Dr. Scott Gottlieb, former commissioner of the FDA. Drew Angerer/Getty Images
Former FDA Commissioner Scott Gottlieb told CNBC he believes the COVID-19 pandemic will soon be an endemic.
An endemic is an outbreak that’s always present in particular regions but far more manageable, like the common cold.
“This is going to become more of an endemic illness where you just see sort of a persistent infection through the winter,” he said.
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Scott Gottlieb, former commissioner of the Food and Drug Administration, said on Friday that he believes the coronavirus pandemic will morph into an endemic.
A pandemic is classified by the World Health Organization as a fast-spreading disease outbreak that covers wide swaths of the world. An endemic is an outbreak in particular regions that’s always present but far easier to predict and control, like the common cold or malaria.
“We’re transitioning from this being a pandemic to being more of an endemic virus, at least here in the United States and probably other western markets,” Gottlieb said on CNBC’s “Squawk Box.”
Still, Gottlieb warned that other parts of the world will continue to have difficulty containing the coronavirus. “There’s still going to be a pandemic in a lot of parts of the world where you don’t have high vaccination rates,” he said.
A Duke University researcher recently told Nature, a British scientific journal, that they forecast poorer countries will have to wait two years to have enough vaccines for their populations to reach sufficient immunity. Our World in Data, an online scientific publication, says only about 1.2% of people living in low-income countries have received at least one dose against the coronavirus.
“It’s not a binary point in time, but I think after we get through this Delta wave, this is going to become more of an endemic illness where you just see sort of a persistent infection through the winter,” Gottlieb added. “But not at the levels we’re experiencing right now.”
Officials are still urging all Americans to get vaccinated against the coronavirus, especially as the Delta variant continues to spike in various parts of the country. About 52% of the US population is fully vaccinated, according to data compiled by Johns Hopkins University.
Gottlieb has recently raised the alarm for the US Northeast, saying the region is particularly susceptible to another surge in positive COVID-19 cases.
In an interview aired last week with CBS’ “Face the Nation,” Gottlieb said the pandemic is “certainly getting worse” in the US with additional concerns stemming from the upcoming school year.
“I think the northern states are more impervious to the kind of spread we saw in the South, but they’re not completely impervious,” Gottlieb said. “They have higher vaccination rates. There’s been more prior infection. But there’s still people who are vulnerable in those states. And the challenge right now is that the infection is going to start to collide with the opening of school.”
Gottlieb served as FDA commissioner from 2017 to 2019 under the Trump administration. He is now a board member at vaccine manufacturer Pfizer, among other companies.
Dr. Scott Gottlieb told CNBC on Friday he expects the coronavirus to become an endemic virus in the U.S. and other Western countries after the recent surge in delta variant infections calms down.
“We’re transitioning from this being a pandemic to being more of an endemic virus, at least here in the United States and probably other Western markets,” Gottlieb said on “Squawk Box.” An endemic virus is one that remains in the American population at a relatively low frequency, like the seasonal flu, for example.
Gottlieb — commissioner of the Food and Drug Administration from 2017 to 2019 during the Trump administration, and now a board member at several companies including vaccine maker Pfizer — has previously said “true herd immunity” for Covid may actually be impossible with new infections occurring in the years ahead.
“It’s not a binary point in time, but I think after we get through this delta wave, this is going to become more of an endemic illness where you just see sort of a persistent infection through the winter … but not at the levels that we’re experiencing certainly right now, and it’s not necessarily dependent upon the booster shots,” Gottlieb added Friday.
Gottlieb said he expects the spread of the highly transmissible delta variant to remain noteworthy in the weeks ahead.
“You’re going to see the delta wave course through probably between late September through October,” Gottlieb said. “Hopefully we’ll be on the other side of it or coming on the other side of it sometime in November, and we won’t see a big surge of infection after this on the other side of this delta wave.”
The tri-state region of New York, New Jersey and Connecticut will begin to see an uptick in delta cases as rates slow down in the South, Gottlieb said.
