To promise: “I will never raise the white flag and surrender. We will defeat this virus. We’ll get it under control, I promise.
President Joe Biden caused a stir in a “60 Minutes” interview on September 18 when he declared the covid-19 pandemic was over.
“We still have a problem with covid — we’re still working on it a lot,” Biden said. “But the pandemic is over.”
Critics countered that the United States still averages about 400 daily deaths from the virus, that nearly 30,000 Americans remain hospitalized, and that many more are suffering from “long covid” symptoms resulting from previous infections.
Two days later, Biden acknowledged that despite backlash from some, the pandemic “is fundamentally not where it was.” White House press secretary Karine Jean-Pierre called the coronavirus “much more manageable.” Past experience means “we know what works,” she said.
PolitiFact followed a campaign promise made by Biden in 2020 that is closely related to, but distinct from, what Biden told “60 Minutes.” During the presidential campaign, Biden said, “I’m never going to raise the white flag and surrender. We will defeat this virus. We’ll get it under control, I promise. “
Biden is on safer linguistic ground with his pledge to get covid under control than saying “the pandemic is over.”
There remains a debate among public health experts over whether the pandemic is “over” – or if, realistically, it ever can be. There is no official arbiter to make this decision, and the word “more” suggests a finality that is not well suited to describe a pathogen that will exist in some form indefinitely.
However, we found a broad consensus among infectious disease specialists that the pandemic is now “under control”.
When Biden was inaugurated, physical distancing was widely enforced, schools were often virtual, public events were rare or tightly controlled, and few Americans had yet received a vaccine. Today, life for many Americans is much closer to the pre-pandemic norm, with virtually all schools open, well-attended concerts and restaurants, and a return to typical levels.
“The nation has clearly made tremendous progress on covid-19 since President Biden was elected,” said Jen Kates, senior vice president and director of global health and HIV policy at KFF. “I would probably say that we are in a pandemic “transition” phase, that is, we are moving from the pandemic to a post-pandemic period. But it’s a continuum, not a cliff, where it’s a pandemic one day and the next,” Kates added.
Dr Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials, added that the promise to bring the pandemic under control “is certainly on track, maybe even delivered, as far as what the federal government can provide to accomplish this.
And Dr. William Schaffner, professor of preventive medicine and health policy at Vanderbilt University, agreed that “the emergent phase of the pandemic is coming to an end. We are now entering the ongoing struggle – call it a truce with the virus. »
Medical experts have said pandemics inevitably become “endemic”, meaning the pathogen is here to stay but does not present a generalized emergency.
“We will still have to manage covid in the medical system,” said Dr. Monica Gandhi, professor of medicine at the University of California-San Francisco. “Unfortunately, although we can reduce deaths to a very low level, I don’t think we will ever reach zero deaths from covid-19.”
The level of deaths in the United States from covid is lower today than it has been for most of the pandemic, and has been so since the spring.
Notably, the number of “excess deaths” is also falling. It is a measure that measures the number of additional deaths above the long-term average for this time of year. The number of excess deaths nationwide per week has consistently been between zero and 5,000 since the spring, after peaking at 20,000 to 25,000 per week in four previous surges since the start of the pandemic.
Hospitalization has held steady recently at some of the lowest rates in the pandemic. And even this level may exaggerate the impact of the virus; routine admission testing often detects asymptomatic cases and largely coincides with the reason a patient is admitted.
Gandhi pointed to data from Massachusetts hospitals showing that most hospitalized patients who test positive for covid have only “accidental infections”, with only 1 in 3 being treated primarily for a covid-related illness.
Experts noted that hospitalizations and deaths, even at these reduced levels, remain too high, and they warned that infections could rise as winter forces people indoors. Yet they credit the availability of vaccines and treatments, as well as knowledge gained from living with the virus for more than two years, with the likelihood that the darkest days of the pandemic are behind us.
“I have no fear at all that we will return to the scale of hospitalizations and deaths of the worst days of the pandemic,” said Brooke Nichols, mathematical modeller of infectious diseases and health economist at Boston University School of Public Health. . “We will likely enter a seasonal covid vaccine situation, potentially combined with influenza in the same vaccine, and these seasonal vaccines will become essential to prevent hospitalizations and deaths during the flu and covid seasons.”
There hasn’t been a major new variant since omicron emerged in late 2021, and even the most recent omicron subvariant to emerge, BA.5, has long been the dominant strain in the United States. , which has prevailed since early July.
This does not mean that a new, more dangerous strain could not emerge. However, public health experts are reassured by recent trends. The trend for most of 2022 suggests that a rapid succession of increasingly baffling – and vaccine-avoiding – variants is not inevitable. If a major new variant emerges, mRNA vaccines like those made by Moderna and Pfizer-BioNTech can be updated quite easily for it.
However, the use of vaccination remains a pressing issue. About a third of Americans are not fully vaccinated, and an even smaller percentage have received boosters. Plescia said “the biggest deciding factor right now won’t be the president or the federal government’s response — it will be the public’s response.”
“I think there’s illness fatigue and vaccine fatigue and mask-wearing fatigue,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “People are just tired of covid and trying to wish for it, and it’s unfortunate because it’s not gone. We’re sick of it, but it’s not tired of us yet.
Some experts warn that a pandemic “under control” does not mean the costs will be minimal.
“The degree of protection offered by currently available vaccines, especially for the most vulnerable, is of limited duration, and non-fatal outcomes from covid may still impact the health of the population,” said Babak Javid, professor fellow in the division of experimental medicine at UCSF.
These consequences are called “long covid”, and nearly 1 in 5 Americans who have had covid suffer from it. The Centers for Disease Control and Prevention defines long covid as symptoms that last three months or more after contracting the virus and have not been experienced before.
“Under control” suggests progress in keeping the spread within modest limits. That doesn’t mean people haven’t lost loved ones or felt the continued effects of the virus; clearly they have.
What else has Biden to do?
Biden and his administration still have work to do, experts said.
Several public health experts have urged Congress to agree to Biden’s request for $22 billion in covid-related funds. The White House has touted this funding as a way to be ready for a resurgence even if case levels are currently low. He proposes that the funding support testing, research into new vaccines and treatments, the preparation of future variants and global assistance. Biden’s open declaration that the pandemic is “over,” however, could make congressional approval less likely.
Gandhi said the federal government should do a better job of targeting boosters and therapeutics to populations most at risk for serious infections, including older Americans and immunocompromised people.
And Schaffner urged more efficient and unified messaging, with efforts to remove all traces of politics. “I want the federal government to come together to figure out who the main messenger is and deliver strong, clear and simple messages,” he said.
Biden may not have used the most appropriate word when describing the pandemic as “over,” but long-term statistical trends are pointing in the right direction, and vaccines and treatments should lessen the severity of the pandemic. future waves. For these reasons, experts say it is fair to declare the pandemic “under control”. If circumstances change, we’ll reassess our rating, but for now, this gets a promise kept.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health policy research organization not affiliated with Kaiser Permanente.