What It Means When COVID-19 Becomes Endemic

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. After 3+ years, the WHO declared the pandemic to no longer be a public health emergency on May 17, 2023.

Medical experts say we are entering a COVID-19 endemic phase – similar to the flu. This means COVID-19 is still present, but it is not going to disrupt everyday life.

Board-certified allergist and immunologist and COVID-19 vaccine researcher Purvi Parikh, MD, discussed the difference between a pandemic and endemic in a recent Allergy & Asthma Network webinar.

What is an endemic phase?

An endemic means the COVID-19 surge has stopped. It won’t disappear altogether – the virus will still circulate but it will be mostly contained.

Here are more signs of an endemic phase:

• It may become seasonal, meaning cases will spike at certain times of the year.
• Outbreaks may be restricted to a locality or region.
• Enough people will have immune protection due to vaccination and natural infection. This will result in less transmission, hospitalizations and deaths.
• Treatments such as monoclonal antibodies and COVID-19 antiviral medications will help fight infections that do occur.

It’s important to remember that an endemic phase does not mean the COVID-19 virus will be harmless. The virus will still have the potential to cause hospitalizations and deaths. Further, as the virus spreads, it can mutate into an infection that may be more transmissible and more severe.

Getting the COVID-19 vaccine remains the best protection against the virus and/or severe complications, especially if you have moderate to severe asthma.

What is the difference between an epidemic, pandemic and endemic?

An epidemic, pandemic and endemic are three different stages of disease or virus transmission.

• Epidemic – a widespread surge of a disease or virus in a particular area or region.
• Pandemic – the surge of cases spreads to several countries and potentially around the world.
• Endemic – cases are consistently present but limited to a particular region or season.

Will I need an annual COVID-19 vaccine booster shot?

CDC and FDA have not confirmed that an annual COVID-19 vaccine booster is needed. CDC Director Mandy Cohen recently said she expects that a COVID-19 booster will become an annual shot. It’s likely to be similar to the annual flu vaccine, which is available in the late summer and fall.

CDC and FDA approved new COVID-19 vaccine boosters in fall 2023. New boosters are formulated to help fight new COVID-19 variants and sub-variants that are dominating infections.

Will I need to wear a mask during an endemic phase?

Most schools, workplaces and public settings have discontinued the requirement of masks in both indoor and outdoor spaces.

The decision to wear a mask in public settings has become an individual choice.

CDC continues to recommend wearing masks indoors when COVID-19 cases are reported to be high in a community. Masks may be particularly beneficial for people who are immunocompromised or at high risk for severe infection.

Some private businesses, such as doctor’s offices, may still ask patrons to wear masks. Since airplanes, trains and buses are enclosed spaces where disease transmission can be high, you may want to wear a mask when traveling.