After two years of the coronavirus, Missouri Gov. Mike Parson and other state officials have said they’re planning an “end” to the coronavirus pandemic as early as March. The state health agency plans on treating the virus as endemic — a persistent problem like the flu instead of an acute threat.
Local and federal health authorities also are ramping down precautionary measures. St. Louis County Executive Sam Page recently announced the county would soon end its mask mandate for indoor public spaces. Late last week, officials from the Centers for Disease Control and Prevention said that most people in many parts of the United States with low transmission rates could also forgo masks.
St. Louis Public Radio’s Sarah Fentem asked Lynelle Phillips, University of Missouri public health professor and Missouri Immunization Coalition Board president, if it's time for Missourians to learn to live with the virus and whether the state is jumping the gun on its new plan.
Sarah Fentem: How will we know that the virus has gone from pandemic to endemic?
Lynelle Phillips: Well, we're getting experience with it. And so we look at things like seven-day case rates and what we think will be typical for the circulating virus. But if we start having a new variant appear, and our hospitals are under strain again, and our case rates start going up, you know … we would be back in the realm of epidemic or pandemic.
Fentem: I don't have to tell you that we've been here before: You know, cases decrease, hospitalizations go down, and we think the viruses in the rearview mirror. And then delta comes, omicron comes. What would you say to people who are worried that the same thing will happen in the near future? Do you think that we could get to that point again?
Phillips: I would say that anybody that's tried to predict the future for COVID, their crystal ball has broken. Nobody has been good at predicting how this is all going to go down. And so we're hopeful that the worst of the pandemic is behind us, and certainly I am among those that is very hopeful, but that doesn't mean that we should drop our guard. We learned so many lessons from this virus, we need to utilize those lessons learned and be prepared.
So hopefully, it'll be like, ‘OK, we're about to get nailed with a snowstorm, we know to put our coat and boots on.’ We might have a new variant emerge, we're about to get swept by it, we need to put our masks on. I hope that people just incorporate that into their lives.
Fentem: Missouri state officials have said they're planning to begin treating the virus as endemic starting as soon as next month, or starting as soon as in March. Do you think the state is at that point yet where we can make that transition?
Phillips: I don't like to predict the future. But again, this is a vaccine-preventable disease. So all of our programs, we are evolving around adult vaccine promotion need to really be ramped up and prioritized. We still have a lot of unvaccinated Missourians.
[And] I think our local public health system still needs basic CPR. I mean, those guys' morale and their infrastructure and their ranks of the public health workforce just all need a lot of TLC and a lot of funding.
We need to move forward, we need to move forward and get funding to our local public health system. They are the frontline, they are going to be the primary players in all of this moving forward in terms of COVID being a vaccine-preventable disease.
Fentem: A lot of this spread is based on immunity or lack of immunity. Have enough people been vaccinated or have gotten sick to keep another big spike from happening in Missouri, especially if we start treating this more as an endemic virus and not as an epidemic?
Phillips: From a purely theoretical standpoint, the omicron virus was so, so contagious. I mean, it spread like measles. And so it seems as though everybody has either been exposed and built up some antibody response to omicron or we’ve been vaccinated.
So the question is, how long and how durable is that immunity? And how long will it persist? Or will it wane over time? We'll need to do some more work to understand how immunity persists in a population and what we need for herd immunity and how that's all going to work moving forward.
Fentem: Do you think it's too soon for the state to make that decision given, like you said, what we know and don't know about long-term immunity?
Phillips: You know, I have mixed feelings about that. I think, on one hand, there's a mental health toll that we've all suffered — some more than others — during this whole pandemic. So kind of putting closure to the whole event, I think, would be very healing for people. But at the same time, it would be easy for people to lapse into, ‘Oh, the pandemic’s over, back to life as normal.’ And that is absolutely not the case.
We're transitioning to a different set of strategies in our toolbox: really promoting vaccines, we're transitioning to putting strategies that we know that work in place for emergency response purposes and outbreak response purposes.
One really effective strategy around the strategy that we used in this state — and we were really front-runners in this — was sewer shed surveillance. It's a huge asset for the state and absolutely needs to continue, because it's our early warning system.
People have really, really suffered in these last few years. And I hope that in a time that we can really give that whole situation some grace and start a healing but grieving process for that as well. Because, you know, there’s a lot of grief out there.
Follow Sarah on Twitter: @petit_smudge
