United Kingdom, France, Spain and Denmark begin to treat the scenario of infections by Sars-CoV-2 as endemic; infectologists explain that change does not represent eradication
ALOISIO MAURICIO/FOTOARENA/ESTADÃO CONTENTWhile initially positive, the change in rating also raises concerns for experts.
With the occasional decline in the rates of new cases, hospitalizations and deaths due to Covid-19, some countries and territories of the world resume part of the sanitary flexibilities. Among the changes adopted are: the removal of masks, the end of social distancing recommendations and even the waiver of the requirement of the vaccine passport for entry into closed environments. However, another determination has been gaining the world’s spotlight: the decision to UK, France, Spain and Denmark to update the Covid-19 classification to endemic. With the change, infections by Sars-CoV-2 are no longer a health emergency. But, in fact, what does this mean for coping with the disease? Before understanding how this change can reflect on the combat and eradication actions of the coronavirusit is necessary to establish the differences in the classification of the disease.
Pandemic vs endemic: what changes?
different from pandemic, which is characterized by the spread and generalized increase of a disease in several territories, endemic is the health situation in which it is assumed that a certain number of cases – and deaths – are expected from a disease. That is, in the endemic situation, there is a control in the statistics, as explained by the infectologist of the Pardini Group Marília Turchi. “Several infectious diseases reach a certain level and then, with a series of control measures, enter an endemic level. That is, with the number of cases that would be within the expected limit. But being in an endemic situation is not necessarily a comfortable or good situation”, says the doctor. She mentions that, in addition to representing a more positive and stable scenario, the change to endemic disease encompasses new strategies for coping with the disease.
However, while initially positive, the change in ranking also raises concerns for experts. The reason is that there are doubts as to which rates of infections, hospitalizations and deaths by Covid-19 will be considered “acceptable” by countries for the endemic moment. The concern is that this level of stability is high and, therefore, continues to represent high numbers of cases and deaths. “If we analyze data from countries that have announced a change in the epidemiological scenario from pandemic to epidemic, some of them are very high numbers of cases and deaths. So what would that necessary level be? Zero cases? We won’t make it either,” he says. To determine this estimated limit, infectious disease specialist Adelino de Melo Freire Júnior, medical director of Target Precision Medicine, explains that it will be up to each country to individually assess the epidemiological data. “The authorities classify pandemic levels according to a historical average, you look back and define. It is not possible to define general values, each location will have its value”, he mentions.
‘Endemia is not eradication of the disease’
Although it is the “expected path”, the change from classification to endemic is far from indicating the end of covid-19 and also far from being a comfortable epidemiological scenario, points out Júnior. “Endemia is not eradication of the disease. It’s just the opposite. When you assume that a disease is endemic, you assume that it will remain there. It doesn’t change anything regarding severity, prevention, the individual approach to treatment. You assume they’re going to keep having affairs, that it’s going to stay. This is what is expected of infection with the new coronavirus. The understanding is almost unanimous that we are not going to get rid of it, we are not going to eradicate it. It’s unlikely that we’ll get rid of it completely, that’s not going to happen.” The infectologist even mentions that in the same way that there was a change from a pandemic to an endemic disease in European countries, the reversal is also possible. “If we have a new variant like Ômicron that escapes immunity, that could change. Maybe a little early. I hope it works out, but only time will tell.”
Scenario in Brazil
While Denmark, the United Kingdom, Spain and France advance in understanding Covid-19 as an endemic disease, Brazil suffers from new records of infections and an increase in deaths. This Friday, 11, 144,240 cases and 1,135 deaths from the disease were recorded in the country, according to the Ministry of Health, which is still worrying. However, in some states, such as São Paulo and Rio de Janeiro, epidemiological data already indicate a decline in hospitalizations, which may indicate a decreasing moment of the wave caused by Ômicron. Even if the scenario is different and inaccurate, the understanding is that, in an optimistic forecast, the SARS-CoV-2 pandemic situation will come to an end in the first half of this year. “If we evolve to a disease that has balanced levels, that doesn’t have new waves, that’s what will happen. [classificação de endemia]. Now say when will it happen? Today, we are experiencing an extreme increase in cases. With Ômicron, we break records of cases every day, this is the opposite of an endemic disease. When will it reduce to stable levels and consecutive months to change the rating? Only time will tell”, concludes Adelino Júnior.