“This is a big country and the delta wave is going to sweep across the country in a regionalized fashion,” he said. “By September, hopefully you’ll see the other side of that curve in the South very clearly, but cases will be picking up in the Northeast, the Great Lakes region, maybe the Pacific Northwest. … It’s probably going to coincide with a restart in school, some businesses returning if you look at last summer as well.”
Gottlieb’s comments Friday morning came before a key Centers for Disease Control and Prevention’s vaccine advisory committee unanimously voted to recommend Covid vaccine booster shots for people with weakened immune systems. If the CDC follows that recommendation, the shots can officially be administered to those vulnerable individuals such as organ transplant recipients, as well as cancer and HIV patients.
A day earlier, the FDA approved booster shots for people who have weakened immune systems. They represent about 2.7% of the U.S. adult population but make up about 44% of hospitalized Covid breakthrough cases in fully vaccinated individuals, according to recent data from the CDC.
Gottlieb said being able to deliver booster shots to those Americans, helping fortify their immunity protection, will drive the U.S. further into the “endemic phase.”
“I think that this is a policy call as much as a public health call that U.S. officials want to continue trying to promote first vaccinations before they pivot to giving people booster shots,” Gottlieb said about the FDA’s Thursday announcement.
Among those people Gottlieb believes should receive Covid booster shots soon are nursing home residents, who tend to be older and have underlying conditions that make them more vulnerable to Covid. That’s particularly worrisome as the delta variant moves into Northern states, and their initial round of vaccinations moves further in the rearview mirror, he said.
“I would be worried about nursing homes right now, the infection getting into those settings against the backdrop where you have a patient population that probably has declining immunity and is more vulnerable than they were certainly five months ago.”
Disclosure: Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic testing start-up Tempus, health-care tech company Aetion and biotech company Illumina. He also serves as co-chair of Norwegian Cruise Line Holdings’ and Royal Caribbean’s “Healthy Sail Panel.”
When is this finally going to end? That’s the question on many minds after a year of living through the COVID-19 pandemic.
But public health experts say we do have an answer, and you’re not going to like it: COVID-19 is never going to end. It now seems poised to become an endemic disease — one that is always a part of our environment, no matter what we do.
“We’ve been told that this virus will disappear. But it will not,” Dr. William Schaffner, a professor at the Vanderbilt University School of Medicine and medical director of the National Foundation For Infectious Diseases, tells CBS News.
“We need to control it. We need to diminish its impact. But it’s going to be around hassling us for the foreseeable future. And by that I mean — years.”
The World Health Organization declared COVID-19 a pandemic on March 11, 2020. A year later, the virus has infected 118 million people worldwide and killed over 2.6 million, including more than 530,000 Americans, according to data compiled by Johns Hopkins University.
One year ago today, the World Health Organization declared COVID-19 a pandemic, warning about “alarming levels of inaction” as the virus rapidly spread.
COVID has now infected 118 million people worldwide and killed over 2.6 million — including more than 530,000 Americans pic.twitter.com/lUILqhMK7s
— CBS News (@CBSNews) March 11, 2021
At the same time, several effective COVID vaccines were developed at an unprecedented pace and have already been administered to nearly 330 million people worldwide.
But researchers say there’s simply no track record of infectious diseases being completely eradicated, and everything about COVID-19 shows that it will be no different.
“The more infectious a microbe is, the harder it is to control,” Dr. Tom Frieden, the CEO of Resolve To Save Lives and a former CDC director, tells CBS News. “COVID is very challenging to control, and the new variants suggest that we may end up playing kind of a game of cat and mouse.”
Prior to COVID, people were already used to living with endemic diseases. The flu is one example. Measles is another. Both continue to spread and kill people every year despite decades of vaccination and containment.
Even the virus that causes COVID-19 is just a new type of coronavirus; other coronaviruses had long been circulating and in some cases could cause the common cold. COVID itself has already gone through mutations that made it more contagious and potentially deadlier.
The only infectious disease in modern history to be eliminated worldwide was smallpox, which the World Health Organization declared eradicated in 1980. But that was nearly 200 years after the creation of the first smallpox vaccine. Smallpox also spread relatively slowly, and people who had it developed a distinctive rash, making the disease easier to identify and control.
