When it comes to covid-19, 2023 was different to the pandemic鈥檚 previous three years. Across the globe, hospitalisations and deaths reached all-time lows. On 5 May, the World Health Organization (WHO) announced the virus was no longer a public health emergency, suggesting the pandemic鈥檚 crisis phase had ended.
鈥淚t is a really important inflection point of accomplishment,鈥� says at the WHO. 鈥淏ut that鈥檚 not the end of the story. While the crisis is over, the virus is still with us.鈥�
SARS-CoV-2, the coronavirus behind covid-19, emerged in China towards the end of 2019. Since then, , of which fewer than 4 per cent occurred in 2023. And while tens of thousands of people died from covid-19 each week between 2020 and 2022, the weekly reported death rate for most of 2023 was well below 10,000 globally.
Advertisement
Hospitalisations and deaths, the two most accurate metrics for gauging an outbreak鈥檚 severity, have really diminished, says at Vanderbilt University in Tennessee. This is largely due to most people having some form of immunity against the virus, he says. For instance, it is estimated that more than 90 per cent of people in the US and the UK have antibodies against covid-19. 鈥淭his indicates that the virus is now becoming endemic, meaning it circulates at lower levels in the population with occasional outbreaks,鈥� says Schaffner.
Some experts have suggested covid-19鈥檚 risk is now on a par with that of seasonal flu. Yet there are considerable differences between these viruses. Most notably, covid-19 is still rapidly evolving. 鈥淲e don鈥檛 have one variant that is dominant worldwide, so there鈥檚 an unpredictability about what鈥檚 next,鈥� says Kerkhove. Early in 2023, a variant called XBB.1.5 dominated due to its improved ability to infect human cells. It was then overtaken by the even more transmissible EG.5.
at the US Centers for Disease Control and Prevention says emergency responses should be in place for both covid-19 and flu. 鈥淲e should start treating them more akin to one another.鈥� One of these responses should be regularly updating vaccines to better protect people against circulating variants, which has long been in place to control flu. In September, new covid-19 booster vaccines became available in countries such as the US, the UK, France and Canada, targeting XBB.1.5 instead of the ancestral strain.
But not everyone who wants the vaccine has been able to get it. Issues with roll-outs have hindered availability in the US and only individuals at high risk of covid-19, such as older adults and healthcare workers, can get it in the UK and other European countries.
While the threat of covid-19 diminished considerably in 2023, its risk is still far from insignificant. Before the pandemic, there were two main respiratory viruses circulating, respiratory syncytial virus (RSV) and flu. The addition of covid-19 means , straining healthcare systems, says Shah. Four years in, we also still have much to learn about the virus, particularly when it comes to long covid and the risk of repeat infections, says Kerkhove. 鈥淲e still have to be vigilant. We still have to maintain our work to deal with covid, but to deal with it in the context of everything else.鈥�
