Experts: Pandemic to become 'endemic' in the UK

With the Omicron wave starting to fade, more vaccine booster shots being rolled out, and new antiviral drugs emerging on the market, experts say the overall situation in the United Kingdom is improving, with the pandemic moving to become endemic.

Multiple studies have shown that Omicron, the latest variant, is more transmissible, but much milder, leading to lower hospital admissions and COVID deaths.

The latest report from the UK's Intensive Care National Audit and Research Center, revealed that the number of COVID patients being admitted to intensive care units stood at 19 on Jan 23, in comparison to nearly 400 people being admitted each day when the infection was at its highest level in the second wave in January 2021.

Ian Jones, a professor of virology at the University of Reading, said: "There is now no doubt that Omicron is attenuated and taking a step toward endemicity.

"With high immunity and a weakened virus, serious cases of COVID should drop dramatically and without the fear of the infection," he said. "It is endemic now."

The current situation in Britain looks like the rates of infection with the Omicron variant are plateauing after falling from a high of 160,000 new infections per day to a seven-day moving average of 80,000 currently, with a more or less constant level of 250 deaths per day attributed to it.

"This has allowed people to get back to pre-COVID life again," said Fan Chung, a professor of respiratory medicine at Imperial College London and consultant physician at the Royal Brompton and Harefield NHS Trust. "Certainly, there are signs that the infection is on the way to becoming endemic from a pandemic situation," he added.

On Feb 9, British Prime Minister Boris Johnson announced that England planned to end mandatory self-isolation after positive COVID tests, by the end of February.

Compared with other European countries, Chung said it is probably fair to say that the UK is ahead of the trajectory coming out of the pandemic, particularly with the fall in the rates of infections and deaths.

"Other European countries are still recording increasing high levels of infections and deaths, although it is coming down in Italy and Spain, and are still maintaining public health measures and achieving high levels of vaccination," Chung said. "Interestingly, Denmark with still high levels of increasing infections has announced the complete lifting of all restrictions as COVID-19 is no longer considered a critical threat."

But experts warn that this does not mean the end of COVID. "The endemic state does not mean that COVID-19 has become a mild disease and that we are completely out of the pandemic situation," Chung said. "We should not forget that COVID-19 is still widespread and continues to be deadly, although the current Omicron variant is not causing the high rates of hospitalization and deaths that were seen with the previous Delta variant."

Andrew Watterson, a professor of public health at the University of Stirling in Scotland, said while the pandemic is currently diminished, it is not finished. "With mitigations and vaccinations, we are moving back to what is still a new normal," he said.

Watterson reckons it could be a couple of years at least before life is what it was before the pandemic if there are no more variants. "Delta plateaued for many months, but did not disappear in the UK," he said. "The concern will be that Omicron may do the same at quite high levels, but with less severe effects on hospital services and in terms of morbidity and mortality."

He pointed out that in an endemic phase, it is important to continue applying mitigation strategies and protect the most vulnerable in society. "This is what living with an endemic (virus) like COVID should mean for some time," he added.

Speaking in an online meeting of the Royal Society of Medicine, Sir Jeremy Farrar, a former government scientific adviser, said: "I just don't think you wake up on Tuesday and it's finished. It's not going to happen like that."

Public health researchers say although further variants are less likely to be more deadly, countries should not allow complacency to threaten the progress out of the pandemic.

Chung said: "The problem with new variants is that these may not only re-spark a pandemic, but they may also make our current vaccines less efficacious.

"In general, the situation is certainly much better than a year ago and it is right to have a good degree of cautious optimism that the world is gradually getting into an endemic situation with COVID-19, but this optimism should not get us into a sense of laziness and complacency," he added.

Jones said: "I do not think a more dangerous virus will emerge, but the bigger the wave, even of a mild virus, the more likely it will find vulnerable people, so it is here to stay. … The availability of anti-COVID drugs is a positive point which, if they become more available, would push the COVID-specific numbers down even further."