Talk:Endemic COVID-19

Endemic does not mean mild
@Crossroads, you've twice now removed the statement that endemic doesn't mean mild disease. (Most recent form: "Endemic does not mean mild:  A stable infection rate can also be associated with any level of disease severity and any mortality rate among infected people. )

Is this because you genuinely think that "stable numbers" means "mild disease", or just because you dislike the specific cited source? You've declared it to be UNDUE. Do you have any reliable sources that espouse a contrary viewpoint? WhatamIdoing (talk) 03:00, 16 August 2023 (UTC)


 * If it isn't found in better sources, that is a strong sign it is UNDUE and does not belong. As I alluded to in the edit summary, there have been multiple modeling studies done in the context of other human coronaviruses and with the knowledge of what has actually taken place since January 2022 (when rates were very high due to the Omicron wave and restrictions were pervasive). The "stable numbers but high severity" possibility needs better, more recent sources if it is to be present in the article, else there is a high risk of being misleading. Another editor removed very similar content. Crossroads -talk- 17:47, 17 August 2023 (UTC)
 * Every source that ever addressed the question of endemicity and disease severity for any/all diseases has come to the same conclusion. Dengue is endemic in parts of the world; dengue kills people.  Malaria is endemic in parts of the world; malaria kills people.  Plague is endemic in parts of the world; plague kills people.  COVID-19 (hopefully) is (or will soon be) endemic; COVID-19 kills (some) people.  This is a statement about what it means (and doesn't) for any disease to be endemic.   WhatamIdoing (talk) 19:08, 17 August 2023 (UTC)
 * Indeed. Many endemic diseases have high severity. Likewise, some pandemics and epidemics have low mortality. Swine flu had a lower than normal mortality. The 1968 flu pandemic was comparable to seasonal flu. Zika has very low mortality in children and adults, but can affect foetal development. A colleague discovered an impetigo epidemic, a minor condition, but an outbreak could be seen in the data.
 * As far as I can see, good sources still say COVID-19 is pandemic. Bondegezou (talk) 14:22, 18 August 2023 (UTC)
 * One of the sources you link below (thanks for those) could be added as well: "an endemic disease can be relatively harmless, like the common cold, or deadly, like malaria". WhatamIdoing (talk) 15:49, 18 August 2023 (UTC)

I don't understand why the "Culture and society" has been tagged undue, with comment "it's excessive weight on an unlikely possibility of endemic severe disease". The misconceptions and myths about disease evolution towards a mild endemic form are widespread and already known before Covid came along to amplify them. What these experts are countering is the idea that a mild endemic disease is likely, inevitable even, whereas the facts are that a tendency towards mildness does not exist, and we are left at the mercy of chance. Particularly so with a RNA virus that is highly mutable and never likely to achieve the stability seen in DNA virus disease. The edit summary seems to suggest that the experts think an endemic severe disease is likely or at least not unlikely. The experts are not saying that. They are saying we don't know, that the future path of covid is not possible to determine, and anyone claiming it is (going to be mildly endemic) doesn't understand. That there's a political element to those who are getting it wrong is also sadly not unusual with Covid.

I recall, pre-covid, a naïve view of disease evolution was that a disease evolved to become mild because "it isn't in its interest to kill off its host too quickly". Myxomatosis was sometimes given as an example. It is remarkable how people can make claims about things that are so easily demonstrated to be untrue. The BMJ article mentions Malaria, TB, HIV, and Lassa fever as well as smallpox and polio. The latter two are well known as killers despite being ancient, and we have defeated them by vaccination rather than waiting till they learn to behave themselves and stop killing us. The myxomatosis comparison is particularly interesting, as though people could see a bright future where humanity is reduced to a handful of resistant individuals who repopulate the world. We don't, unfortunately, breed like rabbits. And anyway, ideas about myxomatosis in rabbits are mostly myth, with the disease still causing epidemics of severe and deadly illness that wipe out local populations from time to time. Not a disease-future I'd welcome. The "it isn't in its interest to kill off its host too quickly" => must become milder myth is amply demonstrated as rubbish by HIV, which is quite "happy" to take years to kill us. Nobody thinks that's a bright future for humanity either. Or rabies or ebola, which are quite "happy" to have animal hosts and carry on swiftly killing humans who catch it.

I recommend the tag be removed. -- Colin°Talk 14:33, 21 August 2023 (UTC)


