The potential transformation of Covid-19 from a pandemic to an endemic has recently been forecasted by the World Health Organisation (WHO). While India has made significant strides in controlling the virus’s spread, the probability of it becoming an endemic could pose a critical vulnerability.
Understanding Endemic Diseases
Before delving into the implications of Covid-19 becoming an endemic disease, it is essential to understand what endemic means in this context. A disease is classified as endemic when its infectious agent or presence is constantly prevalent within a specific geographical area or amongst a certain group of people. If the number of cases starts to grow, it is labelled as an epidemic. When an epidemic spreads across several countries or regions, it becomes a pandemic. Examples of endemic diseases can be found in predictable annual occurrences of chicken pox and malaria in specific parts of the world. According to WHO predictions, the novel coronavirus may join these ranks and become a permanent fixture within communities.
The Role of R0 in Disease Spread
To comprehend how a disease spreads, we must consider the mathematical figure ‘R0’ or “R-naught.” R0 indicates the average number of individuals who will contract a disease from an already infected person within a population that has no immunity to the disease. If R0 equals 1, the disease is endemic. However, when the R0 is above 1, the disease is on the rise and will eventually become an epidemic.
Transition From Epidemic to Endemic
As a disease transitions from being an epidemic to endemic, there is a marked shift in responsibility for protecting oneself from the government to the individual. Instead of governmental agencies actively engaging in identifying and tracking cases, individuals are responsible for managing risk and seeking care. The sociopolitical response might also change, with investment into the disease becoming institutionalized, driving behavioural changes in people. Typically, diseases that are at the epidemic stage have greater mortality and morbidity rates compared to endemic diseases due to a lack of clinical knowledge and experience. However, over time, effective prevention, and treatment methods emerge for endemic diseases.
The Varieties of Endemic Diseases
Endemic diseases can be broadly segmented into two categories: holoendemic and hyperendemic diseases. Holoendemic diseases predominantly affect children and have high prevalence rates in early life stages. Adults are less likely to display signs of the disease. Malaria is an example of a holoendemic disease. Alternatively, hyperendemic diseases maintain continual presence at high rates and affect individuals across all age groups equivalently. African Sleeping Sickness and Chicken Pox are examples of hyperendemic diseases. The potential transition of Covid-19 to an endemic disease adds another layer of complexity to combating the ongoing health crisis.
