Quote card by Opinion.

It has been almost two years since March 13, 2020. Almost two years of not seeing loved ones, wearing masks, quarantining, testing, vaccinating, mandating and sanitizing. Almost two years and it’s difficult to think of a time when the COVID-19 pandemic will not be involved in every aspect of our lives. After these two years, many wonder when there will be a time their efforts to protect themselves and their community from this disease will lessen. 

As COVID cases decrease nationwide, some states — most notably, the state of California — have begun to consider COVID-19 as endemic. Shifting to endemicity does not, as we might hope, entail removing all coronavirus restrictions and returning back to our pre-pandemic lives. Instead, it means reorienting our minds, our resources and our public health policy towards approaching COVID-19 as a long-term issue. 

A pandemic, which is what we have referred to COVID-19 as for roughly the last two years, is a rapidly and unpredictably spreading disease that infects a wide and diverse range of people. COVID-19 has infected every continent, illustrating its reach and labeling it a pandemic. An endemic disease, which is what many states are beginning to consider COVID-19, is one whose spread is predictable and consistent and whose reach is limited to a certain area. While a disease becoming endemic does not mean that all infection and death ceases, it does mean shifting toward treating it as a consistent issue to mitigate, and not an imminent threat to mobilize against.

As we come to terms with COVID-19’s long-lasting effects, it is vital that the federal government provide at-home test kits, KN95 masks and over-the-counter medications to reduce the severity of the disease for those who still become infected. The pandemic exposed how grossly underprepared the United States was for combating a widespread disease outbreak, to the point where even Robert Redfield, then-Centers for Disease Control and Prevention director, acknowledged it all the way back in August 2020. Masks and tests were scarce, and the vaccine distribution was insufficient to prevent the further spread of the disease and the emergence of new variants. If new variants pop up, we should be adequately prepared to quickly equip ourselves with the necessary preventative measures. 

Awarding domestic manufacturers with federal dollars so they continue producing a robust supply of tests, masks and antiviral drugs will be the cornerstone of effective endemic policy. One of the best ways that the federal government can incentivize states to shift to this endemic focus is by awarding states grants to beef up PPE manufacturing, accumulate vaccine and mask reserves and continue to encourage vaccination for those who are eligible. 

As we shift to an endemic stage, the importance of data cannot be undermined. Recently, it surfaced that the CDC was not fully disclosing all the data on COVID-19 hospitalizations and wastewater surveillance it had collected throughout the pandemic. Although CDC officials cited concerns about releasing potentially inaccurate information, they have since received funding intended to improve their ability to collect and disseminate information in a timely and accurate manner. States and localities would benefit immensely from greater access to a state-of-the-art wastewater surveillance database. Receiving that data in real-time would allow jurisdictions to quickly modify public health policy in case of an outbreak and delimit those measures for the region in which the outbreak occurs. Moreover, communicating accurate data to the public could help rebuild public confidence in our medical institutions. 

Some of the recent moves by state governments to end mask and vaccination mandates seem to convey the message that “endemic” means “stop trying.” Indoor masking requirements for vaccinated persons have expired in jurisdictions such as California, Illinois, New York and Washington, D.C. Masking requirements in K-12 schools are also being lifted. Compare that to California Governor Gavin Newsom’s SMARTER plan, which is intended to treat COVID-19 as a permanent part of life — allowing people a sense of normalcy without becoming vulnerable to future COVID-19 variants. Newson’s plan includes stockpiling millions of masks, continuing to encourage vaccination and the development of treatments.

Treatments in particular are key to a safe future. The U.S. Food and Drug Administration approved one antiviral drug for adults and issued emergency authorization for others. Pfizer’s oral COVID-19 treatment, Paxlovid, was in short supply in the months after its emergency authorization. The federal government should play a central role in encouraging the development of more COVID-19 treatments and ensuring that those treatments are widely available throughout the country. A large federal effort akin to Operation Warp Speed could help the states transition to an endemic stage without risking thousands of lives.     

Additionally, one major factor in ensuring that COVID-19 can remain an endemic disease is ensuring that countries around the world receive an adequate number of vaccines. A concerning number of the world’s largest countries have vaccination rates far below the percentage that could provide herd immunity. Should this state of affairs continue, more variants, including potentially vaccine-resistant ones, have the potential to persist. This is because variants are far more likely to emerge when the virus is able to spread, and the virus is more likely to spread through unvaccinated individuals. 

As a wealthy country with a higher-than-average vaccination rate, the United States has the ability, and a moral obligation, to improve the vaccination rates of other countries. An easy way to begin that task would be to donate excess doses to said countries. While the U.S. has, as of March 6, donated around 413.7 million doses of the vaccine to other countries, that number is minute compared to the nearly 3 billion people around the world that have yet to receive even one dose of the vaccine.

While there may not be sweeping policy changes to be made, moving into an endemic state will require a revised mindset and long-term shift. Treating COVID-19 as endemic, and thus returning to relative normalcy, means being prepared to quash future outbreaks quickly. That requires a large and easily accessible supply of masks, tests and treatments and ensuring that the entire world, not just its wealthiest countries, is adequately vaccinated. Endemicity doesn’t mean giving up — it means being prepared to ensure that COVID-19 never again becomes a pandemic.