When the first cases of COVID-19 began accumulating around the world, the World Health Organization (WHO) was under pressure to declare the disease a pandemic. That announcement unlocked the keys to additional funding, resources, and emergency actions to control cases.
Now, in a 60 Minutes interview, President Biden has said that “the pandemic is over.” He cited the fact that people are no longer wearing masks, that large public events such as the Detroit Auto Show have resumed in person, and that concerns about COVID-19 no longer dictate our behaviors in the way they did over the past two years.
But public health experts are wary about the declaration, concerned it will mean that people have license to abandon the already fragile networks of behaviors that are trying to keep a highly contagious virus from breaking free again to cause another wave of disease. It’s also a concerning sentiment to arrive just as health officials in the U.S. launch a booster campaign to reinstate waning protection from vaccines before the fall and winter, when respiratory viruses like SARS-CoV-2 tend to have free reign.
The reality is that while Biden’s statement that hardly anyone is wearing masks is true, that’s largely the result of weariness on the public’s part, and because a judge in Florida overturned federal mandates requiring masks in government buildings and on mass transit. Therefore, the disappearance of masks cannot be interpreted entirely as the result of reduced risk from the virus.
The President’s declaration is “counterproductive because it reinforces the impression that many people have that we don’t have to worry about COVID-19 any more,” says Dr. Eric Toner, senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health. “By pandemic, most people mean that people around the world are susceptible to an infectious disease for which people do not have immunity, and therefore could cause serious illness. It is absolutely true that the pandemic is much less severe than it was. But the fact is, we still have 65,000 new reported cases every day, and 450 deaths a day, which annualized is 170,000 deaths a year. So it’s not over.”
Yes, infections are on the decline, and yes, deaths from COVID-19 are also dramatically lower than they have been since the Omicron wave hit earlier this year. But more than 500 people are dying on average each week from COVID-19, and in a worrying sign, hospitalizations, especially among the elderly, are creeping up as the immunity provided by vaccines declines.
Declaring that the pandemic is over will inevitably lead people to a sense of complacency that infectious disease experts believe is premature. Even if we’re moving toward a reality in which COVID-19 becomes more like the flu, with an annual (or more frequent) shot, COVID-19 still causes far more infections and deaths than flu does on average. The truth is that the Omicron variant, and its latest subvariants, BA.4 and BA.5, are highly contagious. And while they don’t seem to be causing more serious disease, here’s the thing about viruses: the more infections a virus causes, and the more hosts it infects, the more chances it has to replicate. And every time it makes more copies of itself, it can generate mutations. The more mutations are generated, the more likely it might be that one or a few of those mutations could lead to a more virulent version that does cause more severe illness.
The threat from COVID-19 is certainly not the same as it once was, and vaccines and antiviral treatments have changed that. Those have been made available in the U.S. because the government declared COVID-19 a state of public health emergency, which allowed Congress to dedicate funds to provide those shots and therapies for free to the American public. The Department of Health and Human Services (HHS) recently renewed that designation until at least the end of October, and the WHO has not yet declared victory over COVID-19 either.
Declaring the pandemic over could jeopardize that continued funding, just when it might be needed most, to vaccinate people with the first Omicron booster before the winter. “When the administration is trying to get new money from Congress for COVID-19, it just seems like an ill-timed and inaccurate message,” says Toner. Already, the HHS has shifted funds from other health services to provide these booster at no cost to the public, according to Secretary Xavier Becerra during a recent briefing.
When will COVID-19 be over? There are no strict definitions for what constitutes a pandemic, nor for when it has run its course. The scale of the disease, in terms of its range around the world, is among the primary criteria for declaring a pandemic, and similarly, declines in cases and spread of illness would factor into its completion. But those decisions are as much economic as they are epidemiological—as a pandemic, COVID-19 will cost the global economy $12.5 trillion by 2024, according to the latest estimates from the International Monetary Fund. And that funding has strained governments around the world, both in the developed and developing world; if COVID-19 is no longer a pandemic, that would mean governments might be less obligated to dedicate significant resources toward things like testing, vaccine programs, and treatments. And with the White House taking the lead in declaring the pandemic over, that might encourage governors of states who are already inclined to limit COVID-19 response measures to eliminate them altogether. That in turn could lead to lower protection as more people who aren’t boosted gather indoors, unmasked, during the colder weather when viruses spread more easily.
This winter will be an important one when it comes to seeing where the pandemic goes from here—with a new, more closely matched booster to the Omicron variant, it could continue to decline, getting closer to behaving like influenza. Or, if people believe that they don’t have to worry about COVID-19 any more, Omicron, or even a yet-to-named variant, could lead to another surge in cases.
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