Pandemic to endemic?


Double down on protocols, not lockdown

President Ferdinand R. Marcos Jr. has formally lifted the state of public health emergency declared due to the coronavirus disease 2019 (Covid-19) by issuing Proclamation 297. Informally, of course, the public has been acting like the pandemic is over since 2022. People have been moving more freely, visiting tourist destinations, and, going about their daily lives.

Proclamation 297 cited the “continued immunization and decrease in the number of Covid-19 cases,” and the fact that “the country has maintained sufficient healthcare system capacity and low hospital bed utilization rates even after the liberalization of Covid-19 health protocols.”

The President has maintained that Covid-19 remains to be a “serious concern for certain subpopulations and requires continued public health response,” but there is no longer a need to treat it as a public health emergency.

This pronouncement from the Philippine government follows the May 5, 2023 declaration by the World Health Organization (WHO) that Covid-19 is “no longer an international public health emergency.” Many countries have also taken the cue from WHO’s announcement and lifted their own restrictions. The United States lifted its federal public health emergency on May 11, 2023. Even China, which had some of the strictest Covid-19 regulations earlier in the pandemic, has lifted its more rigid measures. Many other countries are in fact en route to treating Covid-19 as endemic leaving almost no major Covid-19 restrictions in place.

But is the pandemic over? More importantly, is the disease already in its endemic stage?

The number of cases is certainly down. According to the Department of Health’s daily tracker, there were only 176 new cases on July 29, 2023. Remember when we were glued to this tracker nervously awaiting the daily count of new infections? The public indifference to the monitoring of new cases also tells us a lot about the frame of mind of the population with regard to Covid-19. But it is important to note that there are still active cases — many mild, some severe. And there are still deaths due to the coronavirus.

According to WHO experts, endemic is a state where the disease’s presence becomes steady or predictable in a particular region, as with the seasonal influenza. But it is not a black and white standard. There is no consensus among epidemiologists what an endemic really looks like. But based on previous pandemics, it would seem that at an endemic state the infection is still present in a region or population but its behavior is predictable and the number of cases and deaths no longer spike. It might be awhile before experts can formally declare Covid-19 as endemic but let us hope that the worse is over and that this new normal will remain our status quo.

Despite the pronouncement from Malacañang that Covid-19 no longer constitutes a public health emergency, I think it is important for government and the public to adopt certain measures to make sure things do not go out of hand. Government needs to push for increased vaccinations despite the public’s indifference. Health officials should continue to encourage people to isolate if they test positive or if they have symptoms. Despite the return to normalcy, I think it makes a lot of sense to avoid very crowded gatherings with little or no ventilation. With all the formal restrictions lifted, it is really up to an individual’s sense of responsibility to promote health and safety.

Whether or not the coronavirus is in the endemic state, it is also important for government and the public as well to learn from our experience during the pandemic and, more importantly, to institutionalize these learnings so we are better prepared when the next public health emergency happens. The first thing we need to do is to strengthen our health care system. During the early days of the pandemic, many people suffered, and sadly, died because our health care system was unable to handle the influx of patients. This means providing more resources to local hospitals to make sure they are equipped to handle a public health emergency.

But the most important lesson that we can take away from the Covid-19 pandemic is the capacity of our people to come back. Despite the loss of lives and livelihood, despite the seeming desperation and helplessness, we persevered. Today, we continue to work hard to recover from our losses. And I am very sure that, just like in past crises, we will endure.  ([email protected] and/or