Endemic COVID-19 may be a more realistic endpoint than herd immunity ??
About herd immunity as a likely epidemiological endpoint for some countries, but the Delta variant has put this out of reach in the short term. Instead, it is most likely as of now that countries will reach an alternative epidemiological endpoint, where COVID-19 becomes endemic and societies decide—much as they have with respect to influenza and other diseases—that the ongoing burden of disease is low enough that COVID-19 can be managed as a constant threat rather than an exceptional one requiring society-defining interventions. One step toward this endpoint could be shifting the focus of public-health efforts from managing case counts to managing severe illnesses and deaths. Singapore’s government has announced that it will make this shift, and more countries may follow its lead.
Other authors have compared the burden of COVID-19 with that of other diseases, such as influenza, as a way to understand when endemicity might occur. In the United States, COVID-19 hospitalization and mortality rates in June and July were nearing the ten-year average rates for influenza but have since risen. Today, the burden of disease caused by COVID-19 in vaccinated people in the United States is similar to or lower than the average burden of influenza over the last decade, while the risks from COVID-19 to unvaccinated people are significantly higher . This comparison should be qualified, insofar as the burden of COVID-19 is dynamic, currently increasing, and uneven geographically. It nevertheless helps illustrate the relative threat posed by the two diseases.