Biden’s claim that Covid pandemic is over sparks debate over future

Joe Biden's recent declaration that the Covid-19 pandemic was over was premature, according to several infectious disease experts, but there was not a consensus among them about whether the remarks will cause a significant change in Americans' attitude towards the virus and lead to worse public health outcomes.

That's partly because Biden was simply catching up to most of the US population, who see how much lower the case and death counts are than earlier in the pandemic, and as such, have stopped wearing masks in public and now gather regularly indoors, the experts said.

Still, an average of more than 400 people die every day due to Covid-19, according to Johns Hopkins University data.

As such, members of the public, including the US president, should continue to treat the virus as a significant threat, the experts say.

"He is reflecting the fact that we're all acting as if it's something of the past, but many of us, especially us older folks, know friends who are getting Covid, some of whom are suffering from it and getting really bad cases," said David Rosner, who studies public health and social history at Columbia University's Mailman School of Public Health. "It's certainly better than it was a year ago and two years ago, but it's not over."

But Biden offered that assessment during a CBS 60 Minutes episode that aired last Sunday.

The president was likely responding to the fact that people are no longer wearing masks and are "living a normal life", said Dr Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who served in Biden's Covid-19 advisory team.

The upcoming midterm elections may have also played a role in the president's comments, said Dr Celine Gounder, an infectious disease epidemiologist and editor-at-large at Kaiser Health News.

The president was "signaling that the country is not suffering the way it was economically and socially from Covid the way it was", said Gounder. "To say that we are coping with the pandemic better than we were, but that there's still room for improvement would have been one thing. But essentially, this is declaring 'mission accomplished' when you still have thousands of people dying each week."

The current rate would amount to about 150,000 deaths per year, which is equivalent to three bad flu seasons, said Bill Hanage, an epidemiologist at the Harvard TH Chan School of Public Health. (Over the last decade, the highest number of deaths during a flu season was about 50,000, according to the CDC.)

"This ended pandemic is still three times as bad as something we would ordinarily consider pretty bad, and I think that's important, especially because we expect cases to tick up in the fall and the winter," Hanage said.

Rather than declare the pandemic over, Biden should have convened stakeholders to discuss possible solutions and "with far better discussion, act", Hanage said.

But since Biden made the comments in prime time, it will now be more difficult for his administration to encourage people to get a vaccine booster shot and to get Congress to approve his $22.5bn funding request for Covid-19 vaccines, treatment and testing, Gounder said.

"How is Congress going to take such a funding request seriously? Why would they step up and allocate funding for a pandemic that's over?" Gounder said.

People at greater risk of the virus, such as the elderly and immunocompromised, also need public health officials to say "it's not illegitimate to be careful," said Rosner.

And Biden's comments could undermine that.

"What I worry about is people often feeling pressure to act in ways that they feel uncomfortable with," said Rosner. Biden's comments give "another level of kind of social legitimacy to the idea of going into crowds, and it just makes some people feel awkward not not doing that".

That doesn't mean Biden's comments will have significant public health consequences.

The US population has "already adopted a lot of the behavior changes" such as not wearing masks and dining indoors "that would come with thinking it's not really important", said Emanuel, who still doesn't dine indoors, largely because he remains very worried about developing long Covid.

And not all experts criticized Biden's comments.

"Perhaps the most significant rationale in favor of the transition from pandemic to endemic," meaning a disease that is contained with predictable rates and spread, "is the growing consensus that Covid-19 will never be eradicated", Dr Leana Wen, an emergency physician and professor of health policy at George Washington University, wrote in a Washington Post article with the headline "Biden is right. The pandemic is over."

Despite his disagreement with Biden's assessment, Hanage thinks the comments could be helpful because they sparked a societal conversation about a "longer-term pandemic management strategy", which should have started ages ago, he said.

Even though the infectious disease experts called for continued vigilance regarding the virus, which is perhaps out of sync with much of the American population, they say there will be a time when they support a declaration that the pandemic is over.

"An appropriate risk threshold should reflect peak weekly deaths, hospitalizations and community prevalence of viral respiratory illnesses during high-severity years," essentially a bad flu season, Gounder and Emanuel argued in a Journal of the American Medical Association report.

Accumulating immunity both from infection and vaccination "will combine to protect the majority of us from the worst consequences of [Covid] and to limit the size of the surges which we see in future", Hanage said. "The trend has been solidly in that direction. The thing is, we are not at a point yet where it's not still causing an historically large amount of severe illness."