The novel coronavirus, meanwhile, is highly contagious while also causing many asymptomatic infections. You can’t look at someone and know whether they have the virus. COVID-19 has also proved to spread to animals as well as humans, with infections confirmed in tigers, gorillas, apes, minks, cats and dogs.
Scientists say all of this makes the virus essentially impossible to control.
“It’s pretty unrealistic to think that we can eliminate a virus from both the human population and from its natural reservoirs,” Dr. Anita McElroy of the University of Pittsburgh School of Medicine tells CBS News.
She adds that since many people will choose not to get vaccinated — either for medical reasons or out of personal opposition to the vaccine — the world will always have “pockets of the population where the virus continues to spread and be susceptible.”
But doctors say that just because COVID is here to stay doesn’t mean it will disrupt our lives as much as it has in the past year. Vaccination and containment measures will eventually get the pandemic under control, potentially turning COVID into another disease we simply learn to live with.
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Schaffner points out that the flu remains a serious threat — infecting millions of Americans and killing tens of thousands every year — and yet it has become so familiar that many people don’t even bother getting vaccinated for it every year.
“Could it be down the road that we become so familiar with COVID that we develop a certain nonchalance about it also?” he says. “Yes. We tend to do that in the United States.”
Schaffner says it would be best to give up the idea of going “back to normal,” and instead settle in for the “new normal” where COVID continues shaping our lives.
COVID vaccinations could become an annual ritual for millions. Masks might remain commonplace for the elderly and people with underlying conditions. Your family celebrations might be shaped by who’s vaccinated, while more vulnerable people only join by Zoom.
“The third, fourth and fifth years of COVID should not be anywhere close to as awful as the first one was,” he says. But in this new normal, “many of us will no longer be quite as carefree as we used to be.”
Here’s how mRNA viruses like COVID-19 mutate, and why certain viruses are harder to develop vaccines for.
USA TODAY
Even as cases continue to decline and more Americans receive their vaccines, the coronavirus isn’t likely to go away anytime soon, health officials say.
The nation’s top infectious diseases expert Dr. Anthony Fauci dismissed the idea that COVID-19 would be eradicated in the next several years at a webinar hosted by think tank Chatham House in November.
“We need to plan that this is something we may need to maintain control over chronically. It may be something that becomes endemic, that we have to just be careful about,” he said.
So, what is an endemic disease and how wouldCOVID-19 become one? Experts say there are multiple endemic diseases in the United States that could foreshadow what the disease caused by the coronavirus may look like in the upcoming years.
What does endemic mean?
The Centers for Disease Control and Prevention defines endemic as the “constant presence and/or usual prevalence” of a disease within a population in a certain geographic area.
An endemic disease spreads at a baseline level every year without causing majordisruption to people’s lives, said Dr. Donald Burke, professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.
“Things that are endemic are present for long periods of time without interruption, continuously circulating in the population,” like the common cold, he said.
A disease can be endemic in one country but can be considered an outbreak or an epidemic in another country, explained Dr. Pritish Tosh, an infectious diseases physician and researcher at the Mayo Clinic.
For example, malaria is considered endemic in some parts of the world where mosquitos carry the parasite. However, a high number of malaria cases in the United States would be considered an epidemic if it were not contained.
What’s the difference between an epidemic and an endemic?
An epidemic is a sudden increase of a disease above what is normally expected among the population in a certain area, according to the CDC.
Epidemics aren’t just caused by diseases that result from viruses or bacteria, the agency says. For example, diabetes and obesity exist in large enough proportions in the U.S. to be considered epidemics. Similarly, a sudden increase in addiction to opioids over the past several years is accurately called an“opioid epidemic.”
The part of the word “epi” means “to be upon,” Burke said, and “demic” comes from “demos,” which means “people.”
“Epidemic means something that comes out and is among the people,” he said. “Things that are epidemic are things that are unusual that are not there and then appear.”
Endemic means “something that’s within the people,” he added. Many epidemics have turned into endemics.