 * At the time the tag was placed, it looks like the section made these points:
 * the definition of endemicity has changed in the last 1.5 centuries,
 * labeling COVID-19 as being endemic (at a particular point in history) was a political and cultural phenomenon (i.e., not a scientific one),
 * the word endemic is one of the most misused of the COVID-19 pandemic,
 * endemicity is not inevitable,
 * endemicity does not mean the disease will become mild,
 * politicians and commentators don't always know what they're talking about, and
 * they sometimes misuse jargon.
 * (I added the rest of the section later.) So, basically, one out of seven claims was about mild disease. We should probably remove the tag.
 * (Syphilis would make a better example of a disease becoming milder, but perhaps the media is squeamish about mentioning a sexually transmitted infection, especially since it's original horrors are not popularly known and it's mostly been in the news during the current decade for rising rates of transmission and increasing antibiotic resistance. Virulence changes can happen; they just aren't guaranteed to happen.) WhatamIdoing (talk) 15:42, 21 August 2023 (UTC)
 * I agree virulence changes can happen. I had a look at Syphilis. Wikipedia says "The symptoms of syphilis have become less severe over the 19th and 20th centuries, in part due to widespread availability of effective treatment, and partly due to virulence of the bacteria". The source says "The clinical manifestations of syphilis have become milder over time. The most important factors leading to this attenuation are the decline in virulence of T. pallidum in the late 19th and early 20th centuries and the widespread use of treponemocidal antibiotics. In addition, improved public health in more affluent countries may have made populations less vulnerable to the effects of treponemal disease". It's source for the text (other than the "In addition" part) is . Worth reading. It is very clear that this idea of decreased virulence is an "opinion" that was widely held "in the early 20th century", and "Such opinions were based primarily on the observations that violent cutaneous reactions and fatalities associated with the secondary stage had become extremely rare by the early 1900s". But importantly they follow this immediately with "Explanations other than a decrease in virulence are certainly possible." and go on to list some ideas they think are "quite plausible". They further note, "Irrespective of whether one questions the decreased virulence of the organism in the first three centuries following its advent, T. pallidum does not appear to have continued its journey toward avirulence over the past 100 years. There is no scientific evidence or proof that the Nichols strain or street strains are less virulent today than they were at the turn of the 20th century." Just in case we are in doubt whether the authors agree with that opinion, their next section opens with In addition to the decreased virulence of the organism, the incidence of syphilis has decreased drastically over the past three centuries, with the major changes occurring with the dawning of the antibiotic era. I don't know if you have other sources that offer better evidence the disease organism itself became less virulent over its first three centuries in Europe. The author's claim of no evidence of further decrease in virulence over the last 100 years isn't supported by any citation so one has to assume they have gone looking for it in the literature I suppose, and found nothing.
 * A complication is that the concept of virulence isn't necessarily discussed wrt the organism itself, but influenced by the health and immunity of the host and community and behaviour. The polio article suggests that the epidemic of paralytic polio in the middle of the last century was due to sanitation changes, rather than the organism becoming more virulent itself. If one's experience of Omicron is as someone who may have had asymptomatic exposure to an early strain and subsequently several vaccines, one might self conclude and report that it was clearly now a mild disease. Opinion is not evidence. -- Colin°Talk 16:55, 21 August 2023 (UTC)
 * Endemic Covid being milder is not dependent on it mutating to become milder, but because population immunity (against severe disease especially) is greater than ever before. Even as it mutates to bypass sterilizing immunity (which other respiratory viruses do too), it is not expected to bypass all immunity. As time goes on everyone who experiences it either has been vaccinated and/or infected in the past, usually at a young age when it is much milder. HIV is not at all comparable as it is a permanent infection; the thing to look to as a comparator is other human coronaviruses. Those commentators who emphasize Covid possibly getting more deadly with time have a poor track record for their predictions. Crossroads -talk- 20:10, 23 August 2023 (UTC)
 * Who are these people who "emphasize Covid possibly getting more deadly with time"? The only sensible people are one saying we simply don't know. There are limits to speculation however. Though Covid is a RNA virus, and thus highly mutable, it only has a few Lego pieces to play with so it it is unlikely to suddenly become a latent virus, say. But the whole idea that endemic is in in any way associated with mild is nonsense, as is the idea that organism evolution tends towards mildness. Evolution would be totally happy with a disease that wiped out 95% of humanity and left the remaining 5% to kill off each other. That would be us being unfit. Humans simply don't reproduce quickly enough to be a significant factor in viral or bacterial evolution (compared with human behaviour such as vaccines, lockdowns, global travel, and degrees of contact) and there are plenty animal hosts for coronavirus that will do. Other human coronaviruses don't necessarily provide guidance any more than "Past performance is no guarantee of future returns". We don't actually know the origin story of most coronavirus. -- Colin°Talk 21:28, 23 August 2023 (UTC)
 * True, but for the (educational) purposes of this article, the main point that I think we should be making is that endemic disease does not mean mild disease, even if an endemic version may well (hopefully will!) correlate with mild disease. Ditto for endemic being permanent:  endemicity may be effectively a permanent state, but it could become a pandemic again (just like flu does), and it technically could even be eradicated (e.g., if future generations develop much better vaccines).
 * This seems to be another dispute about the scope of the article. I think that the article is about what endemic COVID-19 actually is.  Emphasizing that it will be mild/permanent/normal is IMO a different subject, perhaps Predictions for COVID's future – possibly one that conflicts with WP:NOTCRYSTAL. WhatamIdoing (talk) 23:19, 23 August 2023 (UTC)
 * I will concede that it is fair to compare to other coronaviruses, as the article does, to point out that a pattern of repeat infection where weakened immunity is then briefly boosted, usually causes mild reinfections, assuming the virulence of a particular strain stays similar. Wrt "what endemic COVID-19 actually is", wouldn't that also include "what endemic COVID-19 would look like" (verifiable of course) since we don't have a consensus it is endemic or would remain so.  I think the content we have, where politicians and other non-experts have speculated or claimed things that the experts then explain are wrong, is in scope and something that has happened (we aren't speculating about what future politicians might claim). -- Colin°Talk 10:24, 24 August 2023 (UTC)

