Can COVID-19 Become Endemic?
Health experts worldwide predict COVID-19 will stay for a while as the pandemic is at best being controlled into a more manageable endemic, but when will Mexico get to this point?
While a pandemic consists of a virus spreading exponentially beyond borders, an endemic occurs when a virus’s circulation is limited to a specific region over time with predictable spread rates. Endemics still play a large role in a nation’s health and largely contribute to mortality rates, but are overall much less deadly and easier managed than pandemics. Examples of an endemic include Malaria of Influenza in Mexico, diseases whose predicted seasonal spikes are managed through vaccination seasons and allow hospitals to prepare for rises in cases.
“You can expect the (disease to become) endemic all around the world, outside of very isolated nations or in islands where you can control the access to the country…There you can talk about eradication. But Mexico has very transited borders, a very important tourism industry, so you know that there will be cases coming from outside and probably we will not be able to control the cases inside. That’s why we hope for it to become an endemic,” said David Castelo, Infectologist, GSK Mexico.
Eradicating COVID-19 is no longer the goal for most healthcare systems, which instead are hoping to turn the pandemic into an endemic within their country to better control the virus and its impact on inhabitants. Health experts expect this transformation to be first achieved in the US, UK, Portugal and India. For Mexico, an endemic status seems within reach but the quickness with which it arrives will depend on several factors.
Rafael Lozano, Health Systems Director, Health Metrics and Evaluation (IHME) at the University of Washington, says the transition towards an endemic could start in mid-2022 for the country. Before then, Lozano and other health experts warn of new COVID-19 waves to hit Mexico. Once they have dwindled, additional doses for fully-vaccinated populations, the vaccination of minors and the upholding of safety protocols could lead the country towards controlling the pandemic into an endemic.
The government’s focus currently remains on administering the first doses of the vaccine to the adult population and has not even begun considering booster shot distribution. Vaccination for minors has merely just begun for the age groups 12-18 and is only available for those with preexisting health conditions. Furthermore, a global decrease in active cases has led many citizens to follow health protocols less directly, with Campeche’s governor Layda Elena Sansores San Román pushing to lift the state’s mask mandate. These factors could very well delay the transformation of the virus into an endemic but when it arrives, it will do so with additional challenges.
Initially, vaccination campaigns will transform as they begin integrating themselves into annual routines, much like the seasonal Influenza vaccine. However, the cost of administering these vaccines will present a new economic challenge for the country. The cost of administering 32 million influenza doses nationwide amounts to an estimated US$116 million.
Because of this, Enrique Minor, research professor of Tecnológico de Monterrey suggests an eventual opening of vaccine distribution to the private sector. However, as the nation has so far only fully vaccinated half of its population, that transition does not seem to be in the near future. Furthermore, the long-term effects of having contracted COVID-19, known as “long COVID,” continue to be investigated and are likely to present an additional cost for the health sector.
A final determining factor which could delay the prediction of Mexico beginning to transition towards an endemic by mid-2022 is the mutation of the virus. Variants of COVID-19 could be more resistant to the vaccination or spread at faster rates, significantly changing the containment of the virus in the country or resulting in the return to a pandemic during the beginnings of an endemic transition.