May 7, 2023
PANDEMIC TO ENDEMIC
March 11, 2020, WHO declared COVID-19 a PANDEMIC; three years later, on May 5 2023, WHO declared COVID-19 no longer an emergency condition. In the meantime, Society and healthcare downgraded the pandemic to endemic status. 7 million people would die worldwide during the former phase; millions more were sickened. Worldwide, all endured lock-downs, mandatory social isolation and or “distancing”, and protective gear adornment, travel restrictions, as well as disrupted economies and finances, disrupted education and employment. Mental health was affected; existing social, economic, and health inequalities were exposed while deliberate exploitative misinformation tore the society to shreds, or rather into camps that developed some level of intolerance for one another, sabotaging the effectiveness of useful, helpful science-based remedies that had been developed to combat the virus. It must have been a similar experience with the Influenza pandemic of 100 years ago.
As this entry is being made, there are vaccines that have proven effective in significantly decreasing mortality due to COVID-19, and in decreasing the seriousness of the disease; there are proven antiviral treatments to prevent the disease before or after exposure, and to treat the disease itself. While the virus continues to do what viruses do (undergoing mutations resulting sometimes in increased infectiousness and or virulence), the effectiveness and utility of these interventions continue to hold up – thanks to health science. We did not have these remedies at the beginning of the pandemic. And thanks to the society who adopted recommended generic public health although, despite a division of society (especially in the US) along partisan and ideological lines. Public health-directed Free home testing availability helped with early diagnosis and timely implementation of necessary measures and treatment.
The “endemic” part today is that the virus is still very much around as an undying line of mutated strains, is still causing disease, but the incidence of serious illness has diminished – mild enough for the afflicted to successfully opt out of efficacious antiviral treatment. Mandatory mask-wearing is no longer in vogue, and nearly everyone is off masks. Schools have reopened and social gatherings are back in vogue. There are hardly any travel restrictions. The US is set to declare the COVID-19 Emergency ended starting May 11 2023. However, there is still mortality associated with the viral infection in persons placed at high risk because of other underlying conditions.
That is the broad context of our journal which reports on our little clinic system and our patients, staff and community through this dangerous, world-, society- and person-changing pandemic. Over one million COVID deaths were recorded in the US, with over 100,000 in in the state of California alone, of which 800 deaths were reported in Monterey County. Few CSVS patients died (less than ten, to our knowledge) from COVID. No staff person died; however, 60% of the staff tested positive for the virus, with one third of those affected having recurrent infection. There were no staff hospitalizations. This favorable outcome (mild disease only) is a testament to full vaccination of the staff, staff use of PPE, hand-washing and appropriate triaging and isolation of patients to minimize exposure to positive-testing persons.
We use data to tell our story. One caveat: the data-tallies towards the end are not entirely representative, given that the availability of home test kits, pharmacy and other testing and vaccination centers allowed for relevant transactions and activities outside our system that we could not possibly capture.
As COVID-19 joins the list of human afflictions that stay with us all the time, to be subjected to prevention by effective seasonal vaccination (preferably, to confinement to the shelf of eradicated viruses), we leave you with two of some of the unforgettable image-symbols of the pandemic besides face masks (which by the way, will no longer be required at CSVS, starting May 11, 2023)…