2022-01-11 Dr Angela Rasmussen - is SARS-CoV-2 endemic?

Dr. Angela Rasmussen (@angie_rasmussen): I keep getting asked if SARS-CoV-2 is endemic yet.

Record-busting case counts are not endemicity. https://twitter.com/bnodesk/status/1480752636328558592

This is not “living with” the virus. That is not what endemicity means anyway. Endemic means that there is a steady state level of virus circulating. This is explosive exponential, epidemic growth, not a stable level of endemic transmission.

Endemic does not mean that the virus is “milder” and that it just rips through the population at periodic intervals. It does not mean “living with” hospitals becoming overwhelmed. It does not mean complacency or surrender.

And lest the White House thinks that more finger wagging and responsibility shaming is the solution rather than addressing the much more complex and challenging structural reasons why people resist public health measures such as masks and vaccines, I’ll wag my finger right back.

We are here because of repeated, intentional, catastrophically bad policy decisions that emphasize the economy over public health, when these interests are not even fundamentally opposed. These include:

• Exclusive reliance on voluntary vaccine/booster uptake with minimal outreach to the recalcitrant unvaccinated
• No policies that improve vaccine access (paid sick leave, child care, transportation)
• No policies that offer meaningful financial relief for isolation/quarantine
• No efforts to improve access to health care or support those with huge bills from COVID
• No sustained support for people with chronic illness at higher risk and/or because of COVID
• No mask mandate, much less providing quality masks to people at low or no cost
• No rapid tests because of refusal to invest in them more than a year after their approval & despite promising them in early 2020
• Not enough testing, period
• No urgency to get global vaccination rates up
• Not enough vaccine doses exported & no will to improve
• No vaccination requirement for entry to US
• Minimal testing at the border
• No vaccination requirements for domestic travel
• No clear guidance and lack of candor from officials who claim to want to build trust

It is untrue that endemicity means “living with” a never ending, preventable clusterfuck. The solutions have always been in front of us:

• Mass immunization to achieve global population immunity
• National Provider Identifiers (NPIs) and policy to drive down transmission while everyone gets vaccinated

Until that sinks in for our leadership, we are going to continue this vicious cycle of surges. Everyone is sick to death of it. In some cases, literally.

This isn’t endemic yet. We must demand more from our leadership than lip service and failed policy.

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