COVID-19 analysis: Experts weigh in on when the pandemic could officially be over

As New Zealanders enjoy their summer with the height of the COVID-19 Omicron outbreak behind us, life is relatively normal.

But if there's one thing that's holding us back from a complete sense of normality, it's the word "pandemic".

Yes, believe it or not - we are still in one. 

"In most spheres, you can see a return to pre-COVID behaviours although not completely," distinguished Kiwi sociologist Paul Spoonley told Newshub. 

"International travel has not returned to pre-COVID levels and migration remains soft (the numbers remain relatively low although pre-COVID levels were at an all-time high thus giving a false sense of proportion)."

Spoonley explained there is a group of people who want to move on from the pandemic, and he suspects they may now be the majority. 

"They have been fatigued by COVID and what it has meant in terms of sociability, as well as travel and work," he said. "My suspicion is this group makes up a majority of New Zealanders.

"But there is another group that remains concerned about the community transmission of COVID and who maintain a range of public health measures. They take seriously both the threat to their own health and that of family members but they also take seriously the possibility of another spike in COVID in the coming months."

So, could there be a further spike in COVID-19 cases in the coming months - hindering the pandemic's end? 

"The question I think people are really asking… is when the public health emergency is over," said Justin Lessler, a professor of epidemiology at the University of North Carolina's School of Global Public Health. 

"For me, that will be when we stop seeing major surges in hospitalisations and deaths associated with new variants and the like. Recent waves have been more muted but I think it is a bit early to say we have gotten to that point."

Adrian Esterman, an epidemiologist from the University of South Australia, said questions about when the COVID-19 pandemic could officially end were ultimately down to what the virus did.

"At this stage of the pandemic, we simply do not know the likely scenario over the next 2-3 years," he told Newshub. 

That was a view shared by Rod Jackson, an epidemiologist from the University of Auckland.

"This will depend on the characteristics of new variants - whether they are able to bypass current immunity (from vaccines and infection), whether they are more severe (and therefore more disruptive) and whether we get new effective vaccines," Dr Jackson said.

China has entered a wave of COVID-19 infections after ending the world's toughest restrictions, meaning it may be too early to declare the end of the pandemic emergency phase because of a potentially devastating toll to come, World Health Organization advisors told Reuters in late December.

"From a public health perspective, the COVID-19 pandemic ends when it becomes a relatively predictable endemic threat," said Michael Baker, an epidemiologist from the University of Otago. "That is a threat that is present but at a level that is not causing significant disruption in our daily lives. We have not reached that point yet as SARS-CoV-2, the virus causing COVID-19, is constantly mutating and generating new variants and sub-variants that are capable of causing unpredictable new waves of infection, which are highly disruptive."

COVID-19 is here to stay

It's clear COVID-19 isn't going away and will become endemic, like influenza.

"So endemic is on the continuum from pandemic to epidemic to endemic, but endemic refers to diseases that are not spreading as much as an epidemic and are more predictable in their spread," Dr Jackson explained. "Endemic diseases are also generally regional but they could be multi-regional but predictable and not too disruptive."

But while COVID-19 isn't endemic yet, the World Health Organization (WHO) said it's "in sight".

The WHO, nonetheless, still deems the pandemic a public health emergency of international concern. 

"Although the public perception is the pandemic is over in some parts of the world, it remains a public health event that continues to adversely and strongly affect the health of the world's population," the WHO said in October.

WHO Director-General Tedros Adhanom Ghebreyesus said while the global situation had "obviously" improved since the pandemic began, the virus continued to change and uncertainties remained.

"This pandemic has surprised us before and very well could again," Dr Tedros said.

Dr Tedros.
Dr Tedros. Photo credit: Getty Images

Virus keeps mutating

Given SARS-CoV-2, the virus which causes COVID-19, keeps mutating - what would it take to bring the pandemic to end completely?

"The ideal situation would be for a new Omicron subvariant to be incredibly contagious but very mild," Prof Esterman explained.

Pfizer said in October its COVID-19 booster jab, updated for the BA.4 and BA.5 Omicron subvariants, generated a strong immune response and was well-tolerated in testing on humans.

"While we expect more mature immune response data from the clinical trial of our Omicron BA.4/BA.5-adapted bivalent vaccine in the coming weeks, we are pleased to see encouraging responses just one week after vaccination in younger and older adults," said Pfizer chief executive Albert Bourla.

What part will vaccines play in the future? 

Doctors continued to strongly recommend getting vaccinated and boosted against COVID-19 for maximum protection against emerging variants.

Scientists the world over have placed high hopes on nasal spray vaccines against the coronavirus because the method is believed to potentially prevent infection and not just disease by prompting an immune response directly in the airways, where the virus enters the body.

However, attempts by Oxford University researchers and AstraZeneca to create a nasal-spray version of their jointly developed COVID-19 shot suffered a setback in October as initial testing on humans did not yield the desired protection. 

Luckily, though the vaccines currently available are still effective.

"COVID-19 vaccines have played a crucial role in protecting people against serious illness, hospitalisation and death from infection with SARS-CoV-2," said Neil Mabbott, the personal chair of immunopathology at the University of Edinburgh. "COVID-19 vaccines remain the most effective and safest way to protect against serious illness and death from the virus," he wrote for The Conversation

Annual COVID-19 boosters like the flu shot could be the way forward, he said.