What "Endemic" Looks Like "Now"

Back again!  After a really cool mini-vacation in the Hudson River School, then a lot of work, and then a visit from son, daughter-in-law, and The World's Cutest Grandbaby (who didn't sleep one night and so was a little less than cute), The New World is back.

Back in the new world, or at least talking about the new world which may, someday, emerge.  Just in time for Ed Yong's article in the Atlantic, with a compelling title:  "How The Pandemic Now Ends."  It seems like we've passed through a succession of "now"s, and this is the latest one.  

This "now" is the result (I'm sure you will not be surprised) of the Delta variant.  It is also the result of a fundamental change in how we see vaccinations.  "Vaccines remain the best way for individuals to protect themselves, but societies cannot treat vaccines as their only defense."  This is different.  The more we learn about breakthrough infections, the more it is clear that the virus, and especially Delta, can spread through the vaccinated population as well as the unvaccinated (although much more ineffectively.  Still.)

So we return to the concept of "endemic," which we discussed as long ago as May of this year.  There was general agreement among epidemiologists at that time, but Delta has sealed the deal.  I think it's worth reproducing a whole paragraph from the Atlantic article:

This means that the “zero COVID” dream of fully stamping out the virus is a fantasy. Instead, the pandemic ends when almost everyone has immunity, preferably because they were vaccinated or alternatively because they were infected and survived. When that happens, the cycle of surges will stop and the pandemic will peter out. The new coronavirus will become endemic—a recurring part of our lives like its four cousins that cause common colds. It will be less of a problem, not because it has changed but because it is no longer novel and people are no longer immunologically vulnerable. Endemicity was always the likely outcome... but likely is now unavoidable. “Before, it still felt possible that a really concerted effort could get us to a place where COVID-19 almost didn’t exist anymore,” Murray told me. “But Delta has changed the game.”

He goes on to talk about the average person getting COVID pretty much the same way we get a cold, and then living with the discomfort, getting over it, and moving on.  People who are vaccinated will, on the average (which does not guarantee anything for you or me), find their experience less intense. 

Yong doesn't talk about long COVID, except briefly, peripherally, and I think this is a blemish on what is generally a comprehensive and useful picture of our present and future.  And it leaves a question that must be addressed:  why would we reduce our mitigation efforts - ever - if we don't want the lifelong sentence of long COVID?  A cold comes and goes.  COVID can be forever.  We need a new definition of "endemic," and a new way of living in a world that can condemn us to pain and discomfort for a very long time.