Crossroads added "not necessarily" to make the sentence "Endemic does not necessarily mean mild: A stable infection rate can also be associated with any level of disease severity and any mortality rate among infected people. After I removed "not necessarily" from this, with comment "'necessarily' implies it can sometimes "mean mild". There is no correlation whatsoever between endemic and mild. Many endemic diseases are quite horrendous with fatality and morbidity higher than covid." I see that User:KapSoule reintroduced "not necessarily" again with comment "Some endemic diseases are severe, but some are mild (e.g. common cold), so "necessarily" is appropriate". All of us agree some endemic diseases are severe and some are mild. So that's not the point of contention. The introduction of "not necessarily" tells the reader there is a tendency but not a hard rule for endemic diseases to be mild. For our text is then only countering that it isn't inevitable (necessarily strictly implied), rather than countering that it is in any way associated. Neither Crossroads or KapSoule have or added sources that suggest there is such a correlation. Furthermore, the second clause in the sentence makes the point we agree on that endemic can be associated with any severity of disease, mild or severe. I strongly recommend this misleading "not necessarily" be removed, absent evidence there is a correlation. We are dealing with a misconception that there is a pattern, much like when the pointy haired boss in Dilbert thought mauve databases had the most RAM. We don't start giving it credence by adding "not necessarily". Would you change "Black people are not less intelligent than white" to "Black people are not necessarily less intelligent than white"? The former is saying there is no correlation between melanin levels in the skin and intelligence. The latter is saying, well, ok, maybe there are some intelligent black people that are cleverer than some stupid white people. -- Colin°Talk 13:58, 24 August 2023 (UTC)
 * Agree with : it's more accurate, it's also simpler language. Remove "not necessarily". Bondegezou (talk) 13:59, 24 August 2023 (UTC)
 * I've reverted it because it's an error. Endemic never "means" mild.  Mildness has nothing at all to do with the meaning of the word.  Many endemic diseases are mild, but the concepts are unrelated – just as unrelated as "Sports car does not mean red" or "Electric vehicle does not mean a Tesla". WhatamIdoing (talk) 14:58, 24 August 2023 (UTC)
 * Perhaps what people want here is some sort of immediate emotional reassurance, like:
 * "Endemic does not mean mild: A stable infection rate can also be associated with any level of disease severity and any mortality rate among infected people.  But even though that's not relevant to whether it's endemic, most experts believe that COVID-19 will become milder over time, even if it doesn't become endemic." WhatamIdoing (talk) 15:03, 24 August 2023 (UTC)
 * But do you have a source for that? And "COVID-19 will become" is probably going to be read as "the virus will change to a milder variant" rather than "It is likely that so many people will have had prior infections and vaccinations, and our treatment programmes improve, that statistically the proportion of fatal and serious infections will fall." And "milder over time" suggests a downward tread. Is flu becoming "milder over time"? I don't see anyone going, ok, that 1918 one was bad but flu will become milder over time. No, they are going: the next pandemic that will kill millions is probably a flu variant. Is there anyone saying that Covid-19 is inevitably going to become a sniffle, rather than saying that it might end up like flu, with some good years and some bad years. -- Colin°Talk 15:27, 24 August 2023 (UTC)
 * I do apologise, I have misunderstood previous phrasing, thinking it was referring to "endemic disease", rather than "endemic". KapSoule (talk) 20:34, 24 August 2023 (UTC)

My issue is--why are we speculating on what endemic COVID would look like? Speculation is undue, broadly. Are we going to tell readers that this coronavirus may mutate to become more dangerous even though that's not what usually happens with coronaviruses? Seems undue and probably not neutral. SmolBrane (talk) 15:56, 24 August 2023 (UTC)