But an endemic disease does not necessarily mean that it will exist forever. Some endemic diseases have been eliminated in the U.S. after achieving herd immunity through vaccines and natural infection.
What are some endemic diseases?
The four common cold coronaviruses, which are considered cousins of SARS-CoV-2, the virus that causes COVID-19, are considered endemic in most parts of the world, including the U.S., Burke said.
“We don’t notice them,” he said. “They’re transmitted, they’re constant.”
Many childhood diseases also are endemic, he said. The measles, for example, used to be endemic in the U.S.
“In the old days … they were commonplace. Everybody got them,” Burke said. But childhood vaccines helped impede transmission, almost eliminating the measles from the U.S.
CLOSE
Recent numbers about COVID-19 cases are trending in a more positive direction. Experts put it into perspective.
USA TODAY
However, the measles is still considered endemic in some parts of the world, Tosh said. If the highly infectious virus was brought in from another country, it could cause an outbreak and possibly lead to an epidemic in the U.S.
For example, a series of outbreaks in 2019 led to more than 1,200 measles cases in the U.S. – the highest number of cases recorded in the country since 1992, according to the CDC. The agency attributed the outbreaks to travelers who got measles abroad and pockets of unvaccinated people.
Could COVID-19 become endemic?
It’s likely SARS-CoV-2 is here to stay, health experts say.
“It appears as though this virus is likely to remain endemic in populations at least for several years, possibly indefinitely,” Tosh said.
A January study found that the virus “could join the ranks of mild, cold-causing … human coronaviruses in the long run,” according to Emory University and Penn State University scientists.
The model, published in the peer-reviewed journal Science, compares SARS-CoV-2 to four common cold coronaviruses plus the SARS and MERS viruses, which surfaced in 2003 and 2012, respectively.
Researchers determined from the model that if the novel coronavirus continues to circulate in the general population and most people are exposed to it from childhood, it could be added to the list of common colds.
Listen to more details from reporter Adrianna Rodriguez in USA TODAY’s 5 Things podcast below on what epidemiologists say about endemics:
However, the future of the novel coronavirus hinges on many unknowns, experts say. New variants from the United Kingdom and South Africa, which studies have shown may be more transmissible, were discovered in the U.S. Health officials are more concerned about the South Africa variant, as emerging data shows existing COVID-19 vaccines seem to be less effective against it.
Tosh expects more variants to arise as growing immunity and vaccines forces the coronavirus to mutate.
“It will be difficult to project what this will look like five years from now,” he said. “But I think we can anticipate some kind of COVID endemicity over the next several years.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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Here’s how mRNA viruses like COVID-19 mutate, and why certain viruses are harder to develop vaccines for.
USA TODAY
Even as cases continue to decline and more Americans receive their vaccines, the coronavirus isn’t likely to go away anytime soon, health officials say.
The nation’s top infectious diseases expert Dr. Anthony Fauci dismissed the idea that COVID-19 would be eradicated in the next several years at a webinar hosted by think tank Chatham House in November.
“We need to plan that this is something we may need to maintain control over chronically. It may be something that becomes endemic, that we have to just be careful about,” he said.
So, what is an endemic disease and how wouldCOVID-19 become one? Experts say there are multiple endemic diseases in the United States that could foreshadow what the disease caused by the coronavirus may look like in the upcoming years.
What does endemic mean?
The Centers for Disease Control and Prevention defines endemic as the “constant presence and/or usual prevalence” of a disease within a population in a certain geographic area.
An endemic disease spreads at a baseline level every year without causing majordisruption to people’s lives, said Dr. Donald Burke, professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.
“Things that are endemic are present for long periods of time without interruption, continuously circulating in the population,” like the common cold, he said.
A disease can be endemic in one country but can be considered an outbreak or an epidemic in another country, explained Dr. Pritish Tosh, an infectious diseases physician and researcher at the Mayo Clinic.
For example, malaria is considered endemic in some parts of the world where mosquitos carry the parasite. However, a high number of malaria cases in the United States would be considered an epidemic if it were not contained.
What’s the difference between an epidemic and an endemic?
An epidemic is a sudden increase of a disease above what is normally expected among the population in a certain area, according to the CDC.
