Talk:Endemic (epidemiology)

Article should compare several definitions of the word endemic
The article should be rewritten to compare several definitions of the word endemic


 * A disease is endemic if R*S=1 (Endemic steady state)
 * A disease is endemic to an area if it survives within the area without relying on receiving new infected people (and variants) from the outside.
 * A disease is endemic if it has regular outbreaks

Note that influenza is not endemic according to the first two definitions, but it is still often described as an endemic disease. Therefore the third definition is needed

Note that a disease in the endemic steady state cannot have seasonal variations, so this requirement is very strict.

enzootic
The article Strangles links this page for the word enzootic, apparently meaning "endemic" but for people. This word/meaning should be noted.Wakablogger2 (talk) 22:34, 21 August 2009 (UTC)

Wikidata list of endemic diseases and subclasses of them
Most forms of turberculoses are currently included in the following list - but are all of them endemic?

Please enter correct data in these Wikidata items. Some columns of the following auto-generated list can be useful in various language versions of this article. The content may also affect the content of a future Wikidata based infoboxes. Tomastvivlaren (talk) 16:41, 22 March 2020 (UTC)

&sum; 109 items.


 * Why not list the diseases alphabetically? I resorted them for myself, but you say that any changes will be deleted in the next update.
 * What countries are these diseases currently endemic within?
 * Surely there are other endemic diseases afoot in the world. What does a disease have to do to make the cut for this list?
 * Why all the columns that you don't use?
 * Will this chart ever be added to the Endemic article itself after these kinks are ironed out?
 * Thank you for you help, Wordreader (talk) 23:59, 26 April 2020 (UTC)
 * Thank you for you help, Wordreader (talk) 23:59, 26 April 2020 (UTC)


 * . What is the point of this table? This seems like an improper usage of the talk pages. I am tempted to remove it. Jason Quinn (talk) 14:27, 26 October 2021 (UTC)


 * Jason Quinn:The aim was to encourage people to fact-check and improve endemic related items at Wikidata, since infoboxes in some Wikipedia versions (not yet English Wikipedia, but for example a few articles on the Swedish version), many pages at Wikimedia commons, etc, automatically take that information from Wikidata and show it in the local language. I have now hidden the list and inactivated the neverending updates for this page. I realize it is better to refer people to the above wikidata database query.
 * Wordreader: Thanks for good questions. My code sorted the list based on "Instance of", i.e. type of endemic, but that can be changed. The columns correspond to proporties that potentially may be entered in the endemic pages at Wikidata, and may be shown automatically in infoboxes on some wikis. I do not think an automatically updated chart should be added to the endemic article for many years, it is still dangerous to rely on Wikidata, but perhaps the chart may inspire someone to compile a manually updated list. I have stopped working on the topic of endemics. Tomastvivlaren (talk) 22:17, 26 October 2021 (UTC)

What people say is not biomedical information
Here's what I wrote:


 * Hopes for COVID-19 to become endemic make a similar mistake; generally, the speaker expresses a wish that COVID-19 will become relatively harmless and non-disruptive to society, whereas endemicity promises only that there will be a steady, predictable number of sick people.

Here's what @Crossroads has turned it into:


 * Hopes for COVID-19 to become endemic may make a similar mistake; endemic COVID-19 could be mild if immunity from infection against pathology is lifelong or lasts longer than immunity against infection, but endemicity in itself promises only that there will be a steady, predictable number of sick people.

First of all, I think that the "could be mild" idea is POVish. Sure, it "could be mild", but it also "could be not-mild", and with an additional year-plus of data behind us, it seems like "not-mild" is unfortunately possible. There is no lifelong immunity. Some people get extremely sick, some of them stay sick for many months, perhaps the rest of their lives, and some of them die. Or perhaps it's just in line with the definition of "mild COVID" from the early days, when "moderate" meant that you had to be admitted to the hospital for supplemental oxygen, and "mild" just meant you couldn't get out of your own bed without help, which is not how most people normally use those words.

Compare that the hopeful statement about COVID-19 becoming "mild" against the tone struck in newer sources:


 * "Endemic is not equal to harmless. Commonly, endemic is falsely interpreted as the end of COVID-19, bringing to a false complacency. Endemic "label" on an infectious disease, such as malaria, HIV infection, tuberculosis in certain regions of the world, means the overall rates of infection are static - neither rising nor falling. Endemic "label" defines nothing about time duration to reach disease end or how many populations will still be susceptible to the disease."
 * "But reframing COVID-19 as an endemic disease right now is a premature notion at best, representing more of what we want COVID-19 to become than the epidemiological reality...But the evolutionary trajectory of COVID-19 does not at this time suggest a clear path toward endemicity, and epidemiologists and evolutionary biologists warn against impulsively applying this notion to the disease."
 * "While the “boat has sailed” on eliminating SARS-CoV-2, it’s still unclear what kind of endemicity the virus will establish, said Kaushic. Endemic means that a virus is continually present and somewhat predictable — not that it’s harmless or that precautions to prevent infections are unnecessary."
 * "An endemic disease can still have serious consequences. Take the examples of malaria, HIV, tuberculosis and other infectious diseases that are endemic worldwide. In 2020, there were an estimated 241 million cases of malaria worldwide and around 627,000 deaths.3 Outbreaks and sporadic infections will continue to occur"

Second, I deliberately constructed this sentence to talk about how people use this word, and how people use a word is not Biomedical information. This is a statement about linguistics, not about science. The Atlantic is a reliable source for what I wrote.

