President Biden stirred debate among health experts Monday after commenting to CBS's 60 Minutes that the pandemic is over.
Though Biden said the country is still fighting COVID-19, White House officials were nonetheless surprised by his comment: "The pandemic is over. We still have a problem with COVID. We're still doing a lot of work on it. But the pandemic is over."
Some experts took the president's statement to mean that the emergency part of the pandemic is over, while others worry that Biden's comments could thwart global efforts to combat the disease.
"I think what the president meant was that we are finished with the emergency phase of COVID-19 and we are in a better place than we were a year ago. And that's a fair point. But he didn't say that, and I'm concerned that the public will hear something very different," said Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law and professor at Georgetown Law.
Ayoade Alakija, special envoy for the World Health Organization's Access to COVID-19 Tools Accelerator, on the other hand, disagreed with Biden's comments.
"I really love President Joe Biden, but I have to completely and totally disagree with him and say that it is not over," she said.
"The acute phase of the pandemic is not over," Alakija added.
She noted that there are more than 400 people dying daily in the U.S. — a number some feel is an undercount. By comparison, in Africa, "We don't have a means to measure. We don't have access to the tools. There is no Paxlovid [an antiviral treatment used to treat COVID] on the African continent."
The evolution of the virus continues. We need to constantly be in this state of readiness … It cannot be that we are calling victory in the middle of a battleAyoade Alakija
The reason why that matters is, as previously seen, areas with lower protection give way to variants that could surge and keep the virus going.
"The evolution of the virus continues. We need to constantly be in this state of readiness … It cannot be that we are calling victory in the middle of a battle," Alakija said.
Gostin noted Biden's comment was also ill-timed, as COVID-19 cases could surge in winter months, which still threatens to overwhelm hospitals, and at a time when the administration is still asking Congress for more funding to fight the virus.
Dr. Peter Hotez, dean of Baylor College of Medicine's National School of Tropical Medicine, echoed a similar sentiment Monday, saying, "There's very well likely another major new variant of concern out there. We got hit very hard with Alpha in January of 2021 and Omicron in January of 2022. We don't know what January 2023 is going to bring."
Dr. Céline Gounder, who was on Biden's transition team, said whether or not the pandemic is over depends on what we are defining as the new normal.
"If the pandemic is over, that would imply that the President believes that 3,000 deaths a week, or 150,000 deaths per year, is the new normal," said Gounder, an infectious disease specialist and epidemiologist.
"I think it all depends on what we consider a normal level of disease and death. So if you go by the epidemiological definition, or even going by the CDC website … 'Pandemic' basically means that you have an epidemic on multiple continents. An epidemic means that you have an above normal level typically with a sudden increase, of disease and death, beyond what is expected," she said.
Earlier this year, Gounder and two other public health experts – Michael Osterholm and Zeke Emanuel — noted that a bad year of flu deaths and RSV deaths totaled 3,000 deaths per week. By comparison, COVID-19 is killing that number of people weekly alone, marking a significant rise above pre-pandemic levels.
"Could we be in a place where we are willing to accept more deaths? Possibly. But I think that really should be a more explicit conversation," Gounder said.
"We learned a lot from what happened this fall and winter. It's harder to say if we're going to have a bad wave, the way we did that last couple years. It's hard to declare a pandemic over prospectively, it's really something you do in the rearview mirror, in retrospect. We really haven't seen cases and deaths stabilize in a way that we can say, 'Yes, it's over,'" Gounder said.
Beyond the U.S.
Gavin Yamey, professor of global health and public policy at Duke University, said Biden calling the end of the pandemic suggests that science and public health data are no longer the sole deciding factors.
And the implications of that go beyond the U.S.
"By definition, pandemic control requires international collective action. President Biden’s unilateral declaration that the pandemic is over is very unhelpful when it comes to the continuing need for multilateral action. We still have very stark global inequities, for example, in who has access to tests, vaccines, boosters, bivalent boosters, antivirals, and monoclonal antibodies," Yamey said.
While bivalent boosters are available in Europe and the U.S., and some wealthier countries, they are not yet available in lower income countries — which means the inequities that lead to the spread of variants continues to plague the world.
Is the pandemic "over"? Don't know – it's a judgment call. But clearly the threat is far lower than it was, people have the means to stay fairly safe (though many are choosing not to), & at some point we need to shift from an emergency footing to a sustainable long-term strategy.
— Bob Wachter (@Bob_Wachter) September 19, 2022
Experts agreed it was not yet time to call the pandemic over, but some suggested acknowledging we have entered a new phase of the pandemic.
Dr. Isaac Bogoch, an infectious disease expert and associate professor of medicine at University of Toronto, agreed that the time of strict mitigation is over.
"While the era of mandates appears to be coming to an end, people can still reduce (but not eliminate) their individual risk of infection or onward transmission by wearing a mask. This especially makes sense when there is a higher burden of community transmission, and in poorly ventilated or crowded indoor spaces where the vast majority of transmission occurs," Bogoch told Yahoo Finance.
Bogoch emphasized that debating the pandemic's status is less important than focusing on mitigation of the virus.
"Whether we call it pandemic or endemic, COVID-19 is still killing hundreds daily in America and thousands daily around the world," he said.
"This is a global issue, not a regional one, and there are simple, widely available and low cost (even free) solutions that can help mitigate morbidity and mortality, many of which are woefully underutilized," Bogoch added.
Arush Lal, vice chair of Women in Global Health, noted that Biden's comment comes at a time when global efforts are also suffering.
"I worry that premature declarations like this, especially from the U.S. president, can also influence other HIC (high-income country) leaders to follow suit and pump the brakes on response efforts. COVID-19 has affected the most vulnerable communities first, including women and girls, people of color, and low-income communities — statements like this give false hope to policymakers and leaders that COVID-19 is no longer a threat, and it's these marginalized communities that once again will feel the brunt of rising cases again," Lal said.
And while the progress against COVID-19 should be celebrated, Lal said, "We should all be clear eyed about the reality we face — COVID-19 remains a threat to our communities and we need more, not less, political will to bring it under control."
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