Optimism should be maintained to welcome Covid-19 as an endemic and serve to stimulate all parties to work harder to end the pandemic. Unity should be maintained in discipline, rather than relaxed.
By
DEONISIA ARLINTA
·6 minutes read
The saying goes: “This storm, too, shall pass.” The same spirit has prevailed in the current phase of the Covid-19 pandemic. This pandemic storm will surely pass. But when will the pandemic turn into an endemic? The answer may depend on the role we all play.
The first Covid-19 cases in Indonesia were reported on 2 March 2020. Since then, its transmission has gone up and down. At its peak in February 2022, the daily caseload reached 64,000. Yet the pandemic brought a wave of tragedy in July 2021, when the number of cases reached the highest rate of hospitalization and mortality. Health services collapsed. At the same time, the circumstances revealed that our health system was, indeed, fragile.
Restructuring was carried out and improvements were made, not only by the government but also by the public. These efforts included awareness campaigns to control and prevent Covid-19 infections in community.
Today, the pandemic is increasingly under control in Indonesia. Despite the recent rise in cases, Covid-19 infections in Indonesia are still categorized as level one according to the community transmission index of the World Health Organization (WHO).
The index shows that Indonesia’s community transmission is less than 20 confirmed cases per 100,000 people per week. Furthermore, the hospitalization rate is less than 5 cases per 100,000 people per week, while the death rate is below 1 per 100,000 people per week.
The situation has been under control for at least the last six months. In the middle of the year, the government stated that the country was entering a period of transitioning from a pandemic to an endemic. The health protocols were eased, and wearing masks outdoors was no longer mandatory. Travelers were no longer required to present results from Covid-19 tests, whether polymerase chain reaction (PCR) or antigen tests.
This gave rise to euphoria among the public. This transition was seen as the end of the pandemic, as an endemic was believed to restore life to normality, as it had been before the pandemic. In reality, however, an endemic does not mean that infections would disappear. The risk remains that the disease could resurge.
The lessons from the last three pandemics show that a pandemic changes into an endemic 1.5 to 2 years after disease incidence.
As Deputy Health Minister Dante Saksono Harbuwono explained at a meeting with House of Representatives Commission IX on 23 May 2022, the patterns of previous pandemics showed that a shift from a pandemic to an endemic would not necessarily lead to the virus’ elimination in society.
A variant of the H1N1 virus that causes Spanish flu, for instance, continues to exist today. But the pathogen has ceased to spread because many people are protected by the immunity they have developed through vaccination or infection. In addition, the succeeding virus mutations have been relatively less dangerous. The pattern of the virus’ spread can also be detected so they can be predicted.
“The lessons from the last three pandemics show that a pandemic changes into an endemic 1.5 to 2 years after disease incidence,” said Dante.
Optimism
The relatively controlled situation in Indonesia should raise a collective spirit of optimism to welcome Covid-19 as an endemic. The global situation also reflects the same spirit.
WHO Director General Tedros Adhanom Ghebreyesus, in his opening speech on 23 Sept. 2022 at the United Nations General Assembly, said the world had never been in a better position to end the Covid-19 pandemic as a global health emergency. The number of reported weekly deaths had been the lowest since the onset of the pandemic.
Notwithstanding this, many arrangements had to be made to prepare for the end of the pandemic. Vaccination should be expanded and maximized. Vaccination disparity should be overcome immediately, especially in terms of vulnerable groups, like the elderly.
All countries were urged to intensify control, testing and genome sequencing. Besides, supplies of Covid-19 antivirals should be made available everywhere.
“We are not there yet, but the end is in sight,” said Tedros. He compared the end of the pandemic to a marathon runner reaching the finish line: A marathon runner did not stop once the finish line came into view, but simply ran harder with all the energy they had left.
“So must we. Now is the time to run harder and make sure we cross the line and reap the rewards of all our hard work,” Tedros underlined.
We are not there yet, but the end is in sight.
Therefore, what will happen in the future will highly depend on the efforts we make now. If the pandemic is to end soon, we should brace ourselves now. The ongoing virus mutations can be overcome if everyone in society has immunity. Coexisting with Covid-19 is one way of surviving it.
The WHO has issued a guideline on coexisting with Covid-19, in which infections are controlled to sporadic or localized outbreaks, with adequate availability of health facilities and capacity towards minimal risk of transmission and preventive community measures to manage the risk of imported cases. No less important is strong and active public participation.
Epidemiologist Pandu Riono, from the University of Indonesia’s public health faculty, said during a visit in Jakarta on Tuesday (22/11/2022) that public awareness about following the health protocols was also a sign of preparedness to enter the endemic phase. People should voluntarily wear face masks in crowds. They were also expected to maintain clean and healthy lifestyles. People were also aware of the need to be tested or self-isolated if they developed symptoms of Covid-19. Public participation would significantly determine the state of Covid-19 transmissions in the future.
“The present situation should already be an endemic. So, intervention should better focus on vaccination and the health protocols. We should be confident about ending the pandemic together. Also, make sure that the most vulnerable groups are protected,” said Pandu.
For this reason, today’s top task was to achieve optimal vaccination coverage against Covid-19, including boosters for at-risk groups. Vaccination should reach coverage of at least 70 percent of the population. For vulnerable people like the elderly, vaccination coverage should reach 100 percent for optimal protection.
As of 28 Nov. 2022, coverage of the two primary vaccine doses reached just 64 percent of the population, while coverage of the booster dose, or third jab, reached a mere 24.6 percent. Meanwhile, among senior citizens, primary dose coverage was 70 percent of the target, with the first booster dose at 32 percent.
Stakeholders needed to make various breakthrough policies to increase vaccination coverage. Vaccines must be made available to and easily accessed by the public.
The endemic is no longer a mirage. Nevertheless, all parties should realize that the pandemic is still not over yet. The optimism to welcome Covid-19 as an endemic should be developed together with awareness and concrete action in fighting the coronavirus.