COVID: Is the pandemic over? President Biden said so. What do medical experts say?

San Jose Mercury News - 9/19/2022

Two years after declaring on the campaign trail that he “will shut down this virus” if elected, President Joe Biden said in an interview Sunday that the COVID-19 “pandemic is over” — stirring debate in a country where few pay much mind to it anymore while the disease still kills hundreds of Americans a day.

Though the president’s remarks on CBS’ 60 Minutes drew jabs from some quarters and puzzlement from others, they raise a question medical experts have struggled to answer clearly: When will we know the COVID-19 pandemic is over? In many ways, that depends how you define it.

Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health, said that “we’re still in a pandemic by any clear definition of it, but we’ve chosen not to respond to it psychologically and in the way we live our daily lives.”

“The pandemic in people’s minds, if not epidemiologists’ definitions, means that the world has stopped to deal with this,” Swartzberg said. “Our society isn’t turned upside down trying to deal with it (anymore). So I think this is a political and psychological take on the pandemic, as opposed to an epidemiological one.”

Here’s where Americans are with that definition. A Sept. 13 Axios-Ipsos Coronavirus Index poll found the country has “largely — though not completely — moved on from the pandemic,” with 46% having “returned to their pre-COVID lives” and just 37% wearing a mask outside the home at least sometimes.

Reported cases have been declining since July, though they remain almost three times the level in April, according to the Centers for Disease Control and Prevention, and actual numbers undoubtedly are higher due to unreported infections confirmed through at-home tests.

But the CDC reports nearly 400 a day still are dying from COVID-19, almost twice the level of July 2021.

Biden’s remarks came as he walked the floor of the first North American International Auto Show in Detroit held since 2019. Asked if the pandemic is over, the president — walking without the black face mask he wore on the campaign trail and so often in public appearances since — said yes, “the pandemic is over.”

“We still have a problem with COVID, we’re still doing a lot of work on it,” Biden said. “But the pandemic is over. If you notice, no one’s wearing masks. Everybody seems to be in pretty good shape. And so I think it’s changing. And I think this is a perfect example of it.”

Those remarks drew barbs from several medical experts who said they are premature. Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute, said Monday on Twitter that Biden also suggested in June 2021 that the country would celebrate freedom from COVID on Independence Day. What followed were successive waves of infections and deaths from more contagious forms of the SARS-CoV-2 virus, delta and then a series of omicron variants.

“Wish this was true,” Topol tweeted, adding that the president’s remarks will lower interest in vaccine booster shots, ignore ongoing problems with “long COVID” symptoms and the “inevitability of new variants, and our current incapability for blocking infections and transmission.”

“What’s over,” he said was the president’s and “our government’s will to get ahead of it, with magical thinking on the new bivalent boosters.”

Stanford Medical School professor Dr. Jay Bhattacharya, an author of the Great Barrington Declaration that opposed lockdowns to reduce spread of the virus in favor of policies focused on protecting those at highest risk from the virus, responded that the president’s remarks were overdue. History, he said, will remember poorly those in public health “who have been blind to the devastating harms caused by the lockdowns.”

“Pres. Biden is right,” Bhattacharya tweeted. “The pandemic emergency is over. Research for better treatments should continue, but the lockdowns, restrictions, and fear-mongering need to stop.”

But Dr. Bob Wachter, who chairs the medical department at the University of California-San Francisco and has chronicled his efforts to avoid the virus, which infected his wife, to 280,000 Twitter followers, said the answer is more complex.

“Clearly the threat is far lower than it was,” he tweeted Monday, and “people have the means to stay fairly safe,” even though many are choosing not to. But “at some point,” he added, “we need to shift from an emergency footing to a sustainable long-term strategy.”

The director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, said last week that “we’ve never been in a better place to end the COVID19 pandemic, but only if all countries, manufacturers, communities and individuals step up and seize this opportunity. Otherwise we run the risk of more variants, more deaths, disruption and uncertainty. Let’s finish the job!”

Jennifer Taylor, a registered nurse in the emergency room at Kaiser Oakland who lives with her sister with a weakened immune system due to cancer treatment, said Monday that she just saw two more patients admitted with COVID and that “it feels early to call it over.” She still wears a mask indoors and avoids crowded indoor events to protect her sister, and worries the president’s comment will lead people to loosen precautions.

“It’s pretty hard on immunocompromise people to be suddenly calling it over with 400 people still dying every day,” Taylor said.

The U.S. and many state governments, including California, are still treating the pandemic as a public health emergency. A federal public health emergency remains in place at least into next month. And while the CDC has softened guidance for reducing transmission of the virus, vaccine mandates remain at the federal state and local level.

Swartzberg said the epidemiological definition of a pandemic is a significant illness that is impacting countries around the world outside of usual seasonal patterns. In that sense, he said, COVID-19 still is a pandemic. If the current pace of U.S. deaths held steady, there would be about 140,000 COVID-19 deaths a year. By comparison, the CDC estimates that influenza kills 12,000 to 52,000 a year based on 2010-2020 figures. The country will have to decide if that level of COVID-19 deaths is acceptable, he said.

“What Americans are saying when they don’t list COVID as major threat to society,” he said, “is that this is the new norm.”

Staff Writer Harriet Blair Rowan contributed to this report.