A woman walks outside of a COVID-19 testing center at the Incheon International Airport In Incheon, South Korea, on Feb. 10, 2023. 

'The pandemic is still with us': The bumpy road to the end of COVID

Pinpointing the “end” of the coronavirus pandemic depends on the vantage point. The World's host Marco Werman spoke with Dr. Michael Mina, a leading epidemiologist and the chief science officer at EMed, a digital health care company, along with Zeynep Tufekci, a sociologist and professor at Columbia University, to learn more about the "bumpy, difficult off-ramp" from COVID-19.

The World

By now, most of us have gotten used to the idea that COVID-19 will probably never be eliminated.

Still, every day we seem to edge closer to what could be the end of the pandemic.

The White House plans to let COVID-19 emergency declarations expire in May. The leader of the World Health Organization, Tedros Ghebreyesus, said he expects the WHO will declare an end to the pandemic later this year.

But pandemics don't draw to a close for everyone everywhere. At the same time, the end is rarely neat and simple.

To learn more about when and how the end of a pandemic is determined, The World's host Marco Werman spoke with Dr. Michael Mina, a leading epidemiologist and the chief science officer at EMed, a digital health care company, along with Zeynep Tufekci, a sociologist and professor at Columbia University.

Marco Werman: Let's start with the big picture. Michael, I'll turn to you, first. Place us where we are today with the pandemic, early April 2023, some three years after it began. 
Dr. Michael Mina: Yes, we're at a place where nearly every human being on Earth has been exposed to some protein that's associated with this virus. And that means that almost everyone, either through vaccination or infection, has some level of immunity to the virus. It doesn't mean everyone's immune to it, but it means that the role that this virus is having in terms of plaguing society is diminishing. And we are on what I like to call a very, very bumpy, difficult off-ramp of this pandemic. And it's really happening exactly how it was always anticipated to happen, which is the development of immunity, ideally through vaccines and hopefully this virus. You know, as we fast forward in time a decade or more, you know, it really starts to become in our rearview mirror as a significant health threat. That's on the scale of what we've seen over the last few years.
A question for both of you. Medical professionals wait for death rates to subside and immunity to build. Social scientists like you tend to focus on perceived risk. And when fear of a disease diminishes. How do you square those two often competing issues? 
Zeynep Tufekci: Pandemics don't end in just sort of this, you know, "snap your fingers," it's over. Also, when they do stop feeling like pandemics as an emergency, that doesn't mean we have gone back to exactly where we were before. So what we have right now is we've added one more respiratory illness to the annual toll of respiratory illnesses, influenza, RSV. And now we have this. So it's going to be an additional burden on us. The second thing is what happens to people who got long COVID. For them, the risk isn't lower going forward. And before they could kind of count on the rest of us being afraid to try to keep the virus circulating low. But as Dr. Mina has explained, most people have gone back to their pre-pandemic lives. They've been vaccinated. Many people have had a breakthrough, which turned out to be uneventful for them. They're living their lives. But we have a population of people who are still ill, some of them severely ill, who now are left to their own devices.
Michael, give us the medical science take on striking that balance between perceived risk versus real risk.
Dr. Michael Mina: We've spent three years talking about the risk of COVID so much that at the beginning we locked everything down across the globe in order to prevent infections, mitigate the level of spread, in order to protect our hospital systems from being completely overloaded. And, you know, it's very, very difficult after three years to convey to the population that immunity does actually work, that an infection doesn't mean that the vaccine protection that you're getting is not there. It doesn't mean that your immune system is not actually doing a lot to protect you. But trying to explain these nuances to a population across the whole globe that has really just begun to, for the first time, learn about immunity — it is a real challenge.
Marco Werman: Effectively, when you look at how people around the world are behaving regarding COVID, what do you see?
Zeynep Tufekci: So, there were a lot of important advances during the pandemic. For example, the fact that this virus was airborne was admitted. That wasn't the case before. And there's now growing recognition that a lot of respiratory illness, illnesses, viruses are also potentially airborne. And there was an understanding of the value of masks, especially the value of a high quality, high filter. We have mRNA vaccines now which are new and there's now growing recognition that post-viral conditions are quite real and very important. So all of those things going forward could be addressed in an effective way to try to lower the burden not just of this virus, but a lot of other viruses, too. And that's the part that I think is the key tension, because for most people, like, for regular people, what you have is you try to understand your own risk and you go about your own life. What we want from public health is to reduce everybody's risk. So there are steps we could be taking, like making indoor air quality healthier, making sure that we develop treatments and hopefully a cure and better understanding, of course, of post-viral conditions. Try to understand, you know, when and how to use masks to try to reduce viral spread.
Marco Werman: I mean, I still feel that vulnerability. I still wear a mask when I go to a store, But there are times when I'll go into a store or a restaurant now and I just don't put it on. And then I leave and I wonder why I did that. So, Zeynep, help me out. Why are people making these choices? Because from my experience, it's not informed medical science supporting everything I do. 
Zeynep Tufekci: I don't think it should be up to you to decide when you go to the supermarket. Should I do this? Should I do that? That's a very complicated thing. Of course you can make decisions yourself, but the better way going forward is for public health to be able to invest in things that lower the risk for everyone and provides timely guidance also for everyone so that you're not trying to do complicated calculations in your head or depend on your own memory or worrying about exposure through your own social network who may have different practices.
Marco Werman: I'd like to wrap up with a quick take from each of you to this question. What does the end of the pandemic look like to you?
Dr. Michael Mina: To me, the end of this pandemic is probably not going to look too different than what things look like today. I think actually it might get a little bit worse in terms of some of the protections and health care policies that were made to offer many vulnerable individuals added protections through telemedicine and insurance coverage for certain things like tests that they could use at home. So we might see a bump in terms of, unfortunately, more difficult opportunities for people to stay healthy once some of the pandemic protections can come down. But I think we will continue to see this steady decline even amidst new variants. And I think gradually over the next year or two years, three years, we will see less and less discussion. And it will be a virus that is imposing much less of a burden on society as a whole.
Marco Werman: Zeynep, what do you think the end looks like?
Zeynep Tufekci: I think it's a little bit like asking when did 9/11 end? In one sense, it ended on 9/12. The tragedy had already happened and thousands of people had lost their lives. But in another sense, it took years for us to recognize that many firefighters and first responders had been hurt that day, and they had gotten ill from having to work on that site. And it took many years for an advocacy to get Congress to recognize this problem. So in some sense, I agree with everything Dr. Mina has said on the lower severe burden for society as a whole. But I think as long as we haven't found a cure or a treatment and support for the many people who are still suffering with long COVID, the pandemic is still with us in some of the worst forms in the continuing illness of those people. So I would like to say that would be for me, when the pandemic ends is when we can deliver treatment and cure to that population.

This interview was edited and condensed for clarity. 

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