Still a pandemic? Endemic? Becoming like the flu? Whatever the term, covid-19 has become more manageable

Experts in the Pittsburgh region generally agree with Dr. Anthony Fauci’s assessment this week that the United States is “out of the pandemic phase” of covid-19, the virus whose death toll is closing in 1 million in the U.S. alone.

“ ‘Over’ is a strong term,” said Dr. Donald Whiting, chief medical officer of Allegheny Health Network. “Being out of the ‘pandemic phase’ is accurate in that we’re not seeing thousands and thousands of cases every day and hundreds and hundreds of hospitalizations every day.”

The number of people becoming infected with the virus is relatively low, Whiting said, as is the severity of the virus for those who are infected.

“As I’ve been saying for some time, we are seeing a major decoupling of cases from hospitalizations which, to me, marks a transition point in the pandemic,” said Dr. Amesh Adalja, a Pittsburgh-based infectious disease and critical care expert.

The country, experts say, is in a much different position with covid-19 than it was even a year ago.

In Allegheny County, there has been a slight increase in cases after weeks of lows not seen since summer 2021. The positivity rate rose from 8.4% in the second week of April to more than 11% in the third week, though the number of people being tested for the virus fell. From April 21 to 27, 72 covid hospitalizations were reported in the county, according to health department data.

Westmoreland County, too, saw a slight bump in cases over that same time period, according to state data. Eleven people in the county were hospitalized with the virus as of Thursday, data showed.

It’s a trend mirrored across the country, though the rise is slow and slight instead of the rapid and sharp increase seen in previous spikes, like that driven by the omicron variant at the start of the year.

“With a high level of population immunity as well as the medical countermeasures science and medicine have given us, the U.S. is clearly in a different context than in earlier times during the pandemic,” Adalja said.

As it stands, he said, the country is better positioned to overcome covid-19 than other such viruses, noting that “of all the respiratory viruses that circulate, we wield the most tools against SARS-CoV2.”

Fauci, the country’s top infectious disease expert, told The Associated Press that after the surge of the brutal omicron variant, “we’ve now decelerated and transitioned into more of a controlled phase.”

Dr. Donald Yealy, chief medical officer for UPMC, said Fauci is likely trying to communicate in simple terms that the virus and the interventions used against it have evolved.

“Terms like whether or not it’s still technically a pandemic, or has become endemic or some other version, really aren’t particularly helpful at any moment in time,” Yealy said. He said noting how the virus has evolved and how it is affecting people is most important at any given time.

“Words like ‘we’re out of a pandemic and into something else’ I don’t think are terribly illustrative, because the virus may change again and we may experience a set of conditions that look very much like the pandemic did once before.”

Fauci did note that “by no means does that mean the pandemic is over.”

In Allegheny County, just over 81% of residents age 5 and older are at least partially vaccinated, according to the county health department.

That fact coupled with effective medications, said county health director Dr. Debra Bogen, means likely that “we are moving closer to covid-19 becoming more like influenza — that is, an infection that waxes and wanes in the community both locally and around the world.”

Whiting agreed, noting new strains or variants could lead to more severe illness or an uptick in cases and hospitalizations. The way things stand right now, though, is likely what the reality of the virus will be for the foreseeable future.

“(Covid-19) is going to be endemic and with us (and) to some degree, mitigable with vaccinations just like the flu,” he said.

But, Bogen warned, “I don’t have a crystal ball.” She noted that circumstances can change rapidly and people must continue to be adaptable.

“There could be new variants, and we should all keep our masks handy,” she said. “But the current situation does, indeed, suggest that we have moved into the next phase of the pandemic — one in which a return to a ‘new normal’ is realistic.”