As for what you wrote, the source you cite does not say that COVID-19 will become endemic. They write, in fact, that "Epidemics can fade or transition to an endemic phase", which means that there are two options for the end of an epidemic, and only one of them is endemicity. The source also says that "infection does not generate life-long immunity", so that zero-likelihood prospect should probably not be mentioned anywhere.

(As a side note, the bit that runs "if immunity from infection against pathology...lasts longer than immunity against infection" is garbled and needs to be re-written. Perhaps you meant "if previously acquired immunity reduces the risk of death and disability during future infections"?  Another approach would be to shorten it substantially:  "It is possible that COVID-19 could become endemic, i.e., that it would produce a steady and predictable number of infections.") WhatamIdoing (talk) 07:34, 1 December 2022 (UTC)


 * Agree the re-write is not an improvement. The Atlantic article is good for non-WP:BMI. Bon courage (talk) 07:53, 1 December 2022 (UTC)
 * The assertions found in that article and cited to it about viral endemicity are all biomedical information. Crossroads -talk- 20:10, 1 December 2022 (UTC)
 * I agree both that comments about society's "hopes" vs what "endemicity" is does not require a MEDRS source. The cited paper that got added discusses scenarios concerning the severity of an endemic covid, but does not address "what people/society think/say/hope". While it does have some sentences using the "it could be mild if..." they could equally have been written "it could be severe if...". It is clear the journal article writers hope for a mild outcome, but we aren't here to document their hope. There is also a persistent myth that diseases become mild as they evolve in a host population, which is nonsense (think of rabies and smallpox), and if you are thinking of myxomatosis, I don't know how a case fatality rate of 50-95% sounds to you, and we don't breed like rabbits. I don't think this article needs to get bogged down in details of how covid might become mild or might not. What matters is that people (in the West anyway) wrongly thing endemicity is a good thing and associate it with a harmless disease. I'm not sure that folk in central Africa think endemic disease is a harmless thing. Do we have any sources indicating this is a wealthy nation's fallacy? -- Colin°Talk 12:37, 1 December 2022 (UTC)
 * WhatamIdoing, I don't mind adjusting the text I wrote, but your version is POV toward the idea that endemic Covid could be not mild. "Could be mild" is a fact, not POV. Both possibilities should be mentioned here. And the fact is that this article is a medical article, and this aspect of the topic is implying or making medical claims, so we should be relying on medical sources when possible.
 * The four "newer" sources you cite have a total of 7 citations on Google Scholar (5 of them in just the 2nd one), and are mostly rather short articles. The 3rd one especially is written very much like a news report, not a full-on review article. The article I cited has 61 citations. It is from late 2021, well after there were new variants after vaccination and such.
 * I strongly encourage people here to read it. It addresses many of the objections made here. For instance, "no lifelong immunity" against infection doesn't mean that it can't be mild when endemic, because immunity to severe disease could be lifelong or could last significantly longer than immunity to infection, leading to regular 'boosting' from infections (or from yearly vaccine boosters, presumably). Evolving to be more intrinsically more mild is also not necessary at all, though entirely possible and may have happened already with existing human coronaviruses, including one that likely caused the 1890 pandemic - this is all in the article too. Comparisons to smallpox and rabies are irrelevant because these are very different species with very different means of spread - we already have endemic coronaviruses. Regarding the claim the authors "hope for a mild outcome, but we aren't here to document their hope" - actually they explain why and how that would happen like any academic paper rather than mere "hope", they acknowledge it is not a given, and in fact we are here to document the views of experts with WP:DUE weight. Endemicity is a good thing compared to a pandemic when eradication is impossible, as is true for all coronaviruses due to the inability to create lifelong immunity to infection.
 * I think at minimum, as a simplification, we could agree that some experts expect that endemic COVID will be mild and some think it will not. So why only present one view and call the other a "mistake"? Is this not misleading readers? We can't use what basically amounts to 'this is about society so we don't need MEDRS' as a reason to present just the possibility that society doesn't want as though the other one isn't possible. Some in the media like to write articles and thinkpieces debunking people's hope for normalcy or whatever - negativity gets more views and always has - but we should not think that MEDRS mostly think this is the most likely possibility.
 * We should probably also cut the "similar mistake" bit since it's not clear what is "similar", and COVID is very different from AIDS anyway - HIV infections are permanent but COVID infections are not, just for starters. Something like this, integrating a suggestion from WhatamIdoing earlier: "Some in the public wrongly assume that endemic COVID-19 means the disease would necessarily be mild. Endemic COVID-19 could be mild if previously acquired immunity reduces the risk of death and disability during future infections, but in itself endemicity only means that there will be a steady, predictable number of sick people. " Crossroads -talk- 19:37, 1 December 2022 (UTC)