Ending the coronavirus pandemic when it becomes a "flu"

Last update: Friday 3/5/21

Who is going to ring the bell that signals the official end of the coronavirus pandemic? President Biden? His medical policy advisers? U.S. governors? Since March 2020 the U.S. has been engaged in a total war against the coronavirus, but lately no one has been saying what victory will look like. 

In previous months the president's advisers have said that the pandemic would end when the country achieved herd immunity via infections and/or vaccinations. However, as pointed out in another note on this blog, it is far more likely that the attainment of herd immunity will be a ragged process wherein some states achieve herd immunity before others. Governors of immune states will then declare the end of the pandemic in their states and rescind all social mitigation mandates, regardless of what the president's medical advisers recommend.

• "The coming uneven, messy, confusing end of the COVID pandemic", Last update: 2/26/21

Ideally we would know that a state had achieved herd immunity when the number of new cases, hospitalizations, and deaths flattened out at zero for some period of time, e.g. a month. Unfortunately, the rise of significant new mutations makes a zero goal unrealistic. Indeed, the nation's virus experts have increasingly warned that it is likely that we will all have to receive updated booster shots from time to time in order to maintain our immunity against significant new variants -- just like we have to be revaccinated every year against seasonal flu that mutates from year to year.

Everyone in the U.S. and other developed countries might be vaccinated within the next 12 to 18 months, but it is highly unlikely that all of the billions of people in poorer countries will be vaccinated. These countries will provide fertile grounds for the virus to continue to spread and mutate. Travelers to and from these countries will bring the new mutations back with them to the developed countries. 

Given that a zero level is unrealistic, the question of when the pandemic will end for states or for the country as a whole becomes: How low is low enough? 

The seasonal flu suggests an alternative benchmark. We don't lock down states nor the country as a whole during flu season. Upwards of 80,000 Americans die from seasonal flu every year, but we never consider lockdowns as an appropriate response.

In the early months of the coronavirus in 2020, and even later, many people dismissed the virus as just a bad flu, but it wasn't; it was much deadlier. However, in the coming months as more and more people are vaccinated, the virus will become less and less lethal. Sooner or later it will be no more deadly than seasonal flu. At that point for the country as a whole or for individual states, why not declare victory over the virus and rescind restrictive mandates? 

• Upwards of 80,000 Americans die from seasonal flu every year out of a total population of about 330 million. Calculating the number of deaths per 100,000 in the population = (80,000/330,000,000) * 100,000 = about 24 deaths per 100,000. Flu season is about 7 months long (October through April); so the monthly rate is about 24/7 = about 3 deaths per month per 100,000 population.
  
  
• The total U.S. deaths for the virus reached 400,000 on 1/19/20 during its period of greatest activity. (See "The virus death toll in the U.S. has passed 400,000.", Patricia Mazzei, NY Times, 1/19/21).
  
  We passed 500,000 on 3/5/21, about six weeks later. (See "Covid-19: U.S. Surpasses 500,000 Covid-19 Deaths, a Monumental Loss", NY Times, 3/5/21)
  
  A four week month is two-thirds of six weeks, so the monthly increase would be 100,000 * 2/3 = about 67,000
  
  The U.S. coronavirus death rate during its peak period = (67,000/330,000,000) * 100,000 = about 20 deaths per month per 100,000 population ... which is 20/3 = about 7 times the monthly death rate for a flu.

We clearly have a long way to go on a national level, but some states may be much closer to their seasonal flu benchmarks than others. Note that cautious residents of benchmark states would still be free to wear masks, keep social distances, avoid crowds, and wash their hands frequently ... just as they do during flu season.