What We Need To Be Talking About Is The COVID-19 Endemic––That's Coming Next

by Virginia Duan
Originally Published: 
Scary Mommy, CDC/Pexels and Malte Mueller/Getty

Bad news, friends. The coronavirus isn’t going away — at least according to health officials. In fact, about 90% of scientists in a Nature magazine poll felt it would be very likely that COVID-19 would become an endemic virus.

Even though reported cases and fatalities are decreasing, the numbers are still higher than they were during the first peak. Despite people finally being vaccinated and some states cautiously reopening — Texas and Mississippi are not good examples of caution — or of anything, really — COVID-19 seems here to stay.

America’s very own doctor and head of the National Institute of Allergy and Infectious Diseases Dr. Anthony Fauci recently said it’s “possible” we may still need to wear masks well into 2022. Personally, I think mask culture should stick around. The U.S. death toll accounts for about 1 in 5 global coronavirus deaths, whereas East Asian countries have been wearing masks for at least a century and their COVID deaths are just a tiny fraction.

Americans excel at cultural appropriation; why can’t we culturally appropriate life-saving measures for once instead of just aspects white people find “cool” but punish and mock on POC?

What does “endemic” mean, anyway?

If you think the word pandemic is overused, you better start getting used to endemic — the new buzzword in Year 2 of Our Lord Corona. Defined by the Centers for Disease Control and Prevention (CDC) as a constant presence or the baseline/expected level of a particular disease in a specified population and geographic area, endemic basically means that a disease is normally in the general population at a certain frequency.

In other words: it’s always around and very common. Like Karens.

It’s like the shit kids constantly get and pass around like the common cold, the flu, or other everyday viruses like norovirus, enterovirus, or rhinoviruses. Or, it’s like malaria or measles, which are uncommon and thus, not endemic to the U.S., but are endemic to other areas and countries.

What it means if COVID-19 is endemic

So, if the coronavirus keeps turning up like a bad penny, does this mean we’ll be permanently stuck in lockdown? Are things never going to return to normal?

Welp, the short answer is, it depends. Our fate isn’t destined to be this bleak.

Infographic from Nature Magazine on how COVID-19 can become endemic.

Our future with COVID-19 as a permanent fixture in our epidemiological landscape depends on how the virus mutates and changes, the kinds of immunity we acquire either through infection and reinfection, vaccination, or some combination of both, and how well we tolerate and adapt to the inevitable deaths and recurrent illnesses the virus will bring.

Vaccinations, herd immunity, and eradication

While we’d all love for the vaccine and preventative measures to eradicate the SARS-CoV-2 coronavirus in the next year or two like Western Australia (which has spent much of 2020 living the coronavirus free life with no masks or temperature checks), that’s unlikely. Not only are there variants of COVID-19 cropping up, those from the U.K., South Africa, and Brazil spread particularly easily. Thus far, it seems as if the current vaccines allow our bodies to recognize these variants, but it’s inevitable that there will eventually be one that our current vaccines cannot accommodate.

However, let’s say there is a super-vaccine that can zap all mutations present or future of COVID — even then, it’s not plausible to quickly return to pre-pandemic times. According to one model, in order to reach temporary herd immunity (where a large portion of the population is immune to a disease) paired with some social distancing measures, a vaccine that can effectively block 90% of transmissions will need to reach at least 55% of the public.

If we wish to lift all social distancing measures, the vaccine will need to reach approximately 67% of the population. Of course, if the transmission rate is higher or the vaccine is less effective, the minimum population coverage will need to be higher, too. And unfortunately, vaccinating 55% of people will be onerous for many countries and if parts of the world don’t get vaccinated, the virus will stay in certain pockets of the world like the Zika virus or malaria currently do.

Remember, even in 1955 after polio vaccinations became widespread in the U.S., polio wasn’t completely expunged in America until 1979. That’s 24 years — almost the age one has to be in order to run for the U.S. House of Representatives.

It would do well for us to recognize that polio can still be brought into the U.S. by international travelers infected with the polio virus. (For the curious, this last occurred in 1993.) The only reason the U.S. remains polio-free is because we keep our immunity rate up by vaccinating our children — and finishing the vaccination rounds. Like measles, this completely preventable disease could return if pockets of our general population continue to be willfully obtuse and refuse to vaccinate.

Childhood virus

Maria Stavreva/Getty

One likely scenario is that once folks develop some immunity to COVID-19 from either vaccinations or infection, the symptoms will become less and less over time. Pregnant people would be vaccinated so their newborns would have temporary protection and children would encounter SARS-CoV-2 when they are very young and the infection is mild.

This is particularly plausible, because four currently endemic coronaviruses are behind the common cold. Of these four, at least three have been in the human population for hundreds of years and two are responsible for about 15% of respiratory infections. According to one scientific model, most children come into contact with these viruses before six years old, generally have a relatively benign first infection, and develop immunity to them. While the immunity wanes quickly and doesn’t prevent reinfection, it does seem to prevent adults from getting sick.

Like the flu

Alternatively, COVID could become like the flu where we get influenza vaccines during the winter, with outbreaks and deaths occurring on a more seasonal basis. Just like the flu vaccine, the COVID vaccine would likely need to be updated every year to accommodate the new variant strains and the evolving brinkmanship between virus and science.

Animal reservoirs

The prevalence of SARS-CoV-2 also depends on how entrenched it becomes in wild animal populations. Diseases like yellow fever and Ebola linger and resurge because animal reservoirs like insects, birds, and monkeys provide opportunities for these viruses to cross back over to humans. COVID-19 likely originated from bats, but it also easily infects cats, rabbits, hamsters, and especially minks.

Ultimately, there are a lot of variables that can affect a future where COVID is endemic. What is absolutely clear is that if countries — I’m staring at you, America — abandon strategies to flatten the curve and reduce spread of the virus, the pandemic could get significantly worse.

Get vaccinated. Wear a mask. Don’t be a dick. We’re all sick of being in lockdown and the sooner COVID graduates from pandemic to endemic, we’ll all feel a lot better.

Information about COVID-19 is rapidly changing, and Scary Mommy is committed to providing the most recent data in our coverage. With news being updated so frequently, some of the information in this story may have changed after publication. For this reason, we are encouraging readers to use online resources from local public health departments, the Centers for Disease Control, and the World Health Organization to remain as informed as possible.

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