WHO declares pandemic no longer public health emergency

“It’s moving from essentially a new threat to something that we are learning to live with.” - Dr. Christopher Murray, IHME Director.

Key takeaways:

• The WHO announcement is appropriate given the meaning of the word “pandemic.” It reflects the change we have all experienced from living with the disease as opposed to an emergency response to the disease. We may have even considered the emergency over after Omicron appeared and nearly all mandates on social distancing, masking, etc. had been lifted.
• While no longer an emergency, the spread of COVID is still a major threat to some populations: the elderly and those with comorbidities. For all people, but especially those groups, it is important to stay up to date on vaccinations in order to prevent severe disease or hospitalization.
• We must continue investing in tools that will help prevent and fight future pandemics, including surveillance efforts for new pathogens and development of new vaccines and antivirals.

This transcript has been lightly edited for clarity.

My reaction to the WHO announcement is really grounded in the true meaning to us all of the term pandemic. It is a formal epidemiological term, which is an epidemic that's covering many parts of the globe. 

And in that sense, COVID is still a pandemic. It’s an infection, but it’s moving from essentially a new threat to something that we are learning to live with.

If you think of the pandemic as something that requires a concerted set of quite extraordinary measures from governments and individuals to be able to manage it, then I think the pandemic ended when Omicron showed up last year, because very soon, if you look at the institution of social distancing mandates or other efforts, within a couple of months of Omicron showing up, there were very few mandates left in the world.

And so in that sense, I think the WHO announcement is appropriate and perhaps might have come six months ago as well, reflecting that change from living with the disease as opposed to an emergency response to the disease.

Because we’re changing the way we describe COVID from being a pandemic to a disease that is present, this does not mean it is benign. It is actually still a very major threat to the elderly and to those with comorbidities.

And I think it’s very important that we adopt the mindset, each individual, and then for certain communities at risk, of managing immunity.

Because we can get immunity from vaccination, that’s the safest way to get immunity, but it wanes. You can get immunity from infection; that also wanes over time.

And so, roughly speaking, at about six months since your last infection or vaccination, immunity against severe disease is still pretty good. It’s still high – 80% as far as we can tell. But it may well start to decline quite a bit more after that point.

And so it’s very important to get a booster if you’re in that risk group, to maintain that immunity if you haven’t been vaccinated or been infected in the last 6 to 10 months, let’s say.

Now, we also should remember that vaccination or past infection isn’t really going to protect you from getting sick. The main thing it does is protects you from having severe illness, going to hospital, or dying.

And so that’s also part of learning to live with COVID and managing the important thing, which is immunity against severe disease. We’ve had waves of Omicron sub-lineages, you know, B.A.1, B.A.2, BA.5, XBB, Kraken, now Arcturus.

And this is what we expect to see, which is continued versions of Omicron that are very highly transmissible, but not that severe unless you’re in an at-risk group. And in some sense, this turnover of variants is what we expect to see.

It’s much better for us all than a completely new variant that replaces Omicron and might go back to being more severe.

So there’s nothing particularly alarming so far that we’ve seen for Arcturus. And in fact, it may be the mechanism by which we block worse variants emerging, because of the high transmissibility of these Omicron sub-lineages.

We need as a local, national, and global community to make sure that the surveillance around the world to detect a bad version of COVID, if it does occur, as early as possible, is paid for and sustained, because that’s going to be a critical part of protecting ourselves against what we hope is a low probability, but still a distinct risk, that we go back to a more severe variant that is very transmissible and catches us all off guard.

So that’s the most important, I think, that we maintain our vigilance. And the way we do that is by encouraging governments to invest in good, active surveillance, and transparent reporting to the world.

Anticipation and preparation for either future COVID outbreaks or future pandemics from some novel pathogen or an existing pathogen is, as we’ve learned, incredibly important for protecting people’s health and actually protecting people’s livelihoods as well.

Are we in a better place than we were for COVID? Perhaps not.

Perhaps we have not really made the progress we need to. There are attempts to invest in better labs and having more efforts at surveillance. I’m not sure we’ve made enough distance on that. And the resources may not be there.

But if you go back to the beginning of COVID, it wasn’t even the speed with which we learned about the outbreak in Wuhan. It was the slowness with which governments around the world – with a few exceptions in Southeast Asia – it was the slowness of the rest of the governments around the world in reacting.

It took many, many, many weeks before governments took the threat seriously. If they had acted earlier, we could have avoided potentially a lot of the deaths that did occur.

And the tricky part here is that there are infectious disease potential threats emerging every day. There are five or six potential threats that get announced on various alert systems on a daily basis. And it’s sifting through that huge volume of essentially noise to find the signal of a real threat and then getting the balance of the costs of inaction versus the costs of action, both in terms of the toll on human lives and the economic costs. It’s getting that right.

And we haven’t yet made progress on that really challenging decision-making process of jumping on the thing that we need to jump on without having the world shutting down, week after week, as potential threats are evaluated.

And lastly, I think we need to make sure that we continue investing in the tools that will allow us to respond quickly if and when a new pathogen emerges.

The innovations in diagnostics, the innovations in how we make vaccines, the innovations in antivirals are examples of where we could have a better set of tools so that we could then react even more quickly than we did for COVID-19.