 * "even though that's not what usually happens with coronaviruses". Really. I could have sworn we just had a pandemic of a new kind of coronavirus. And there was MERS before, which was nasty but died out. These weren't just placed on earth by God. They evolved just as Covid will evolve. The next nasty coronavirus could well come from an entirely different evolutionary branch, from some animal reservoir perhaps, but also could simply evolve from this one. Just like we fear a flu variant like the 1918 one comes back.
 * The important thing is "we" are not speculating. That would be OR. If anything, the scientists are saying that the speculation by politicians is not reasonable. -- Colin°Talk 17:24, 24 August 2023 (UTC)
 * The problem with "endemic does not mean mild" is that - while it's technically true that "endemic" does not mean "mild" in the same way that "endemic" does not mean "purple" as these are separate words - it is very easy to read that phrase as something like "an endemic disease is not mild". Clearly the editors such as myself who object to it find it misleading in that way, and readers likely will as well. There are better ways to phrase this concept.
 * Regarding the possibility of endemic flu getting more severe, note what the CDC says (emphasis added): Flu pandemics happen when a new (novel) flu A virus emerges that is able to infect people easily and spread from person to person in an efficient and sustained way, and to which most of the world’s population do not have immunity. Covid, likewise, was such an issue because it was a novel virus to which all people lacked immunity. We don't see endemic flu strains or human coronaviruses causing pandemics. Crossroads -talk- 20:08, 24 August 2023 (UTC)
 * To answer SmolBrane about why people are speculating:
 * Beginning a few months after the lockdowns started, the English-language media started presenting a speculative story about that glorious future that looked a lot like the nostalgic past, when you could go about your normal life, not just by going to the grocery store and finding the shelves full, but also with kids passing around germs at school (because they're in school again) and college students getting drunk at concerts (because there are concerts again) and you chatting up folks next to the office refrigerator (because you're in the office again) and so forth, because eventually there would be vaccines and herd immunity and natural immunity for individuals. (Natural immunity is the kind you get by getting infected.)
 * Among other things, they called this story "when COVID becomes endemic", and it caused the public perception of endemic COVID to change from "What do you mean, this thing isn't going to burn out like the 2002 SARS did?! I don't want to live with this for the rest of my life!!" to "Endemic COVID is going to be just like the wonderful 'before times'.  Endemic COVID will hardly be noticeable.  Endemic COVID is just what we need".
 * This is how the idea of endemicity got mixed up in people's minds with the idea that the disease would be mild if it reached an endemic state. The fact that it's mixed up is why we have to educate people that both "endemic and mild" and "endemic and not-so-mild" are possible (as is "not actually endemic").
 * Now to what Crossroads says: We don't see endemic flu strains or human coronaviruses causing pandemics.
 * We don't? There's a flu pandemic every ~25 years on average; the H1N1 strain caused three of them in less than a century.  H1N1 doesn't go extinct in between pandemics.  It's always there.
 * Our pre-pandemic sample size for human coronaviruses was six strains. Two of them (both producing sudden and severe symptoms) promptly went extinct, and four are currently both endemic and usually mild.  That sample size is not enough to make solid predictions from.  The first six strains of "endemic" flu you look at probably wouldn't trigger pandemics either, but if you look at dozens, you are very likely to find a pandemic flu virus in there.
 * More relevantly to this discussion, flu pandemics can produce mild disease. We do see endemic flu strains becoming pandemic flu strains, and those pandemic flu strains can have any degree of disease severity.  A pandemic of a mild virus is still a pandemic, even if nobody dies from it. WhatamIdoing (talk) 00:46, 25 August 2023 (UTC)
 * I wish Crossroads would stop removing the "Endemic does not mean mild" claim from the text. The point of the sentence, which follows our sources isn't a bland "it might or might not", which the second clause already states. The point is that there is a preconception, a myth, that endemic means mild and that myth is wrong. It is this jarring of a preconception that may trouble some readers, not the potential that anyone might misinterpret this as meaning "an endemic disease is not mild", which, you know if we wanted to say that then we just would. In my previous argument about the "not necessarily", this was wrong because a correct reading of the sentence gave the wrong message. Crossroads's argument seems to be that people who read the sentence incorrectly will get the wrong impression, which isn't a persuasive argument. Clearly this message is uncomfortable for those in some political camps who preached that Covid will become endemic and thus mild, but, WP:NOTCENSORED, we don't remove text just because it makes some politically uncomfortable. Myths are best addressed with a direct "it is wrong" message. "The moon is not made of cheese" is quite a different message than "The moon is composed primarily of silicate rocks and metals". It tells readers that there is a preconception or belief that is wrong. -- Colin°Talk 07:42, 25 August 2023 (UTC)
 * WhatamIdoing, I mean, can you really blame people for wanting a glorious future that looked a lot like the nostalgic past? What point is even being made here? Almost nobody, including health officials, seriously expected the general public were going to live like 2020 permanently for this. And it didn't happen - things look very much like the before times even now. A return to normalcy was always inevitable, and if it didn't happen with eradication - the last hope of which died around the time it bypassed vaccine sterilizing immunity - then it was going to happen with endemicity, or close to it.
 * If you disagree that flu pandemics happen when there is a novel virus, take it up with the CDC, which I quoted already. Just because something is H1N1 doesn't mean it can't be a novel strain. The 2009 H1N1 swine flu pandemic was from zoonosis from swine. If existing, endemic flu or human coronavirus strains can suddenly become pandemic, then there should be sources saying so - but the burden of proof is on those making that claim.
 * Colin, I don't know why you're bringing up politics or censorship. We should strive to be as clear as possible, not giving misleading impressions either way, or expecting people to reason 'well I guess if they meant X they would have said that'. This could be worded better. The Moon article doesn't have a "not made of green cheese" statement. Crossroads -talk- 22:19, 25 August 2023 (UTC)
 * A return to normalcy was something that many people had difficulty believing in April 2020. Also, it was never actually inevitable; it may be unbearable to think about human extinction, but it is technically possible that humanity could be wiped out, or so many deaths that modern civilization is destroyed, by a virus.  WhatamIdoing (talk) 03:41, 26 August 2023 (UTC)
 * "it was never actually inevitable...it is technically possible that humanity could be wiped out, or so many deaths that modern civilization is destroyed" ...quite frankly the idea that a disease with a sub-1-percent case fatality rate heavily skewed towards the very elderly and heavily away from the young could ever lead to human extinction is totally unfounded. JM2023 (talk) 09:15, 25 September 2023 (UTC)
 * Good luck nobody said that then. Bon courage (talk) 09:17, 25 September 2023 (UTC)
 * i literally quoted the person saying that. JM2023 (talk) 09:22, 25 September 2023 (UTC)
 * Falsely. Bon courage (talk) 11:00, 25 September 2023 (UTC)
 * thats and unfounded and unwarranted accusation. maintain good faith. and truthfulness, for that matter. anyone can see the correctness of what i wrote, its right there. what specially is the issue you have? you shouldn't answer unless it's going to be productive. we are here to improve articles with verifiable statements, not go after people for the fact you for whatever reason contest an accurate quote. You've been here a rather long time, since I was just 5 years old, so you should know better. JM2023 (talk) 18:06, 25 September 2023 (UTC)
 * We could equally say, quite frankly, that it's totally unfounded to assume that it's impossible for a disease that currently has a sub-1-percent case fatality rate to never mutate in ways that cause more deaths, or cause deaths among younger people. You don't need a dramatic fatality rate to end up with extinction eventually. WhatamIdoing (talk) 03:10, 26 September 2023 (UTC)
 * Yes it is technically possible that humanity could be wiped out by a virus. Which is what you said (not that it would be wiped out by a disease as is it today). Bon courage (talk) 07:21, 26 September 2023 (UTC)
 * There is a huge difference between saying that humanity could be destroyed by a virus devoid of context, and saying as a frame of reference "A return to normalcy was something that many people had difficulty believing in April 2020. Also, it was never actually inevitable...it is technically possible that humanity could be wiped out" which shows that the topic is clearly COVID. We must be able to realize at least that. JM2023 (talk) 13:44, 26 September 2023 (UTC)
 * WP:CLEARLY not. Bon courage (talk) 13:45, 26 September 2023 (UTC)
 * "Some essays represent widespread norms; others only represent minority viewpoints." JM2023 (talk) 13:50, 26 September 2023 (UTC)
 * If SARS-CoV-2 mutates to the point that it has a 10% CFR for young people and maintains a high infection rate, it's no longer SARS-CoV-2, is it? JM2023 (talk) 13:41, 26 September 2023 (UTC)
 * Good job nobody said it was. "A virus" means "a virus". Bon courage (talk) 13:46, 26 September 2023 (UTC)
 * please stop removing all context from everything anyone says. "a virus" means SARS-CoV-2 when the context is SARS-CoV-2, when the context is "April 2020", when the context is "Endemic COVID-19". JM2023 (talk) 13:52, 26 September 2023 (UTC)