Epidemics aren’t just caused by diseases that result from viruses or bacteria, the agency says. For example, diabetes and obesity exist in large enough proportions in the U.S. to be considered epidemics. Similarly, a sudden increase in addiction to opioids over the past several years is accurately called an“opioid epidemic.”
The part of the word “epi” means “to be upon,” Burke said, and “demic” comes from “demos,” which means “people.”
“Epidemic means something that comes out and is among the people,” he said. “Things that are epidemic are things that are unusual that are not there and then appear.”
Endemic means “something that’s within the people,” he added. Many epidemics have turned into endemics.
But an endemic disease does not necessarily mean that it will exist forever. Some endemic diseases have been eliminated in the U.S. after achieving herd immunity through vaccines and natural infection.
What are some endemic diseases?
The four common cold coronaviruses, which are considered cousins of SARS-CoV-2, the virus that causes COVID-19, are considered endemic in most parts of the world, including the U.S., Burke said.
“We don’t notice them,” he said. “They’re transmitted, they’re constant.”
Many childhood diseases also are endemic, he said. The measles, for example, used to be endemic in the U.S.
“In the old days … they were commonplace. Everybody got them,” Burke said. But childhood vaccines helped impede transmission, almost eliminating the measles from the U.S.
CLOSE
Recent numbers about COVID-19 cases are trending in a more positive direction. Experts put it into perspective.
USA TODAY
However, the measles is still considered endemic in some parts of the world, Tosh said. If the highly infectious virus was brought in from another country, it could cause an outbreak and possibly lead to an epidemic in the U.S.
For example, a series of outbreaks in 2019 led to more than 1,200 measles cases in the U.S. – the highest number of cases recorded in the country since 1992, according to the CDC. The agency attributed the outbreaks to travelers who got measles abroad and pockets of unvaccinated people.
Could COVID-19 become endemic?
It’s likely SARS-CoV-2 is here to stay, health experts say.
“It appears as though this virus is likely to remain endemic in populations at least for several years, possibly indefinitely,” Tosh said.
A January study found that the virus “could join the ranks of mild, cold-causing … human coronaviruses in the long run,” according to Emory University and Penn State University scientists.
The model, published in the peer-reviewed journal Science, compares SARS-CoV-2 to four common cold coronaviruses plus the SARS and MERS viruses, which surfaced in 2003 and 2012, respectively.
Researchers determined from the model that if the novel coronavirus continues to circulate in the general population and most people are exposed to it from childhood, it could be added to the list of common colds.
Listen to more details from reporter Adrianna Rodriguez in USA TODAY’s 5 Things podcast below on what epidemiologists say about endemics:
However, the future of the novel coronavirus hinges on many unknowns, experts say. New variants from the United Kingdom and South Africa, which studies have shown may be more transmissible, were discovered in the U.S. Health officials are more concerned about the South Africa variant, as emerging data shows existing COVID-19 vaccines seem to be less effective against it.
Tosh expects more variants to arise as growing immunity and vaccines forces the coronavirus to mutate.
“It will be difficult to project what this will look like five years from now,” he said. “But I think we can anticipate some kind of COVID endemicity over the next several years.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
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Healthcare workers wearing protective gear prepare to attend patients at the Portimao Arena sports pavilion converted in a field hospital for Covid-19 patients at Portimao, in the Algarve region, on February 9, 2021. (Photo by PATRICIA DE MELO MOREIRA / AFP) (Photo by PATRICIA DE MELO MOREIRA/AFP via Getty Images)
PATRICIA DE MELO MOREIRA | AFP | Getty Images
LONDON — A growing chorus of physicians and public health officials have warned that even with the mass rollout of safe and effective Covid-19 vaccines, the disease may become endemic.
White House coronavirus advisor Dr. Anthony Fauci, Moderna CEO Stephane Bancel and the World Health Organization’s Executive Director of the Health Emergencies Program Dr. Mike Ryan have all said in recent weeks that the coronavirus may never go away.
To date, more than 107 million people worldwide have contracted Covid-19, with 2.36 million deaths, according to data compiled by Johns Hopkins University.
