Is COVID-19 Endemic Yet?

Throughout the pandemic, researchers have said that we’re unlikely to fully eradicate COVID-19. Instead, they’ve emphasized that the virus will likely become endemic.

They hope that instead of uncontrolled transmission and rising case counts, we’ll get to a point where COVID-19 will circulate less and more predictably. For example, we typically know what to expect from each flu season. But are we at an endemic state yet with COVID-19?

Experts say we still have a ways to go.

“Endemic is where we can start to really predict what’s going to go on,” Mackenzie Weise, MPH, CIC, Infection Prevention Clinical Program Manager at Wolters Kluwer, Health, told Verywell. “Right now, it’s extremely unpredictable. We don’t know what next week holds at this point.”

What Does Endemic Mean?

An endemic disease is one that is always present in a given population or geographic area.

“Endemic pretty much refers to the constant presence and or usual prevalence of a disease or an infectious agent in a given population within a particular area,” Weise said. “Something that is eradicated here in the U.S. can still be endemic in another geographic area around the world.”

Malaria is an example of a disease that remains endemic in many tropical and subtropical regions elsewhere, she explained, but transmission has been eliminated in the U.S.

The endemic level of a disease doesn’t necessarily mean the preferred level. It would be best if we didn’t have strains of respiratory syncytial virus (RSV), the seasonal flu, or the common cold circulating at all. But we do.

All of these examples are endemic in the U.S. Although case rates change somewhat from year to year, for the most part, experts know what to expect from these typically seasonal viruses. But even though a disease is endemic, that doesn’t mean it’s less severe.

“Severe diseases can still be endemic,” Weise said. For example, cholera, a potentially severe intestinal infection, is endemic in about 50 countries.

Is COVID-19 Endemic Yet?

So have we moved yet from the crisis stage of a global pandemic to a situation where COVID-19 has become endemic? Verywell spoke to several experts to get their take.

“Right now, SARS-CoV-2, the virus causing all of this, is constantly changing,” Weise said. “It’s not genetically stable. There’s no way to predict what’s happening. That’s far from becoming endemic. In order to get to that point, we would definitely need to have a lot more control and more ability to predict possible transmission.”

The resounding consensus is that we’re not there yet. But, we could be, eventually.

“I’ve read a lot of other experts, epidemiologists, public health folks talking about this,” Bernadette M. Boden-Albala, DrPh, MPH, director and founding dean of the program in public health at the University of California, told Verywell. “And I think we wait with bated breath.”

Most experts are just watching and waiting to see which path COVID-19 takes next.

“I personally would sit on the fence a little longer to see how this plays out,” Scott Lillibridge, MD, director of emergency response for International Medical Corps, told Verywell.

Is Omicron a Path Toward Endemicity?

In a study in the International Journal of Infectious Diseases, researchers noted that the Omicron variant, although highly transmissible, appears to cause less severe disease than other variants. The potential for less severe outcomes has led some experts to suggest that perhaps we’re trending in the direction of COVID-19 becoming an endemic disease.

But the experts we spoke to said there’s a lot to consider. First, Omicron isn’t less severe for everyone. And severity isn’t necessarily a factor when it comes to a disease being considered endemic or at baseline. But for infectious diseases, the rate of transmission does factor in.

If the reproduction number is less than one—where, on average, one infected person infects one or no persons—then a disease is considered stable.

Right now, the Omicron variant is transmitting rapidly in the United States. With the 2022 post-holidays surge, the average number of daily new cases is higher than it’s been for any other wave during the entire pandemic.

High transmission can be a recipe for disaster in many ways, leading to even more unpredictability. “Because it’s transmitting so much, regardless of being mild, we’re still sort of feeding the virus’ ability to mutate further, get smarter, and learn how to thrive,” Weise said.

Omicron Doesn't Have a 'Mild' Impact on Society

Experts also caution against the use of the word “mild.” High case counts don’t have a mild impact on society. Plus, Omicron still presents the potential for severe illness in many people.

“Omicron may be less severe on average, of course,” Tedros Adhanom Ghebreyesus, PhD, MSc, director-general of the World Health Organization (WHO), said in a recent press briefing. “But the narrative that it is a mild disease is misleading, hurts the overall response, and costs more lives. Make no mistake, Omicron is causing hospitalizations and deaths. And even the less severe cases are inundating healthcare facilities.”

A large number of Omicron cases have overwhelmed hospitals with patients. And it’s caused staffing shortages. Infected healthcare workers have had to quarantine, according to Becker’s Hospital Review.

“Among the unvaccinated, it is still really a terrible disease,” Boden-Albala said. “And even among the vaccinated, but not boosted, it’s hitting hard.”

Weise added that people who are immunocompromised or who have underlying illnesses may also still face a more severe course of the disease, especially if unvaccinated.

COVID-19 is still taking a dramatic toll on society—so it’s far from stable. “Whether it’s in terms of death, whether it’s in terms of people being out sick, and things like surgeries being rescheduled—all that would be functioning more normally,” Boden-Albala said.

“The burden on our healthcare system impacts patient care and patient safety across the board, up and beyond just COVID-19,” Weise added. “There are a lot of other patient safety issues and concerns that are increasing and can’t get the attention that they deserve because of the COVID-19 response.”

Ultimately, because of high transmission and an overwhelmed healthcare system, the U.S. and much of the rest of the world, are still functioning in crisis mode.

How Will COVID-19 Become Endemic?

Experts said they remain cautiously optimistic that increased immunity will help interrupt chains of transmission.

“We hope there will be a trend downward,” Boden-Albala explained. “Between more and more people getting boosted, between increased vaccination, and between the number of people that have had Omicron and Delta—that maybe we’re pushing the virus into becoming endemic.”

“I think we’re well on our way to having this disease become an endemic problem,” Lillibridge added.

The experts we spoke to agreed that continued mitigation efforts are the best path toward a future where we consider COVID-19 to be less of a looming threat.

“COVID-19 will become endemic if we can be in a world where enough people receive vaccine-induced immune protection,” Weise said. “That will most certainly significantly reduce the occurrence of severe illnesses, hospitalizations, and deaths, and most certainly transmission in general.”

Boden-Albala emphasized that masking, vaccination, and boosting were the way forward for everyone.

Once we get to an endemic state, then the goal will be to maintain a baseline. One lesson from the pandemic is that we need a more cohesive worldwide approach to public health. “The evidence-based strategies that we know through science to control infectious diseases only work when they’re standardized and fully implemented by the global health community,” Weise explained.

“We’re going to have to intensify our infectious disease surveillance,” Lillibridge added. Improved testing measures could help quickly identify outbreaks, often called epidemics, when transmission rises. Better surveillance can quickly identify, sequence, and monitor new variants, tracking their behavior and movement among populations, he explained.

And experts have some thoughts on what should be left behind on this path forward. “One of the biggest missteps that would sabotage this work is anyone deciding to follow conspiracy or ‘internet science,’ rather than listening, giving a chance to the experts who have dedicated so many years of their life working to protect the public’s health,” Weise said.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.