When will the Covid pandemic end?

There is much for us to learn from the Indian experience. India can ‘show the world how to tackle endemic Covid-19.’ What are we waiting for?

By Dr R Neerunjun Gopee

In his address at the COP26 meeting on climate change in Glasgow, President Obama expressed hisfeeling of ‘a certain bleakness about the future.’ Although he was referring to climate change and the environment, one could say the same about the current Covid situation locally – there is a prevailing sense of foreboding about the future with the seemingly uncontrollable rising number of infected cases and the mounting daily deaths. Families are grieving the loss of loved ones, in some of them more than one having fallen victim to the virus. Hospitals are overburdened with cases that keep arriving, and hospital staff have not only been infected but equally are suffering from exhaustion and burnout, both physically and mentally.


“There is a prevailing sense of foreboding about the future with the seemingly uncontrollable rising number of infected cases and the mounting daily deaths. Families are grieving the loss of loved ones, in some of them more than one having fallen victim to the virus. Hospitals are overburdened with cases that keep arriving, and hospital staff have not only been infected but equally are suffering from exhaustion and burnout, both physically and mentally. With the Delta variant having entered the country, the medical profession had anticipated that local circumstances would favour the spread of the virus and that we should expect a surge…”


With the Delta variant having entered the country, the medical profession had anticipated that local circumstances would favour the spread of the virus and that we should expect a surge. Thus, in an interview to this paper earlier, Specialist PhysicianDr P. Chitson had already seen this coming, when he said that, ‘The surge in the UK came with the opening of schools and I suspect that’s what happened in Mauritius, plus the declining immunity due to passage of time, and the Delta virus. The three public holidays in one week will make matters worse soon. Some form of public restrictions must be put back.’ (italics added)

In fact, a new set of restrictions were framed, which many felt were perhaps too little too late, and in the meantime the epidemic continues its deadly march. And the question that is gnawing everybody is ‘When will the Covid pandemic end?’

In an article titled ‘Post-Corona: Back to basics and…’ in March 2020, I had written, ‘Like other pandemics that came before it, the current Covid-19 episode will also come to pass. When, not even the best experts can say at the moment, but based on the past experience of the evolution of disease patterns over time, the most reasonable estimate is that it will be a few months at least.’ Alas, this overblown optimism was misplaced: it was too early days to entertain such a hope, in light of what soon started to emerge, namely that we were being attacked by an ‘unknown unknown’ as far as the epidemiology of the SARS-COV-2 was concerned.

Much more time was required before the timing of any outcome about the future course could be reliably made, except in generalities, to wit that ‘In course of time, viruses circulate among the population as a normal phenomenon, and produce disease when the conditions are conducive – like the influenza virus which attacks during the cold weather, and then we talk about the ‘flu season… This may happen with Covid-19 too, and by then a majority of people would have developed a degree of immunity to it. If a large enough segment of the population, about 75-80%, acquires such immunity, then the rest of the population is also protected, a phenomenon known as herd immunity.’ That’s when the virus transitions from epidemic to endemic, and short of being eliminated altogether, this was the best hoped for scenario as regards Covid-19.

Has any country reached that stage? Yes, India is the first to have done so, as Dr T Jacob John, former Professor of Clinical Virology, CMC, Vellore and Dr MS Seshadri Medical Director, Thirumalai Mission Hospital write in The Indian Express of 15 November: ‘Currently, India is the only country in the world to have reached a sustained endemic state while in other nations, the pandemic is still raging. This is a historic opportunity for us to show the world how to tackle endemic Covid-19.’

They started with the pertinent question: Are we out of the woods yet? Then went on, ‘After the first wave abated, we entered a 10-week endemic phase, only to be interrupted by the second wave. The Delta variant of the second wave had far higher transmission efficiency than the first wave variant (Wuhan-G614D). The recent AY.4.2 variant remains below 0.1%, showing low transmission efficiency that cannot overtake Delta transmission. India has thus become the world’s first country to reach endemic prevalence.’

As they explain, ‘Epidemic means daily numbers of Covid cases rise to a crescendo and decline until a steady state with low numbers (endemic prevalence) is reached.’ With the surge that is raging – and likely to last until at least mid-December- and our capacities being stretched, it is clear that we are very far from such a steady state. To arrive there, we must be prepared to learn from those who have more experience than us by virtue of resources available, capacities and sheer scale, all of which are exemplified by India.

The authors of that article posed two questions: What determined the transition? What changes in strategy should India adopt to mitigate the ill-effects of endemic Covid?

They then proceed to give a fairly technical account in answer to these questions, in an outline of the measures which have allowed India to attain the remarkable control it has achieved over the pandemic. People are now moving about freely, except in a few areas in only a few states.

There is much for us to learn from the Indian experience. India can ‘show the world how to tackle endemic Covid-19.’ What are we waiting for?


* Published in print edition on 19 November 2021

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