prominent. The population has a higher immunity this year — more people have been vaccinated and those who had the virus last year have natural immunity.
The fall “remains the big unknown,” he said, and he urged the public to monitor public health recommendations about vaccines and other protective measures. “The pandemic is not over yet and it’s still going to be impacting this year at the very least.”
People who have weakened immune systems or have immunocompromised people in their households may choose to get vaccinated and keep wearing masks, whether the government recommends them or not.
“It’s really shifting to a mask-optional mindset,” O’Horo said.
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Despite the societal upheaval it caused, the pandemic has at least increased public awareness of public health, particularly among young people. And more of us now know what individuals can do to help improve public health.
“Widespread vaccination campaigns and measures like masking were something that our generation had not really experienced until two years ago,” he said. “Now that we’ve understood what it’s like to go through a pandemic … I hope we will take those lessons learned to prevent experiencing another one during our lifetimes.”
Those lessons learned include the scientific community’s “robust” ability to make vaccines rapidly, as well as governments’ inability to fully convince the public that COVID-19 vaccines are safe and necessary.
“Having several vaccine candidates come forward in such a short period that are so effective at preventing hospitalization and death is something that I never would have anticipated,” O’Horo said. “… We can take away a real win on the vaccine development process and a need for further work on the communication and outreach process.”
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