Open AccessLiving with COVID-19: The road ahead
Author(s) -
Wycliffe Enli Wei,
Wei Tan,
Alex R. Cook,
Li Yang Hsu,
Yik Ying Teo,
Ver Jian Ming Lee
Publication year - 2021
Publication title -
annals, academy of medicine, singapore/annals of the academy of medicine, singapore
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.299
H-Index - 60
ISSN - 0304-4602
DOI - 10.47102/annals-acadmedsg.2021244
Subject(s) - pandemic , medicine , preparedness , psychological intervention , vaccination , outbreak , environmental health , epidemiology , disease , covid-19 , development economics , infectious disease (medical specialty) , immunology , virology , pathology , political science , economics , law , psychiatry
: The COVID-19 pandemic has affected the world for more than a year, with multiple waves ofinfections resulting in morbidity, mortality and disruption to the economy and society. Response measuresemployed to control it have generally been effective but are unlikely to be sustainable over the long term.Methods: We examined the evidence for a vaccine-driven COVID-19 exit strategy including academicpapers, governmental reports and epidemiological data, and discuss the shift from the current pandemicfooting to an endemic approach similar to influenza and other re spiratory infectious diseases.Results: A desired endemic state is characterised by a baseline prevalence of infections with a generally milddisease profile that can be sustainably managed by the healthcare system, together with the resumption ofnear normalcy in human activities. Such an endemic state is attainable for COVID-19 given the promisingdata around vaccine efficacy, although uncertainty remains around vaccine immunity escape in emergentvariants of concern. Maintenance of non-pharmaceutical interventions remains crucial until high vaccinationcoverage is attained to avoid runaway outbreaks. It may also be worthwhile to de-escalate measures inphases, before standing down most measures for an endemic state. If a variant that substantially evadesimmunity emerges, it will need to be managed akin to a new disease threat, with pandemic preparednessand response plans.Conclusion: An endemic state for COVID-19, characterised by sustainable disease control measures, islikely attainable through vaccination.Keywords: COVID-19, endemic, non-pharmaceutical interventions, transition, vaccination