David Heymann, professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, had warned the virus appeared to be on course to become endemic late last year. He reaffirmed his position earlier this week during a webinar for think tank Chatham House.
“I think if you speak with most epidemiologists and most public health workers, they would say today that they believe this disease will become endemic, at least in the short term and most likely in the long term,” he said.
Heymann is the chair of the WHO’s strategic and technical advisory group for infectious hazards and led the health agency’s infectious disease unit during the SARS epidemic in 2002-2003.
We need to learn lessons from 2020 and act swiftly. Every day counts.
Dr. Jeremy Farrar
Director of Wellcome
He cautioned it was not yet possible to be sure of the virus’s destiny since its outcome depends on many unknown factors.
“Right now, the emphasis is on saving lives, which it should be, and on making sure that hospitals are not overburdened with Covid patients — and this will be possible moving forward,” Heymann said, citing the mass rollout of Covid vaccines.
‘Need to learn lessons from 2020’
The mass delivery of Covid vaccines started in many high-income countries almost two months ago and has since been gathering pace, but the mass immunization of populations will take time.
To be sure, some low-income countries are still yet to receive a single dose of a vaccine to protect people most at risk from the coronavirus.
A doctor takes notes during a training session provided by Chinese doctors and medical experts through a teleconference in Maputo, Mozambique, on May 21, 2020. Chinese obstetricians and pediatricians share their experience with Mozambican doctors on the prevention and treatment of Covid-19 among pregnant women and children through a teleconference at Maputo Central Hospital.
Nie Zuguo | Xinhua News Agency | Getty Images
A report published by the Economist Intelligence Unit last month projected the bulk of the adult population of advanced economies would be vaccinated by the middle of next year. In contrast, however, this timeline extends to early 2023 for many middle-income countries and even as far out as 2024 for some low-income countries.
It underscores the scale of the challenge to bring the pandemic under control around the world.
“Covid-19 is an endemic human infection. The scientific reality is that, with so many people infected worldwide, the virus will continue to mutate,” said Dr. Jeremy Farrar, director of Wellcome and a member of the UK.’s Scientific Advisory Group for Emergencies (Sage).
“Living with this virus does not, however, mean we cannot control it. We need to learn lessons from 2020 and act swiftly. Every day counts,” he added.
Balancing our living with endemic diseases
“I think it is good to put this in context and think about the other infectious diseases that are endemic today,” Heymann said during an online event on Wednesday, when asked whether policymakers should be mindful of other endemic diseases in responding to the Covid pandemic.
He cited tuberculosis and HIV, as well as four endemic coronaviruses that are known to cause the common cold.
“We have learned to live with all of these infections, we’ve learned how to do our own risk assessments. We have got vaccines for some, we have therapeutics for others, we have diagnostic tests that can help us all do a better job of living with these infections.”
“There are a couple of unknowns that make it very difficult for political leaders and public health leaders to make decisions as to what would be the best strategies, inducing the fact that we don’t completely understand ‘long Covid’ and its impact or its occurrence after even very minor infections,” he continued.
“So, it is not a matter of this being a special disease. This is one of many that we will have to balance our living with and understand how to deal with it as we do influenza, as we do with other infections,” Heymann said.
A nurse (R) checks a computer with Hospital Director, Doctor Yutaka Kobayashi, on the coronavirus ward at Sakura General Hospital on February 10, 2021 in Oguchi, Japan. The hospital, like many others in Japan, has seen a consistent flow of Covid-19 coronavirus patients throughout the last year as the country grapples with the ongoing viral pandemic.
Carl Court | Getty Images News | Getty Images
The term “long Covid” refers to patients suffering from prolonged illness after initially contracting the virus, with symptoms including shortness of breath, migraines and chronic fatigue.
Public discourse on the pandemic has largely focused on those with a severe or fatal illness, whereas ongoing medical problems as a result of the virus are often either underappreciated or misunderstood.
Last month, the largest global study of long Covid to date found that many of those suffering with the ongoing illness after infection with the virus had been unable to return to work at full capacity six months later.
