Endemic vs Pandemic: What’s The Difference And Why Should You Care?

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Endemic vs Pandemic, which one is what, and when and how are you supposed to know the difference? If you are someone who is wondering the difference between an endemic and a pandemic and how it actually affects your life, then you have come to the right place. Because today I am breaking down the difference between an endemic and a pandemic and what it means to you.

First, I'll talk about the definition of an endemic vs the definition of a pandemic? Then I'll talk about eradication or getting rid of a disease altogether. And is that possible in the case of COVID-19? And then I'll answer the question, are we there yet? Have we moved from being in a pandemic to now being in an endemic when it comes to COVID-19? Lastly, I'll discuss what this all means to you. If and when we are in an endemic with COVID-19, does that mean life can totally go back to normal? Let's get started.


What Is A Pandemic?

You may recall that the World Health Organization declared that COVID-19 was a pandemic in March of 2020. So what does that mean? For a pandemic, you have to have an outbreak of an illness or an epidemic worldwide, in a very large geographic location crossing international borders, and you just have really high cases. These high cases are often unpredictable, and they disrupt society.

We had a pandemic with the Spanish flu in 1918. We had a pandemic with H1N1 in 2009. And of course, as of March 2020, it was declared that we had a pandemic with COVID-19. So what does it mean to be endemic?


What Is An Endemic?

In order to be endemic, the disease is not totally gone, it's not eradicated, but it's more in the background. It's in a steady-state, it's static and it's predictable. That's what's key, it's predictable. In an endemic, scientists are able to predict the number of cases that a disease is likely to cause. They're able to predict the community which will be affected. And they're able to the time of year or the season when a disease will rear its ugly head.

We have endemics such as the flu. We know when flu season is, we know how many vaccines to order for flu season. We can present how many hospitalizations we will have in a flu season from year to year. Chickenpox is endemic. Pneumonia is endemic. Is COVID-19 endemic? Okay, we'll keep discussing it, but this is the definition of an endemic.


what is an endemic


What Does It Mean When A Disease Is Eradicated?

And then you have cases where certain illnesses have been eradicated. The one disease we have been successful in eradicating is smallpox. The last case of naturally occurring smallpox was in 1977. Smallpox was completely eradicated, and prior to being eradicated, it killed something like half a billion people in the 20th century.

But it was completely eradicated thanks to vaccines. Be sure to watch my YouTube video on the truth about vaccines after you finish reading this article. For COVID-19, will we be able to completely eradicate it? Well, I'm a pretty optimistic person. I look at life through rose-colored goggles and with the glass being half full, but quite honestly, it is very unlikely that we will be able to eradicate COVID-19.

One of the reasons is that COVID-19 can be found in animals, it has animal reservoirs. When you have diseases that have animal reservoirs, it's very difficult to eradicate them, especially when the animals are able to pass the diseases to humans. And we know that COVID-19 has been found in hamsters and deer. And so it's not likely to be eradicated for that reason among others.


endemic vs pandemic


Has Covid-19 Entered the Endemic Phase?

Can COVID-19 be an endemic? And are we there yet? That's really the big question, are we there yet? When you look at cases and you compare them from the very beginning of the pandemic in 2020 and then you fast forward to two years later, March of 2022, indeed, cases and hospitalizations have gone down very significantly.

But just because they have improved does that mean that it's time to relax? Are we in an endemic phase? Well, if you take a look at February 2022, two years into the COVID-19 pandemic we lost 60,000 people from COVID-19. That's a lot of deaths. And if you compare it to even a bad flu season, we lost more people in one month than we've lost in an entire year with the flu. Quite significant. And even when you start looking into 2022, two years after the pandemic of COVID-19, the deaths have gone down quite significantly.

In fact, during the first week of March 2022, we were down to just about 1,200 deaths a day in the United States. But just think about that number in terms of people who have lost their lives. That's still a lot of people. And so when I gave a definition of endemic, we talked about not disrupting life, right? We talked about in order to be endemic a disease has to be at a steady-state. It has to be at a place where it's predictable. And quite honestly, with numbers like that, 60,000 people dying in one month, 1,200 people, 1,300 people dying in a day, that is still at a point where it is disruptive to everyday life.


has covid-19 entered the endemic phase


Is COVID-19 Predictable?

The other thing to consider with COVID-19 is predictability. And as long as we have variants, which we know we do with COVID-19, it's not so predictable. We have the Delta variant, and once the Delta variant started to decrease and be less prevalent, a lot of people celebrated and started taking off masks and opening the world back up. And then what happened? We got the Omicron variant, which was even more transmissible than the Delta variant. Well, fast forward to March of 2022 when the Omicron variant has decreased significantly. Now you have people saying, "Okay, well now are we there yet? Are we in an endemic?" Well, guess what? There are still variants.

