Omicron shows the danger of treating coronavirus like an emergency

Has Omicron hastened the transition from pandemic to endemic?
Has Omicron hastened the transition from pandemic to endemic?
Image: Reuters/Dado Ruvic
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Almost 21 months after the World Health Organization (WHO) declared covid-19 a pandemic, the world is once again paralyzed by the emergence of a new, as yet somewhat unknown, variant. Omicron, which was first sequenced in South Africa, is believed to be extremely contagious, though not necessarily especially severe. Reports so far point to very mild cases that don’t require hospitalization.

Nevertheless, the covid-19 emergency machine kicked into full gear. The US banned travel from eight southern African countries, of which two, South Africa and Botswana, have reported cases. The EU, Japan, Canada, and others are expected to replicate the approach, despite the fact that the benefits of travel bans are temporary at best, and the global spread of covid-19 despite travel restrictions showed their limited efficacy.

But the true limits of the travel ban are in the thinking it betrays. It’s yet another example of treating covid-19 as an emergency, rather than the consequence of systemic issues.

The danger of a pandemic mindset

In a 2009 essay he co-authored, titled What is a Pandemic?, Anthony Fauci, the White House chief medical advisor who leads the US covid-19 response, discussed the complicated matter of defining a pandemic as opposed, for instance, to endemic disease. He identified several elements that characterize pandemics, including novelty, widespread geographic distribution, high attack rate, and low population immunity. Yet in the essay, he doesn’t address the public health implications of political decisions to label a widespread disease a pandemic and sustain a level of high alert.

We see that component play out clearly with covid-19. “The thought is that if you can maintain a state of emergency, if you can make people feel the crisis, then you will be able to generate enough political momentum to institute effective policies to protect people,” says Eric Reinhart, a physician and anthropologist at Northwestern University.

A series of international cooperation measures—such as patent licensing for antiviral drugs—are contingent on maintaining the emergency, and will cease once the WHO declares the pandemic over. Domestically, in the US, free covid-19 testing, vaccinations, and treatment are emergency provisions.

Yet the problem of relying on this framing of emergency is that it implies the situation prior to covid-19 was acceptable, and once the crisis is over things can go back to what they were. “The prior state of normalcy to which people are trying to return, and our politicians certainly wish to return, is a state that produced the crisis that we are presently in,” says Reinhart. “We might more appropriately say that the pre-pandemic state was a state of constant crisis.”

Both on a local and global scale, the pandemic has not so much introduced a new crisis as highlighted existing ones. For disadvantaged populations, both in the US and globally, the state of emergency is actually the norm. Within the US, the same groups that are now paying the highest price for covid-19 were, prior to the pandemic, disproportionately affected by the burdens of chronic disease and other social determinants of poor health. Globally, the same populations now left without enough vaccines or treatments have long been suffering and dying from diseases that are treatable in wealthy nations, such as tuberculosis, HIV, or diarrheal disease.

How to move beyond the pandemic

Whether or not omicron ends up being a truly dangerous variant, the sudden disruption its emergence has caused should point to the inherent failure of addressing the ongoing pandemic as if ad hoc, emergency solutions are sufficient.

One way to move past the current approach is to think of the pandemic as a sustained status—essentially using the political momentum that is strengthened during a crisis to introduce lasting change. This begins with taking a more equitable and collective approach to controlling covid-19, one that distributes resources in a way that takes into account global health rather than allocating resources and profits to rich countries.

Whenever it rears its head, covid-19 shows us the world and its health are truly interconnected, and individual defenses aren’t enough to fend off a global threat. But the only way to reduce the impact of future epidemics—or ensure they are handled more efficiently—is to hold onto this kind of collective mindset. Changes such as frameworks for international patent sharing or continued access to testing and care without out-of-pocket costs must become part of the system even in the absence of a recognized pandemic. This way, we can move toward a system against which the losses of hundreds of thousands of lives is truly the exception—not just a variation of routine occurrence that hits closer to rich western homes.