From pandemic to endemic: living with Covid-19 in the Pacific

Excerpt from Australian Strategic Policy Institute

When the Mamas and Papas sang ‘The darkest hour is just before dawn’, they referenced an age-old belief that dire events appear bleakest just before they improve. Certainly, the rise in Covid-19 deaths and cases around the globe has made it as dark as it has ever been. So, do the array of vaccines coming on the market constitute the first rays of the post-Covid dawn?

The notion of a sudden end of the pandemic is problematic, unfortunately. According to a December 2020 briefing by World Health Organization, the ‘destiny’ of Covid-19 is to become endemic, not to disappear. This means that the occurrence of the disease will simply reduce to a level that will appear ‘normal’.

The transition from pandemic to endemic, however, will be very complicated, especially for the Pacific island states, on several counts.

The problems start with the nature of Covid-19 as a pandemic. Pandemics are essentially an epidemic that occurs simultaneously in a number of countries and even, as in the case of Covid, worldwide.

The WHO has grappled regularly with the nuances of what qualifies a particular level of disease as an epidemic or pandemic. Combinations of factors—such as intensity, spread, severity and seasonality—go into the definitional mix.

Covid creates a problem for the basic WHO definition of an epidemic as ‘an illness … clearly in excess of normal expectancy’. Since Covid is a novel coronavirus, there’s no baseline for normal expectancy.

Aspects of this issue were found when, for example, Fiji declared an outbreak of dengue fever and leptospirosis diseases in August 2020 while grappling with the pandemic raging in the rest of the world. At that time, the country had recorded only one Covid death, but there were four from dengue and 10 from leptospirosis.