COVID-19 endgame

Just recently, National Inter-Agency Task Force chief implementer Secretary Carlito Galvez announced that government is preparing what it calls an endgame plan in preparation for the transition from a pandemic to an endemic state once the country achieves its desired rate of vaccination against COVID-19.

Transitioning to normalization, he said, required vaccinating at least 70 to 80 percent of the country’s total population, especially children five to 11 years of age in time for the opening of classes by August this year.

An article by the Columbia University School of Public Health explains the differences between an epidemic, endemic, and pandemic.

Citing the Centers for Disease Control and Prevention (CDC), it said that an epidemic is an unexpected increase in the number of disease cases in a specific geographical area. Some examples of epidemics that occurred throughout American history are yellow fever, smallpox, measles, and polio. But an epidemic disease doesn’t necessarily have to be contagious, saying that the rapid increase in obesity rates or specific health-related behavior like smoking, with rates clearly above the expected occurrence in a community or region can also be considered epidemics.

A pandemic, meanwhile, is when a disease’s growth is exponential and each day cases grow more than the day prior. It has nothing to do with virology, population immunity or disease severity. It basically means that a virus instead covers a wide area, affecting several countries and populations, the article explained.

Notable past pandemics, according to the article, would include the Black Death, which caused an estimated 25 million deaths across the world in the 14th century, the American plagues of the 16th century, the flu pandemic from 1889-1990, the Spanish flu from 1918-1920, and the Asian flu pandemic from 1957-1958. And now we have the COVID-19 pandemic.

On the other hand, an endemic is a disease outbreak that is consistently present, but limited to a particular region, which makes the disease spread and the rates predictable. Malaria, for example, is considered an endemic in certain countries and region, the study noted. A pandemic cuts across international boundaries, as opposed to regional endemics.

The World Health Organization, it mentioned, defines pandemics, epidemics, and endemics based on a disease’s rate of spread. The difference isn’t in the severity of the disease, but the degree to which it has spread.

In the US, governors and public health officials are still split over whether the COVID-19 pandemic is reaching the endemic phase. When referring to endemic, some governors say this means moving out of the pandemic mode and normalizing, learning to live with COVID.

Some medical authorities however are saying that even epidemiologists and health officials do not agree on what endemic means, especially for COVID-19. One epidemiologist said that generally, a disease that is endemic has a predictable pattern of cases, whether that means it has reliable seasonality or a stable geographic distribution.

Some warn that a new variant could emerge and lead to new surges, and that could cause whiplash if states are already thinking of the coronavirus as endemic.

One expert said that there are those using the term endemic as a way to say that we are going to live with this and try to behave in a normal way. However, there is a lot of quantification, for instance, deciding on what is a tolerable level of cases to call it an endemic disease, that needs to happen in order to predict and respond, according to an article by Chia-Yi Hou for thehill.com.

In the Philippines, because infection rates are going down and vaccination rates are relatively high, everyone is already thinking about how to start living normal lives again.

Just recently, the Legal Education Board announced in a memorandum circular that limited face-to-face classes are now allowed in all law schools and there is no more application required. Law schools only need to notify the LEB it they want to conduct limited face-to-face classes provided they are eligible. However, they can choose not to shift to face-to-face classes and continue implementing flexible learning.

National Task Force against COVID-19 medical adviser Dr. Ted Herbosa has also said that face masks may no longer be required when in open spaces by the last quarter of 2022 if the government manages to fully vaccinate 90 million Filipinos by then or around 90 percent of the population.

Elsewhere in the world, Denmark recently became the first country in the European Union to lift all COVID restrictions despite having the second-highest infection rate in the world, which means no more masks, social distancing, isolation requirements. Their health experts say they no longer see COVID as a socially critical disease.

Singapore has simplified its COVID-19 rules and has removed the requirement for safe distancing in mask-on settings. In making safe-management measures simple and easier for businesses and people to understand and comply with, the country is encouraging a greater sense of personal responsibility that it said will play an increasingly important part in the journey towards COVID resilience.

Tourists going to Singapore no longer need to undergo mandatory quarantine provided they are fully-vaccinated.

The Philippines, too, has opened its doors to fully vaccinated international tourists from non-visa required countries, with negative RT-PCR test taken within 48 hours of departure from their country of origin beginning last Feb. 10. Facility-based quarantine is no longer required for those who comply with these requirements.

Two years is a very long time to be cowering in fear. Our government has done its part. This time, its citizens should be responsible for their safety – having themselves vaccinated, getting booster shots, avoiding crowded places, wearing masks for added protection. Just recently, I was inside a mall and saw a woman wearing a mask walking with her child who was not wearing one. How is that for being responsible?

We do not know when the next COVID-19 variant of concern will come or when the next surge will happen. But what we are sure of is that we are in a much better state than where we were two years’ ago.

Our government made mistakes along the way, and so did we. But it is not too late to learn from out mistakes and shortcomings.

In planning for a shift to an “endemic” state or whatever that means, our government should probably include in its plan ways to make its citizens healthier, giving free vitamins and other supplements to boost immunity, providing free at-home COVID-19 test kits to those who request them, just like what other countries have been doing, conducting a thorough review of the state of our public health system, including that of PhilHealth and government hospitals, among others.

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