There is a variant of the original Omicron, BA.1, and the variant is called BA.2. With the BA.2 variant, as of the second week in March 2022, it accounted for 11.6% of the cases in the United States, which was up from the previous week of 6.6% of the cases. Does that sound familiar?

Yes, a new variant that already was starting to move pretty quickly. And guess what else? We thought that the Omicron variant was the most transmissible thing we had ever seen. Well, as of the first week, March 2022, scientists are calculating that the BA.2 variant is actually 30% more transmissible than the Omicron variant. Of course, these numbers can change. Science is dynamic. But the point is just because numbers are down, it doesn't mean that COVID-19 is no longer an issue. It's definitely not static. And it's definitely not predictable at this point.



what is the difference between an endemic and a pandemic


Does An Endemic Mean the Covid-19 Pandemic Is Over?

In the United States, we have to step outside of ourselves and look at other countries. So look at the UK, right? And the UK often has illnesses before we get them here. They'll have their epidemic, and then we'll follow. You know, we've seen that with other variants, including the Omicron variant. The UK cases have been steadily decreasing after they peaked with Omicron, and then they hit their decline. But as of the first week in March 2022, that BA.2 variant (the new variant since the original Omicron variant) is actually the dominant variant in many countries. The point is even though cases overall have decreased and there are somewhat fewer deaths for sure, COVID-19 is not static and it's not predictable. And we still have these variants we have to be on the lookout for. The numbers, of course, are all relative. And when I look at people getting excited just because we have a lot fewer deaths than we had with COVID-19 at the beginning of the pandemic, and of course, we have fewer cases and fewer hospitalizations, that's definitely something to celebrate, but it's all relative. We're celebrating, but it's not over.

It's as if you had a student who used to be an A student, and then they had some type of psychological trauma, and they went from being a straight-A student to a straight F student. And now you've been working with them, and now they're up to being a D student. And okay, yes, you can celebrate the Ds or even the Cs, but you're not done yet. You still need to do whatever interventions to try to get them back to being an A student. Or for me, when I'm counseling my patients, if I have someone who I have on a weight loss program, they may go from being, you know, 100 pounds overweight to being 75 pounds overweight. And yes, I'm going to celebrate, that's great. But I'm not finished. We still have to have the same interventions of healthy habits. And that's how I'm looking at COVID-19.


Will COVID -19 Get To An Endemic Phrase?

Yes, you know, we were in a pandemic, and we know all the deaths that we've had and all the hospitalizations have been absolutely horrific. And so even though two years out from the pandemic, it may be better than it was. We're not there yet. So do I think that at some point we will be in an endemic phase for COVID-19? I do, I really do. No, I don't think we'll eradicate it, but I do think we'll get into an endemic phase. But once we are, does that mean life can totally go back to normal? Does that mean that we can burn our masks and not worry about vaccines? The answer is no because even once we get to a point where COVID-19 is in the background, when it's static, when it's a little more predictable, we still have people who are vulnerable in our population. We have the very young. We have the very old. We have people who are immunocompromised, transplant patients, and chemotherapy patients. We have patients who are not vaccinated. Yes, we have to worry about them too, because the unvaccinated people are still the ones who are dying mostly from COVID-19.

So even when we reach an endemic phase, we still have to be careful. And if you're a vulnerable person, you will still have to be careful in the endemic phase. Let's remember, there are certain diseases that are endemic. Malaria is a disease that's endemic. And in 2020, malaria killed over 600,000 people. Other diseases like tuberculosis, is endemic, but it still kills millions of people. And smallpox before it was eradicated was still killing millions of people, even when it was considered to be static and predictable. The point is just because a disease is endemic does not mean that you don't have to worry about it. You still have to be careful, and you have to watch and you have to do some sequencing. There has to be testing.


does an endemic mean the covid-19 pandemic is over


What Does The Future Look Like With COVID-19?

With COVID-19, maybe in the future instead of having to wear masks everywhere, you might have to always have some masks on deck or for times when cases do increase, or when you're around vulnerable populations. That may be indefinite. We don't know. It's the same thing with testing, we do need to continue to test so that we find out about COVID-19 outbreaks or peaks before it's too late. It may be a case you may have to always keep a few of those rapid COVID tests at home.

The point is it is not likely that we will go all the way back to normal, or all the way back to life the way it was before the COVID-19 pandemic and we're definitely not there yet. And we will always have to remember our lessons. We'll always have to remember the testing, the masks, and to follow the science. Again, remember, the one disease we have been successful at eradicating, smallpox, was eradicated due to vaccines.

And there are other diseases that have declined due to mitigation factors, measles, for example. The only reason we had a measles outbreak somewhat recently was because there were populations that were unvaccinated. What do you think when it comes to endemic vs pandemic? Let me know in the comments below.

Dr. Frita
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