 * People (including the author) are telling you you misunderstand, so insisting you alone understand seems perverse. As it happens it's also true that back in 2020 some serious people worried that COVID-19 could precipitate human extinction. Bon courage (talk) 14:05, 26 September 2023 (UTC)
 * the author didnt tell me i misunderstood, they doubled down and said COVID could mutate and kill us all.
 * and then you render the whole discussion redundant by then admitting that yes somebody has said that "COVID-19 could precipitate human extinction", thereby falsifying your original response "nobody said that".
 * as i said originally, the two of you are making quite frankly totally unfounded assertions by saying that COVID-19 could ever lead to human extinction. a disease with a sub-1-percent case fatality rate heavily skewed towards the very elderly and heavily away from the young is not going to kill us all or cause extinction-level events. there's a reason there's an article titled "endemic covid-19" and not an article titled "covid-19 and human extinction". JM2023 (talk) 14:17, 26 September 2023 (UTC)
 * Wrong again. Nobody (here) ever said COVID-19 would lead to human extinction, though it was a (fringe) view from some in 2020 out there in the wider world. Future viruses though, who knows what they might do? Also (to get back on topic), 'endemic' does not mean mild. Endemic diseases can be deadly. Bon courage (talk) 14:22, 26 September 2023 (UTC)
 * someone said this right here above: "it's totally unfounded to assume that it's impossible for a disease that currently has a sub-1-percent case fatality rate to nevermutate in ways that cause more deaths, or cause deaths among younger people. You don't need a dramatic fatality rate to end up with extinction eventually." explain how this is not a claim that COVID could cause human extinction?
 * secondly, the only time I claimed here that someone here made the extinction claim is in the response you just responded to, and in this response.
 * anyway, you originally contested my comment because you had a problem with the fact that I claimed people were saying COVID could cause extinction, then you said actually there were people indeed saying COVID could cause extinction (meaning you agree with my statement that you contested in the first place).
 * but you also said "Yes it is technically possible that humanity could be wiped out by a virus" in response to them saying what i quoted above; you agreed with the assertion that COVID could mutate and kill everyone. so are you not asserting that a mutated COVID could kill everyone, thus adopting the position you call fringe that COVID-19 could lead to human extinction? JM2023 (talk) 14:33, 26 September 2023 (UTC)
 * This seems confused. You started by dissing "the idea that a disease with a sub-1-percent case fatality rate" could wipe out the human race. Bun nobody here had aired that idea. Mutated viruses and the diseases they cause technically could be that bad though. That was the original point. This is plain, but if you want to have the WP:LASTWORD, go for it. Bon courage (talk) 14:44, 26 September 2023 (UTC)
 * While I was speaking generally ("a virus", as in "any virus", not "the virus" or "this particular virus"), I'm willing to stand by my statement even if applied solely to SARS-CoV-2.
 * If SARS-CoV-2 mutates to the point that it has a 10% CFR for young people and maintains a high infection rate, it's no longer SARS-CoV-2, is it? – Nope. It could still be SARS-CoV-2.  Becoming more virulent (which is a combination of a virus' own qualities and the host reaction to it [e.g., pre-existing immunity]) doesn't make it a different virus.
 * Also, human extinction doesn't require a sudden, dramatic, made-for-the-movies plot. A relatively small increase in pre-fertility death rates is enough to get us there in the end.  At this point, it is very extremely unlikely that the virus will mutate enough and/or that our immunity will decline enough (e.g., due to a resurgence of measles, which knocks your immune system down for about 18 months) for this to happen, but it is still technically, theoretically, barely possible.  It might be a one-in-zillions chance, but there's no rule that says it simply cannot happen, and no enforceable guarantee from the universe that it won't happen. WhatamIdoing (talk) 20:30, 26 September 2023 (UTC)
 * The United States is currently run by the "very elderly" and next year's electoral choices appear to be between "very elderly" and "very elderly". China and Russia's leaders are 70. India's is 73. Pakistan's is 74. All a virus needs to do is destabilise a nuclear power. Targeting the "very elderly" would seem to be an optimal approach. Just saying. -- Colin°Talk 10:45, 26 September 2023 (UTC)
 * The natural death of a world leader has never once led to a nuclear war. It's not something anyone should expect to happen. JM2023 (talk) 13:39, 26 September 2023 (UTC)
 * User:JM2023, I was mocking this debate, which several people seem to be taking far too seriously. Have you got any concrete proposals for changing article content, or do you just want to argue with random people on the internet? You do realise you are arguing on the internet with someone about the potential causes of an extinction-level nuclear war, and saying that because my speculated cause has "never once happened" it is "not something anyone should expect to happen"!  I think everyone here should go find something better to do. This is silly. -- Colin°Talk 15:02, 26 September 2023 (UTC)
 * Funnily enough in a fairly morbid way, the youngest leader of a nuclear power is probably still at reasonable risk despite his age; and his death is probably the most likely to risk some craziness with their nuclear weapons. Nil Einne (talk) 14:32, 30 September 2023 (UTC)
 * Please ensure NPOV with regard to existing content/commentary on severity:
 * A February 2023 review of the four common cold coronaviruses concluded that the virus would become seasonal and, like the common cold, cause less severe disease for most people.
 * The severity of a disease in an endemic phase depends on how long-lasting immunity against severe outcomes is. If such immunity is lifelong, or lasts longer than immunity against re-infection, then re-infections will mostly be mild, resulting in a endemic phase with mild disease severity. In other existing human coronaviruses, protection against infection is temporary, but observed reinfections are relatively mild.
 * We already have clear, concise and well sourced info on this matter. Stating that endemic doesn't mean mild is begging the question. SmolBrane (talk) 16:39, 25 August 2023 (UTC)
 * I don't think that contradicting a common misconception is an instance of begging the question. This is not a case of "wool sweaters are superior to nylon jackets because wool sweaters have higher wool content", to quote the example from that article.  A case of "begging the question" would be "endemic COVID-19 is better than pandemic COVID-19 because the disease rates will be more stable".
 * This is just a case of "telling people that wool sweaters can't be identified by their color". A statement like that might prompt or raise a question about why we feel it is necessary to mention this fact, but fortunately, we already have clear, concise and well-sourced info on this matter right there in the article:  We need to mention this fact because this is a common misconception caused by the lay media's conflation of endemicity with positive outcomes.  WhatamIdoing (talk) 16:47, 25 August 2023 (UTC)
 * But the "conflation" of endemic Covid-19 - this specific virus - with being mild isn't wrong. That is the likely outcome according to the modeling studies that have been done and "most virologists". Yet above this gets attacked as merely false hope from politicians and minimizers, with the POV in Katzourakis' Jan. 2022 World View piece being treated as the harsh but necessary truth that de facto overshadows all else. Incidentally, the idea that Covid is going to be severe (and perhaps mitigations necessary long-term) is certainly no less political than the opposite. Crossroads -talk- 22:33, 25 August 2023 (UTC)
 * Do you see the difference between "Endemic does not mean mild" and "Endemic COVID-19 may or may not be mild"? The first is a statement about the definition of endemicity in general.  It is a statement like Secondary does not mean independent, or Self-published does not mean primary.  We're trying in this one paragraph to get people to understand what the word means.  "If  happens, almost no healthy people will die from it" is probably true, but telling them that the  is likely to be correlated with happy news is not helping people understand the meaning of that . WhatamIdoing (talk) 03:46, 26 August 2023 (UTC)
 * I'm reluctant to make any claims about Covid19's future or what "most virologists think" today, based on a New Scientist article in January 2021. That's ancient history wrt Covid19. -- Colin°Talk 12:56, 26 August 2023 (UTC)
 * Would you prefer a February 2022 source that says it may happen in the next one to ten years?
 * A December 2022 source that says "Doctors for years have been saying the virus likely is to become endemic"?  ("For years" presumably means "all almost-three of them".)
 * Or a May 2023 source that says "covid is killing at a slower, steadier pace than in 2020-21. Yet endemic covid remains surprisingly deadly"? WhatamIdoing (talk) 19:29, 27 August 2023 (UTC)
 * The Economist model is interesting but they do themselves point out its crude results and huge range of possible error. The "Yet endemic covid remains surprisingly deadly" statement is drawn from that model, while at the same time using the endemic word when they don't actually claim infections are endemic. I'm a little sceptical about the excess deaths model post-pandemic. See this for example. Most of the UK's continued high excess deaths are to do with the dire state of our NHS and care sectors rather than catching Covid 19. The Sky story has around 1300 excess deaths, per week, with 1000 of those non-Covid and 500 of those just due to a delay being seen in an emergency (e.g., ambulance times for a heart attack are supposed to be 18 minutes but are currently over an hour). Those health services were impacted by Covid 19, with a backlog built up, but most commentators think the factors for their current state are political choices since 2010. If the Covid 19 pandemic had been like a bad flu season, we'd actually have seen a following year of lower-than-normal deaths, as the frail would have been taken a year early. -- Colin°Talk 08:44, 29 August 2023 (UTC)

