When can we say that the Covid-19 pandemic is over?

Reading time: 8 mins

For those who have experienced the pandemic and its health, social and economic impacts, sometimes being intimately confronted with illness and death and undergoing restrictions that are altogether liberticidal, nothing would be sweeter than being awakened by a voice saying : “Hey, wake up, the pandemic is over.” But what does “the pandemic is over” mean? Are there specific indicators to allow us to say that it is indeed behind us? As you will see, there is no clear answer or, at least, this one is located within a thousand sheets of more or less vague answers, borrowing as well from epidemiology and virology as cultural, political, social and semantic.

Let's start. Would you say today that the Covid-19 pandemic is over? Unfortunately not, for most of you, it seems to us. If we have just experienced, in France, a remarkable decline, the indicators, temporarily blurred by the end of free tests, could testify to a slight increase of which we cannot know if it will turn into a rebound, a fifth wave or if it will settle on its own.

At the same time, the situation remains dramatic in many countries, particularly in Eastern Europe, which record daily records for both new infections and deaths from Covid. In addition, the situation never improved this summer in the United Kingdom, after the Prime Minister lifted all restrictions on July 19, thinking he could count on high vaccination coverage alone to get out of the crisis. Worse, the trend currently seems to be worsening, with new daily contamination records and high mortality which does not stop climbing, which, in view of the experience acquired over the past few months, does not bode well. good – but let's not guess ourselves.

Despite our "pandemic fatigue", our desire to see the end of the tunnel, weary of reading macabre counts every day and weary of submitting to health constraints, we have to recognize that the Covid-19 pandemic is not not finished.

An epidemic has an end, not a pandemic

But what is it? Back to basics: what is a pandemic? The term comes from the ancient Greek πᾶν / pãn (“all”) and δῆμος / dễmos (“people”) and designates an epidemic present on several continents. In the common sense, it affects a particularly large part of the world's population. But "particularly large part of the world's population" is a very subjective notion and it appears that there is no consensual definition of the pandemic, nor a threshold figure allowing us to say "We are in a pandemic" or "We are not not in a pandemic”. Thus, the International Health Regulations do not even mention the term "pandemic", while the WHO only mentioned it in connection with influenza in its preparedness plans. She had also declared that the emergence of the H1N1 flu was a pandemic in 2009, then authorized herself to name the emergence of Covid-19 a pandemic, then proposed “temporary recommendations” falling within the framework of her prerogatives strictly framed by the International Health Regulations.

Saying that an epidemic starts or goes out is paradoxically not a source of much debate. Theoretical epidemiology is the scientific discipline that comes to settle the question. It is the reproduction rate R which arbitrates the match. When it is greater than 1, the virus has the upper hand, the epidemic sets in. When it reaches the value of 1, the peak of the epidemic is reached, then if it drops below 1, the epidemic dies out. But then, why not adopt this simple definition to characterize the extinction of a pandemic? Because then, the pandemic would have been declared over at the end of the first wave. Some have done it elsewhere and we all agree that they were wrong. So the pandemic was not over after the first, nor after the second and we are at the end of the fourth, without daring to hope that it is finally over.

However, for the 2009 H1N1 flu pandemic mentioned above, we suffered seasonal waves for the following ten consecutive years, sweeping all regions of the globe, without anyone venturing to say that it was the umpteenth wave of the H1N1 flu pandemic. Why? what differentiates the successive post-pandemic seasonal waves of H1N1 flu so much from the original H1N1 flu pandemic of 2009-2010 (because during the winter of 2010, we were still talking about a pandemic)? Virology? The variants that emerge each year and characterize seasonal epidemics? But like Covid-19 and its variants with Greek letters, the H1N1 variants appeared very early in the pandemic without it being said that it was over, so the explanation must be sought elsewhere.

READ ALSO

Variants of Covid-19: what will happen when we have exhausted the Greek alphabet?

The share of social representations

We may perceive that we are dealing with a concept that we could think of as being of a health or scientific nature, but which ultimately seems intimately linked to its social and economic consequences and to the measures taken to contain it. Would we have accepted the health restrictions that we have experienced without the word “pandemic”, with its catastrophic connotation, being pronounced? And, conversely, the announcement of the pandemic was probably a catalyst mobilizing the leaders of nations to prepare to have to act and the population to expect to have to withstand a shock without really knowing either its nature, its magnitude or its duration. Hold on, maybe that's the beginning of a definition of a pandemic!

