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Will COVID-19 become endemic? Why ‘mild Omicron’ isn’t a cure for Australia


From the very beginning of the COVID-19 pandemic, the biggest question on everyone’s minds was: “When will this all be over?”

Even with most people in Australia double-vaccinated, cases are still going up, people are still getting hospitalised, and people are still dying from the disease.

Nobody expects the virus to just vanish one day. The hope is that COVID-19 will become endemic.

A milder but more infectious strain of COVID could result in more deaths simply because more people are catching it.
A milder but more infectious strain of COVID could result in more deaths simply because more people are catching it. (Getty)

“Endemic means that there’s an expected rate in a population of infection,” Brisbane’s Mater Hospital Director of Infectious Diseases Paul Griffin said.

“We would see it in our population, it could be seasonal or constant.

“But it doesn’t mean it’s gone away or doesn’t cause problems.”

If COVID-19 becomes endemic, it won’t stop it being infectious or deadly.

But it would mean there’s enough herd immunity in the community to keep the virus from spreading out of control – and keep hospitals from being overwhelmed.

At present, there is little indication COVID-19 will quickly become endemic.
At present, there is little indication COVID-19 will quickly become endemic. (Getty)

Professor of Biosecurity at the University of NSW Raina MacIntyre said COVID-19 will never be endemic.

“Case numbers can rise very quickly, requiring surge capacity in the health system,” she said.

“If case numbers overwhelm the health system, people who could have survived with oxygen or other therapy are unable to get into hospital and the death rates rises.

“The death rates we quote depend on everyone who needs hospital care receiving it.”

Dr Griffin is more optimistic about COVID-19’s endemic potential.

“I think it’s very likely, but it really is too soon to know what it’s going to do,” he said.

“Most of us are thinking it will be endemic and here to stay, but exactly what that looks like is dependent on what the next variants are like.”

The ‘Spanish flu’ killed millions of people before eventually mutating into a more benign strain. (National Museum of Health and Medicine)

The so-called Spanish flu pandemic of 1918 ended largely because a more mild strain of the virus took over the deadlier but less infectious strains.

But just because Omicron is less deadly and more infectious than Delta, doesn’t mean widespread transmission will spell the end of the pandemic.

“Omicron may be 30-50 per cent less severe than Delta, but Delta was twice as severe as Alpha and the 2020 virus,” Professor MacIntyre said.

“And the super-transmissibility of Omicron means much higher case numbers will translate to high numbers of severe cases compared to previous variants.”

However, while Omicron is the dominant strain now, that doesn’t mean it will be that way forever.

“Every susceptible host in which the virus replicates gives it an opportunity to spontaneously mutate,” Dr Griffin said.

“We can’t assume the next one will be another step forward like Omicron.

“The next one could go back the other way to what Delta was or worse.”

Developing a vaccine that is resistant to Omicron could be done extraordinarily quickly – but the question is whether it is worth the effort.

“We can adapt our vaccines very quickly,” Dr Griffin said.

“It is very likely that we will need to roll out that variant specific booster.

“It’s hard to know when it will happen.”

While the evidence shows Omicron is more resistant to the vaccine than previous variants, it still makes a big difference.

“We have to do whatever we can to protect people, because we do not know what the next variant will bring,” Professor MacIntyre said.

“Ultimately a universal coronavirus vaccine is the holy grail, and will reduce the need for variant-specific vaccine boosters.”

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Omicron has become the dominant strain of COVID-19 in Australia, however there are still many cases of Delta still in the country, largely in New South Wales and Victoria.



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