Break
is again watering-down or removing the "Endemic does not mean mild" wording, this time in the lede. Are we going to have to re-litigate this? Seems like a total waste of time. The lede must summarize the article, and this is a major theme. Bon courage (talk) 18:26, 5 October 2023 (UTC)


 * I like the sentence saying that ending the PHEIC is not the same as achieving endemicity; I think that's well expressed.
 * I'm less enthusiastic about the sentence saying politicians and commentators have sold the public a bill of goods. It's true enough, but it doesn't sound as formal as the rest of the article. WhatamIdoing (talk) 19:38, 5 October 2023 (UTC)
 * I agree that sentence needs to be better expressed if kept. They did conflate the two, it is true, but at the same time it isn't inaccurate to say that many things around that time and since then have returned to "pre-pandemic normality", including many public health guidelines. It's bizarre to imply that a return to normality is a lie or something when it is in large part a reality even now.
 * Regarding Bon courage's post, I just saw this, but I addressed this below at . I'm fine with going over the whole "what the word endemic does and does not mean" issue in the lead, but we also need to cover what the sources show about what the range of possible outcomes is and what factors they are dependent on. This is a huge aspect of the sources and focusing only on the definitional technicality is misleading. The article is about "Endemic COVID-19", not "Endemic (word)". Crossroads -talk- 19:56, 5 October 2023 (UTC)
 * Perhaps the sentence would work better as Some politicians and commentators have conflated what they termed endemic COVID-19 with the lifting of public health restrictions or a comforting return to pre-pandemic normality. Crossroads -talk- 00:11, 7 October 2023 (UTC)
 * That has more of the formal, encyclopedic tone. I think it would be appropriate.  @Bon courage, can you live with this in the lead? WhatamIdoing (talk) 03:58, 7 October 2023 (UTC)
 * Yeah, seems better than what I wrote. Bon courage (talk) 05:17, 7 October 2023 (UTC)
 * Let's do that, then. @Crossroads, it's your wording, so would you please make that edit? WhatamIdoing (talk) 22:06, 7 October 2023 (UTC)
 * Done, thanks all. Crossroads -talk- 23:16, 7 October 2023 (UTC)
 * WhatamIdoing (talk) 02:43, 8 October 2023 (UTC)

