Covid Will Become Endemic. The World Must Decide What That Means

A collage with an image of people in PPE and art by Jenny Sharaf - Illustration: Jenny Sharaf; Getty Images

Covid Will Become Endemic. The World Must Decide What That Means
Print title: “The Endemic Times”
WIRED, December 31, 2021
By Maryn McKenna

“The task of 2022 will be figuring out how much action we’re willing to take and how much disease and death we’ll tolerate.”


A month ago, it felt like we could see the future. Boosters were rolling out. School-age kids were getting their second shots in time to see grandparents over winter break. Life in the United States was sliding toward something that looked like it might be normal—not pre-pandemic normal, of course, but maybe a post-pandemic glimpse.


And then came the Omicron variant, squashing hopes for the holidays as completely as Delta chilled hot vax summer in July. Weeks later, we’re still not sure exactly what it portends. It’s vastly more transmissible. It may or may not be more virulent. It is tearing through countries and spreading through friend groups and sending universities back online for the spring semester.

This is not the year-end we wanted, but it’s the year-end we’ve got. Inside it, like a gift basket accidentally left under the tree too long, lurks a rancid truth: The vaccines, which looked like the salvation of 2021, worked but weren’t enough to rescue us. If we’re going to save 2022, we’ll also have to embrace masking, testing, and maybe staying home sometimes, what epidemiologists broadly call nonpharmaceutical interventions, or NPIs.


Acknowledging that complexity will let us practice for the day Covid settles into a circulating, endemic virus. That day hasn’t arrived yet; enough people remain vulnerable that we have to prepare for variants and surges. But at some point, we’ll achieve a balance that represents how much work we’re willing to do to control Covid, and how much illness and death we’ll tolerate to stay there.


“The key question—which the world hasn’t had to deal with at this scale in living memory—is how do we move on, rationally and emotionally, from a state of acute [emergency] to a state of transition to endemicity?” says Jeremy Farrar, an infectious disease physician who is director of the global health philanthropy the Wellcome Trust. “That transition period is going to be very bumpy, and will look very, very different around the world.”


To start, let’s be clear about what endemicity is, and isn’t. Endemicity doesn’t mean that there will be no more infections, let alone illnesses and deaths. It also doesn’t mean that future infections will cause milder illness than they do now. Simply put, it indicates that immunity and infections will have reached a steady state. Not enough people will be immune to deny the virus a host. Not enough people will be vulnerable to spark widespread outbreaks.

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About the Author:

Maryn McKenna is a senior writer at WIRED covering health, public health and medicine, including the Covid pandemic, and a faculty member at Emory University’s Center for the Study of Human Health. Before coming to WIRED she freelanced for magazines in the US and Europe including Scientific American, Smithsonian, The New Republic, the Guardian, the New York Times Magazine, and The Atlantic. She graduated from Georgetown University, earned a master’s degree in journalism from Northwestern University, and was a Knight journalism fellow at University of Michigan and MIT. She is the author of Big Chicken, Superbug and Beating Back the Devil.