On August 24, World Health Organisation chief scientist Dr Soumya Swaminathan, reportedly, said that India may be entering a stage of endemicity where there is low or moderate level of transmission going on. This means that India is moving toward a time in near future when the population will learn to live with the virus, instead of letting it continue to overwhelm every aspect of their lives. In an interview to a website, she further added that India may not see the kind of exponential growth and peaks that were there a few months ago. This means that those parts of the country which were perhaps less affected by first and second waves or those areas with low levels of vaccine coverage could witness peaks and troughs for the next several months.
Three keywords in the area of emerging diseases will help further one's understanding in this context: Outbreak, Epidemic and Pandemic. While Outbreak is the term used to describe the spread of a disease limited to a specific local area, such as what happened in Wuhan (until Dec 31, 2019), epidemic is used to describe the fact that the disease has now covered more than one area of nation (which happened by mid-January in 2020). Pandemic is used to declare that the disease has reached global levels (which happened on March 11 when WHO declared COVID-19 as such.)
These terminologies are not linked to the impact or the severity of diseases, but to the spread of diseases. Now, once the number of cases start coming down, as is happening in India, the disease can no longer be termed a pandemic or even epidemic, and epidemiologists then use the term Endemic to highlight that the risk of transmission is coming down but will never become zero and the cases will continue to be reported but will not go high. New cases will keep coming but at a steady pace, explains Dr Chandrakant Lahariya, a public health expert who worked with the WHO for 13 years before starting out as an independent researcher. COVID-19 will soon become akin to the flu virus with which we have been living for years now. "Yes, flu is endemic and that's exactly what will be with COVID-19, too," says Lahariya.
But, at the same time, he cautions against believing what Swaminathan, reportedly, said. Lahariya says that although calling a disease endemic means that the possibility of subsequent waves is negligible, it is too soon to say so. "Even though the number of cases at the national level may stabilise, we should not forget the sub-state and district levels in a nation as diverse as India. There is every possibility of there being subsequent waves at the sub-state and district levels and even if the numbers may be low, we cannot rule it out and hence we cannot say that COVID-19 in India has reached endemic proportions.” His opinion is seconded by Dr S.N. Aravinda, consultant - Internal Medicine, Aster RV Hospital, Bengaluru. "The total number of cases in India is becoming stable. However, there are some pockets of areas with high test positivity rate. We believe that some states like ours (Karnataka) might be moving towards the endemic stage but not that the whole of India has reached that stage. The next one month will be crucial for deciding that.”
Swaminathan said that she hopes that by the end of 2022, "we would be in that position that we have achieved vaccine coverage, say 70 per cent, and then countries can get back to normal". But medical experts and epidemiologists in India aren't convinced. "Given the way the speed of the vaccination is at the moment, one has to be an eternal optimist to say that 70 per cent of India will be vaccinated by the end of next year. Several states are facing acute shortages in vaccines and citizens are being shown the door at vaccination centres for the lack of availability of doses. How can one be so positive," said an executive from Mumbai Corporation's public health department, who preferred anonymity.
India registered 25,000 new coronavirus cases on Thursday, pushing the tally of infections to 3,24,74,773 since the pandemic broke out in January 2020. With 354 deaths, the country’s toll rose to 4,35,110.