Latest sources
2023 papers:

Bondegezou (talk) 14:38, 18 August 2023 (UTC)
 * (lengthy discussion of how COVID-19 still pandemic)
 * (COVID-19 still pandemic as a background comment)
 * (COVID-19 still pandemic as a background comment)
 * (discusses an endemic status as a future situation)
 * (medical humanities paper discussing how people have used "endemic" in the context of COVID-19)


 * These may also be relevant at the COVID-19 pandemic article, where there is a push to have Wikipedia refer to the pandemic in the past tense. Bon courage (talk) 14:13, 31 August 2023 (UTC)


 * Good idea. Done. Bondegezou (talk) 14:22, 31 August 2023 (UTC)
 * ("Endemic, epidemic and pandemic infections: the roles of natural and acquired herd immunity") looks like it might be relevant, but it's paywalled, so I'm not sure if it actually discusses endemicity wrt COVID-19 in any depth. WhatamIdoing (talk) 04:07, 13 February 2024 (UTC)

Misrepresenting possible severity of endemicity
How on earth is this "POV-pushing tripe"? That is what the sources say. This version is misleading and POV-pushing, since it confusingly implies that the practical nature of this time (as opposed to the technical 'what does the word mean' issue which almost everyone will overlook) is that it will not be mild or probably will not be mild. None of the sources say this whatsoever. Several say that it is likely to be mild.

The bottom line is that the sources show that endemic Covid may be mild, or it may not be mild. We don't know yet. But we do know the factors that will be in play, so I named them in the edit. All of this is easy to find in the sources. What is the issue? Crossroads -talk- 18:06, 5 October 2023 (UTC)
 * Endemic does not mean mild. End of. Bon courage (talk) 18:11, 5 October 2023 (UTC)
 * Endemic COVID-19 is predicted to be mild by many sources. End of. Crossroads -talk- 18:14, 5 October 2023 (UTC)
 * Different thing (dunno how accurate). Endemic does not mean mild. They are not synonyms. Bon courage (talk) 18:19, 5 October 2023 (UTC)
 * Yes, we all know this by now. But this article isn't about a word, it's specifically about endemic Covid-19. We should tell the readers specifically what the possibilities are for what that may be like (per sources, it may be of a variety of degrees of severity; may or may not be mild) and the factors that cause it. Do you disagree with that? Why shouldn't it be in the lead if the sources in the body are so focused on it? I'm okay with also clarifying what the word "endemic" means in the lead as part of that, but in isolation it is extremely misleading. Crossroads -talk- 18:23, 5 October 2023 (UTC)
 * Just follow the sources. They say the term has been widely mis-used and that endemic does not mean mild. So Wikipedia does too. NPOV right. A para about this in the lede is good. Bon courage (talk) 18:29, 5 October 2023 (UTC)
 * About severity: We're probably failing to communicate adequately that the disease severity is fairly likely to change over time.  When sources say that it will probably be mild (a situation to be hoped for, of course), they're not saying it will be that way until the end of the universe.   WhatamIdoing (talk) 01:11, 7 October 2023 (UTC)

This is not "consensus text". It does not appear in the body, and fragments of it that do are surrounded by helpful context that were repeatedly excised by you from the lead. This is even worse. This has no consensus whatsoever, and again is all about implying that pre-pandemic normalcy will never come back. Just a completely slanted POV of what the sources say about future possibilities. Crossroads -talk- 18:14, 5 October 2023 (UTC)


 * Endemic does not mean 'normalcy'. This is an article about Endemic COVID-19, and a big part of that topic in RS is how the term 'endemic' has been misused and spun. That's the sourced reality, and cannot be dodged. Bon courage (talk) 18:21, 5 October 2023 (UTC)
 * Kind of hate to be the one to break it to you, Crossroads, but: pre-pandemic normalcy will never come back.  We will never have pre-pandemic life again, even if SARS-CoV-2 is eradicated. WhatamIdoing (talk) 20:02, 5 October 2023 (UTC)
 * Obviously history will never be turned back - in a variety of ways - but usually when people and the media talked about getting back to normal in 2020-22 it was about things like going to in-person events, and not being required to wear masks everywhere, and so on. Certainly things are far more normal now than in, say, 2021. Perhaps this goes to show more than anything that the term "pre-pandemic normality" is vague and unhelpful. Crossroads -talk- 20:16, 5 October 2023 (UTC)
 * I think the word you're looking for is subjective, though that's not necessarily a bad thing, especially when the WP:YESPOV policy applies. I was reading a piece in The New York Times recently that you comment reminded me of.  They said that when you ask Americans (now) what they remember about the pandemic, they don't remember 1 in every 250 people dying, or refrigerator trucks being turned into makeshift morgues, or the unceasing blare of ambulance sirens in the big cities, or the hospitals about to collapse.  They remember the mask mandates and school closures.  If it wasn't your loved one dying, your loved one's body being zipped in a bag and stacked in the truck, your loved one waiting for an ambulance, or your loved one at the hospital, alone, and not getting the care they needed because there was a shortage of respirators and staff that were trained to use them, then what people remember is the (relatively) little stuff, like whether the grocery store had a sign up about wearing a mask. WhatamIdoing (talk) 20:44, 5 October 2023 (UTC)

