Is Covid ‘under control’ in US? Experts say yes

Commitment: “I will never raise the white flag and surrender. We are going to defeat this virus. We’re going to get it under control, I promise you.”

President Joe Biden caused a stir in a “60 Minutes” interview on September 18 when he announced that the Covid-19 pandemic was over.

“We still have a problem with Covid — we’re still working a lot on it,” Biden said. “But the epidemic is over.”

Critics counter that the US is still average 400 people die every day from the virus, nearly 30,000 Americans are hospitalized, and many more Suffering from “chronic covid”. Symptoms stemming from a previous infection.

Two days later, Biden acknowledged that despite the negative reaction from some, the pandemic is “not where it originally was.” White House press secretary Karin Jean-Pierre called the coronavirus “much more manageable.” Past experience means “we know what works,” he said.

PolitiFact is tracking a campaign promise from Biden in 2020 that is closely related to, but separate from, what Biden told “60 Minutes.” During the presidential campaign, Biden said, “I will never raise the white flag and surrender. We are going to defeat this virus. We’re going to get it under control, I promise you. “

Biden is on safer linguistic ground, promising to get Covid “under control” rather than saying the “pandemic is over”.

There is some debate among public health experts as to whether the epidemic is “over” — or whether it ever actually will be. There is no official arbiter to make that decision, and the word “over” suggests a finality that is not appropriate to describe a pathogen that will exist in some form indefinitely.

However, we find broad agreement among infectious-disease experts that the epidemic is now “under control.”

When Biden was inaugurated, physical distancing was widely enforced, schools were often virtual, public events were rare or tightly controlled, and very few Americans had yet received a vaccine. Today, life for many Americans is much closer to pre-pandemic ideals, with virtually all schools open, concerts and restaurants well attended and returning to normal levels.

“The nation has clearly made tremendous progress on COVID-19 since the election of President Biden,” said Jane Cates, senior vice president and director of global health and HIV policy at KFF. “I would probably say that we are in a pandemic ‘transition’ phase – that is, moving from pandemic to post-pandemic. But it’s a continuum, not a cliff, where it’s an epidemic one day and the next,” Cates added.

Dr Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, added that the pledge to bring the epidemic under control “is certainly as good, or perhaps fulfilled, as far as the federal government can deliver. Fill it in.”

And Dr. William Schaffner, professor of preventive medicine and health policy at Vanderbilt University, agreed that “the emergent phase of the epidemic is coming to an end. We are now moving into an ongoing struggle — call it a truce with the virus.”

Medical experts say epidemics inevitably become “endemic,” meaning the pathogen is here to stay but does not represent a widespread emergency.

Dr. Monica Gandhi, professor of medicine at the University of California-San Francisco, said, “We always have to manage Covid in the medical system. “Unfortunately, even though we can bring deaths down a lot, I don’t think we’ll ever get to zero deaths from Covid-19.”

The U.S. death rate from Covid is lower today than during most of the pandemic, and has been since the spring.

Significantly, the number of “excess deaths” has also decreased. It’s a metric that measures how many more deaths are occurring than the long-term average for that time of year. The number of excess deaths nationally has been consistently between zero and 5,000 per week since the spring, after peaking at 20,000 to 25,000 per week during the four previous surges since the pandemic began.

Hospitalization rates have recently stabilized at some of the lowest rates of the epidemic. Even this level may overstate the effect of the virus; Routine testing on admission often detects cases that are asymptomatic and largely coincident with the patient’s reason for admission.

Gandhi pointed to data from a Massachusetts hospital showing that most hospitalized patients who test positive for Covid only have “incidental infections”, with 1 in 3 being treated initially for a Covid-related illness.

Experts note that hospitalizations and deaths, even at these reduced levels, remain too high, and they warn that infections could increase as winter forces people indoors. Still, they credit the availability of vaccines and therapeutics, as well as knowledge gained from living with the virus for more than two years, for the possibility that the pandemic’s dark days are behind us.

“I’m not at all worried that we’ll go back to the scale of hospitalizations and deaths from the worst days of the pandemic,” said Brooke Nichols, an infectious-disease mathematical modeler and health economist at the Boston University School of Public Health. “We will likely enter a seasonal Covid vaccine situation, potentially combining flu as well as the same vaccine, and these seasonal vaccines will become important to avoid hospitalizations and deaths during the flu and Covid season.”

There have been no major new variants since omicron emerged in late 2021, and even the most recent omicron subvariant, BA.5, has long been the dominant strain in the United States, prevailing since early July.

This does not mean that more dangerous new strains could not emerge. However, public health experts take solace from the latest trends. The trend through most of 2022 suggests that a rapid succession of increasingly confusing — and vaccine-evading — variants is not inevitable. If a major new variant emerges, mRNA vaccines made by Moderna and Pfizer-BioNTech can be updated fairly easily.

Vaccination uptake, however, remains an urgent question. About one-third of Americans are not fully vaccinated, and an even smaller percentage have received boosters. Plessia said “the major deciding factor right now is not going to be the response of the president or the federal government — it’s going to be the response of the people.”

“I think there’s disease fatigue and vaccine fatigue and mask fatigue,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “People are just tired of Covid and trying to keep it at bay and it’s unfortunate because it hasn’t gone away. We’re tired of it, but it’s not tired of us yet.”

Some experts caution that having an epidemic “under control” does not mean costs will be minimal.

“The degree of protection afforded by current vaccines, especially for the most vulnerable, is limited in duration, and unexpected consequences from Covid could still have knock-on consequences for population health,” said Babak Javid, an associate professor. Department of Experimental Medicine at UCSF.

These consequences are called “long covid” and about 1 in 5 Americans with covid suffer from it. The Centers for Disease Control and Prevention defines prolonged Covid as symptoms lasting three or more months after exposure to the virus that were not previously seen.

“Under control” suggests progress in keeping further spread within modest limits. That doesn’t mean people haven’t lost loved ones or felt lingering effects from the virus; Obviously, they have.

What does Biden still need to do?

Biden and his administration still have work to do, experts say.

Several public health experts have urged Congress to pass Biden’s request for $22 billion in Covid-related funding. The White House created the fund as a way to prepare for a resurgence even though the caseload is now low. It proposes that funding support testing, research into new vaccines and therapeutics, preparation for future variants, and global support. Biden’s open declaration that the pandemic is “over” could make congressional approval less likely.

Gandhi said the federal government should do a better job targeting boosters and therapeutics to populations at risk of serious breakthrough infections, particularly older Americans and those who are immunocompromised.

And Schaffner called for more effective and unified messaging, including efforts to remove any hint of politics. “I hope the federal government will come together on who the main messenger is and deliver a sustained, clear, simple message,” he said.

Biden probably didn’t use the most appropriate word when describing the pandemic as “over,” but long-term statistical trends are trending in the right direction, and vaccines and treatments will reduce the severity of future waves. For this reason, experts say it is fair to declare the epidemic “under control”. If circumstances change, we’ll re-evaluate our rating, but for now, it’s a promise kept.

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