Endemic Covid Seniors

California is opening up again and looking to the future. Omicron case rates have dropped 65% in California since the peak wintertime surge in early January 2022. The indoor mask mandate imposed in mid-December 2021 will lift next week, and outdoor large event restrictions will ease too. The state is planning to modify its strategy toward coronavirus from pandemic response to endemic management. As the current wave of cases ebbs, seniors and caregivers in San Diego can look at early signs of how California might adapt to endemic Covid-19.

Coronavirus is considered a pandemic disease up to now because of its exponential rate of spread. As rate of spread begins to slow, a virus downgrades to epidemic, endemic and even sporadic status. Viruses that don’t burn themselves out of new hosts, and history is full of plagues like this. For every smallpox, bubonic plague, or yellow fever that science neutralized, there’s a flu, cold or malaria that we live with but can’t purge completely. These endemic diseases aren’t necessarily milder than their original pandemic versions, they just spread less aggressively. For example, tuberculosis, cholera, malaria and influenza are all considered endemic now, but have killed millions collectively before modern medicine and vaccines tamed them. Still, 627,000 people died from malaria worldwide in 2020, and the CDC estimates that 12,000 – 52,000 people die from the flu and flu-related causes each year in the U.S. Coronavirus is still pandemic, and aggressive variants are still developing, but after two years, many states including California, are looking ahead to how we can all live with Covid. These four recent developments show how California and the rest of the world might adapt to endemic Covid-19:

  1. California’s indoor public mask mandate ends February 15, 2022, as the state’s Covid-19 numbers continue to fall. KPBS San Diego reported that schoolkids will still have to wear masks, as will everyone in “higher-risk areas like public transit and nursing homes and other congregate living facilities … Indoor “mega events” with more than 1,000 people will have to require vaccinations or negative tests for those attending and those who are unvaccinated will be required to wear masks. For outdoor events with more than 10,000 people, there is no vaccination requirement, but masks or negative tests are recommended.” These attendance limits are an increase from 500 indoors and 5000 outdoors, respectively, but the lower level still applies to Super Bowl LVI on February 13 at SoFi Stadium in Los Angeles.
  2. California will adjust its approach to managing Covid-19 in future because health experts assume now that it is here to stay. After nearly two years of strict pandemic control measures, Governor Newsom announced that the state’s new approach considers “the impact on people and businesses from California’s rules, regulations and requirements … [and] allows for the kind of flexibility of thinking that is incumbent upon all of us as it relates to dealing with any endemic, particularly one as stubborn … as COVID.” Some of the new measures include offering up to two weeks of paid time off to workers sick with Covid-19 to encourage them to stay home, supporting new vaccinations and booster shots, requiring quarantines and testing as needed.
  3. A study done in California (pre-Omicron) by the CDC shows that wearing masks inside public places did help curb the spread of Covid-19 in California. After testing randomly selected Californians, the study revealed that “[a]lways using a face mask or respirator in an indoor public setting gave you lower odds of a positive test result, compared with never wearing protection in those settings.” As Omicron is even more infectious than previous versions of Covid-19, wearing a mask indoors is even more important.
  4. A recent study showed that a combined Covid-19 and influenza vaccine is as effective as individual shots administered separately. According to KPBS San Diego, “The study followed over 300 people split into three groups. One group received just the flu vaccine, one just the COVID-19 booster vaccine, and the other a mixture of the two. Researchers found the group who got the combo vaccine had just as much protection against COVID-19 and the flu as the groups who got the stand-alone vaccines.” The participants experienced no serious side effects from the combined vaccines. Moderna is developing a combo vaccine that may be available within 18 months.

We will need to continue to take precautions against Covid-19 in the future, as we do for the other diseases that shifted from pandemic to endemic status. Just as many people get the flu shot each year, we may all need to continue to wear masks, distance appropriately, and get boosted regularly.