Are we out of the pandemic? What Fauci meant by ‘a transitional phase’

National Institute of Allergy and Infectious Diseases Director Anthony Fauci testifies before the Senate Health, Education, Labor, and Pensions Committee about the response to the ongoing COVID-19 pandemic in the Dirksen Senate Office Building on Capitol Hill in Washington, DC. Kent Nishimura / Los Angeles Times via Getty Images

Dr. Anthony Fauci, the nation’s leading infectious disease expert, said last week that the U.S. is transitioning “out of the pandemic phase” of the COVID-19 health crisis. His comments were followed by news that the European Union is moving out of the emergency phase of the pandemic as COVID-19 deaths and hospitalizations across Europe decline significantly, according to the New York Times

“We’re really in a transitional phase, from a deceleration of the numbers into hopefully a more controlled phase and endemicity,” Fauci said, according to The Washington Post

While Fauci’s comments signal hope that the U.S. and other nations could finally be moving into a post-pandemic world, officials should proceed with caution, says Wendy Parmet, Matthews Distinguished University Professor of Law and co-director of Northeastern’s Center for Health Policy and Law.

Portraits of Wendy E. Parmet, Matthews University Distinguished Professor of Law and professor of public policy and urban affairs and Neil Maniar, director of the Master of Public Health program and a professor of the practice in the Bouvé College of Health Sciences. Photos by Matthew Modoono/Northeastern University

So much of the government’s response to the COVID-19 pandemic relied on so-called emergency powers, Parmet says. If federal officials are confident that a post-pandemic transition is in progress, then pandemic-era flexibilities, such as COVID-related health-care coverage, could soon be dispensed with as well, she says. 

There’s also the problem of the public’s perception of what “transitioning out of the pandemic” really means for public health.  

“To the public I think ‘pandemic’ has often come to mean ‘dangerous,’” Parmet says. “And so the opposite, ‘When it’s not a pandemic it’s not dangerous,’ is itself dangerous thinking.”

Amid a steep decline in COVID-19 cases and hospitalizations over the last several months, state, local, and federal officials began rolling back health protocols, such as masking and testing mandates. 

However, Parmet says officials should continue to take steps to protect against another surge, or the next pandemic. Those steps include ensuring that sufficient testing capacity remains in place at all levels of government; that the healthcare system remains resilient; and that more communities measure COVID-19 levels in wastewater to continue real-time monitoring of potential outbreaks. 

Endemicity, or the idea that an outbreak of disease is such that it can be managed without overwhelming the health-care system, is the goal, Parmet says. But even in an endemic period, disease levels can grow to alarming levels. 

“We want the disease to be endemic—we want it to be, it should be; but it should be endemic at a low rate [of disease]—not a high rate,” Parmet says. Endemic diseases such as “smallpox and diphtheria killed lots of children.” 

“Endemics can be really bad,” Parmet continued. “I’m not saying we’re there. I’m saying that when people hear these terms—what they’re hearing and what they have come to mean in popular discussion is not necessarily the same as what the scientists say they mean.”

Fauci’s comments come as cases in the U.S. have been ticking back up as the highly contagious COVID-19 subvariant, known as BA.2, spreads—although some experts have suggested that the rise may not necessarily lead to another surge. Case counts are still at their lowest levels since last summer—and hospitalizations are close to record lows, according to the New York Times

“Case counts are lower, hospitalizations and deaths have decreased,” says Neil Maniar, director of the Master of Public Health program, associate chair of the Department of Health Sciences, and professor of public health practice at Northeastern. 

Maniar interprets the White House’s messaging as a sign that we could be “emerging from the pandemic,” and that “for the time being,” disease levels are under control. 

“It means we are in an environment right now where the burden of COVID is much more manageable,” Maniar says. “It does not mean that COVID has gone away, and it does not mean that the pandemic is over, globally.”

Maniar says it’s important to recognize that, even amid such progress, health-care systems vary worldwide in their ability to handle certain caseloads, meaning local outbreaks can continue to threaten communities around the world. 

“Globally we know there’s a lot of variation in terms of health-care infrastructure,” Maniar says. “But I do think that there’s a general framework of using multiple sources of data to really understand what the burden of COVID is in a given place, and how we can effectively manage and control the spread of disease.” 

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