Well, that does not help us define the term of this pandemic. History tends to show that the pandemic character of the great influenza epidemics of the 20th century was ultimately neither immediately recognized nor designated, perhaps because people simply had other things to think about and live with, or that the scientific culture of the time was less. During the Spanish flu, in 1918-1920, not only had the virus not been identified (virology did not exist at that time), but also the populations were emerging from a devastating war. A certain relativism reigned then, even if it is reported that in some places people were literally dropping like flies from the onslaught of the virus – most of the time it was actually due to super-infections, c ie bacterial complications of viral infection that people were swept away, not by the virus itself. We can say that at the time, we considered that the pandemic was over when the flu and its consequences no longer killed en masse. Still, the virus had of course not been eradicated.

Ditto with the Asian flu of 1957 (H2N2), then that of Hong Kong (1968-70) which many of us had simply not heard of until very recently – perhaps because the then leaders of the countries westerners looked away, busy as they were having to manage the crises of their society and their youth. If these influenza pandemics are considered to be over, this does not mean that their viruses would no longer circulate, or even would no longer be responsible for epidemic waves of seasonal influenza, sometimes just as deadly as the pandemic itself.

READ ALSO

Plague, Spanish flu... Have the great pandemics given birth to a "new world"?

The same is true with the H1N1 epidemic (2009). Who would claim that it is not over today even though the H1N1 virus has continued to circulate until today?

We guess here that we can not say that a pandemic is over when the virus no longer circulates - which would also be illusory, because only smallpox has been eradicated and this thanks to a human intervention that is the vaccine. Well, there is another exception that may interest us today: SARS-CoV, the SARS coronavirus that emerged in 2003 from mainland China, died out quickly never to reappear in humans. But we had never talked about a SARS pandemic… We are not making much progress!

Consider another pandemic: HIV/AIDS. Would you say it's over? Probably not. Why? Undoubtedly because on the one hand, we keep the not so distant memory of a violent massacre which participated in building us and largely framed our sexuality for forty years. On the other hand, because AIDS and the opportunistic illnesses it causes remain extremely serious when the infection is not treated by treatment and the virus is not under control. And then, we must also recognize and salute the continuous action of activists who have continued over the years to never normalize HIV and to always bring it back to the social and political agenda. We see the share of social representations in the notion of a pandemic and how much it escapes epidemiologists and virologists, to finally be on the side of the general public and collective memory.

The answer is yours

So when will we be done with the Covid pandemic? The answer is far from simple.

We could perhaps tell ourselves that the pandemic will be over when the effective R (RE) is below the value 1 for a long enough time to be determined, on all continents, thus drawing a situation that allows us to lift all measures. sanitary. That is to say, we would have come out of the pandemic as soon as we could live again as before, or almost, without the numbers soaring again. It would fit with the idea that the AIDS pandemic is not really over, since we continue to recommend the condom to guard against HIV infection. Suffice to say that the end of the Covid-19 pandemic is simply unpredictable.

Another way to define the end of the pandemic would be to center it on our daily life: it would happen when we really and lastingly turn the page, when we talk to you about something else in the columns of Slate.fr, when whole days will pass without any reference to defense advice, reports from the Scientific Council, or the speeches of experts on TV sets. When the Covid-19 tabs no longer appear on Facebook, Twitter or Google news (hey they disappeared from the latter!).

READ ALSO

Covid-19: should we take advantage of the lull to ease health measures?

It would therefore be a kind of concrete threshold, but which would not care whether the virus is circulating or no longer circulating, which would shamelessly ignore the antics of the reproduction rate. Because ultimately, the Covid and the discussions it arouses will no longer circulate in our daily lives and will pass to the stage of old memories and good humorist jokes.

So to the question "When can we say that the pandemic is over?", we will answer that we don't know, but that most likely it is you, dear readers, who will tell us!

Related Articles

  • Allylikes Spring Wear Complementary Ideas to look Fashion

    Allylikes Spring Wear Complementary Ideas to look Fashion

    GO

  • How to apply blush to change your face

    How to apply blush to change your face

    GO

  • 6 make-up brands available exclusively in Belgium

    6 make-up brands available exclusively in Belgium

    GO

  • Bic pen, Duralex glass, Laguiole knife... thirty dream objects, designed and manufactured in France

    Bic pen, Duralex glass, Laguiole knife... thirty dream objects, designed and manufactured in France

    GO