I'm not a fan of "COVID-19 endemicity is distinct from the COVID-19 public health emergency of international concern, which was ended by the World Health Organization on May 5, 2023" I don't disagree with it but it is hard to understand. The term "COVID-19 endemicity" seems like jargon to me. Endemicity can mean either a state (which is how it is being used here and compared to the state of PHEIC) or a quality (such as whether a species of plant or animal is endemic to a geographic area). It isn't a commonly used word and if we are trying to explain misunderstood epidemiology then using jargon in the lead doesn't help. Also "COVID-19 public health emergency of international concern" is a formal term that is declared by WHO, not a set of words you'd casually write. How about 'The World Health Organization officially ended the "COVID-19 public health emergency of international concern" on May 5, 2023 but this did not mean COVID-19 had become endemic.' Thoughts? -- Colin°Talk 14:48, 6 October 2023 (UTC)


 * Nice. Bon courage (talk) 15:13, 6 October 2023 (UTC)
 * I'm fine with either wording overall, but disagree with the use of quotes in this one. It doesn't seem to match MOS:QUOTE and I think the blue wikilink already makes it very clear that PHEIC is a specific term. Maybe capitalizing it or adding in the PHEIC abbreviation is fine, but I don't like something that looks like scare quotes. Crossroads -talk- 18:08, 6 October 2023 (UTC)

Again
The recent spate of "pandemic's over, so it's obviously endemic" edits makes me think that we are being unclear. Perhaps we should think about putting a sentence in the first paragraph that says something like:

"Endemic COVID-19 is not the only possible outcome of the COVID-19 pandemic, as a new virus could remain a pandemic indefinitely, be reduced to sporadic outbreaks, or be seen in local or regional epidemics rather than becoming endemic."

I've also been thinking about turning the bullet list in Endemic COVID-19 into a table with a suitable graph showing each item, in the hope that if we put in a few color glossy pictures with circles and arrows and a paragraph on the back of each one that people might notice them, and if they notice the colorful pictures, they might read the words next to them, and then they might, possibly, just perhaps notice that it's a little bit more complicated than "I feel like the pandemic's over and therefore it's endemic".

Alternatively (or additionally), we could put a FAQ at the top of the talk page that says something like:


 * When is Wikipedia going to admit that the pandemic is over and COVID-19 is endemic already?
 * Just as soon as multiple major medical journal articles directly investigate the subject, define what they mean by 'endemic', and make a clear and direct statement that COVID-19 has entered an endemic phase. Note, for the record:
 * Multiple sources, not just one;
 * Major journals, not a predatory journal that will print anything as long as they get paid;
 * Medical journal articles (sources that are both peer-reviewed and review articles or meta-analyses are preferred), not newspapers, magazines, or social media;
 * Directly investigate the subject, not just a passing mention like 'now that the pandemic is over'. Direct investigations sound like "Based on the last six pages of data and calculations, we conclude that COVID-19 has become endemic in Europe";
 * Define their terms, because there are multiple valid definitions for endemic (e.g. one that includes seasonal flu and another that doesn't), and we need to know exactly what to say in this article without misrepresenting the sources;
 * Clear and direct statement, not just 'they said that "the pandemic was something", so that obviously proves that it is endemic instead of sporadic or epidemic or any of the other options'. A clear and direct statement will likely sound something like "COVID-19 entered a hyperendemic phase with moderate semi-annual seasonal variation in late 2022".

What do you think? WhatamIdoing (talk) 04:32, 18 July 2024 (UTC)
 * I'm not convinced that "a new virus could remain a pandemic indefinitely" is sourceable or true, nor that the above is necessary. As noted previously at the pandemic's talk page, some experts and published papers have said it is endemic already, or that the concept is so vaguely/inconsistently defined such that it depends on the definition. This should be consistent with that, if nothing else. However, at this point I honestly think we should just redirect this to COVID-19_pandemic. Most of what's here is already covered better there, or from poor sources like old commentary pieces in journals that we can just get rid of anyway. If people want to have content about different definitions of endemic in detail, and whether different diseases technically meet such and such threshold, that can go at Endemic (epidemiology), which is still pretty short, and can cover various diseases all at once. Crossroads -talk- 21:14, 18 July 2024 (UTC)
 * As we frequently say about blocks, Indefinite is not infinite. If someone knows the ending date in advance for every pandemic, then I'm sure that would be interesting to researchers, but it doesn't sound very plausible.
 * Can you give me some links to articles in medical journals that directly address the question of COVID-19's endemicity? I'm not looking for a history paper like the "Historiographical article", written in 2020 and published in a special issue (a Supplement (publishing)?  MEDRS warns against those), which is cited in COVID-19 pandemic.  I'm not even sure that was peer-reviewed.  The issue says that the history journal "Centaurus contains articles, historiographical articles, book reviews and editorial communications. Articles must report original research and will be subjected to review by referees" – with the obvious-to-me implication that "historiographical articles, book reviews and editorial communications" are not peer-reviewed.) I'm specifically looking for papers that say something like "Here's our definition of endemic, here are the metrics for it, here's the data, and the end result is that we are/aren't in an endemic phase right now".  It doesn't matter to me whether the metrics are "prevalence of SARS-CoV-2 virus detection in wastewater" or "proportion of public services operating at pre-pandemic capacity"; I just want something that chooses a definition and determines whether or not we are there yet. WhatamIdoing (talk) 22:18, 18 July 2024 (UTC)

Endemic overview
COVID-19 was predicted to become an endemic disease by many experts. The observed behavior of SARS-CoV-2, the virus that causes COVID-19, suggests it is unlikely it will die out, and the lack of a COVID-19 vaccine that provides long-lasting immunity against infection means it cannot immediately be eradicated; thus, the transition to an endemic phase was probable. In the current endemic phase, people continue to become infected and ill, but in numbers that we will accept like we do for the flu as an example. Such a transition took until 2023 but there is no specific date or month for when the pandemic ended. We can clearly see from Boston University that we see that the number of the COVID-19 hospitalizations from January 2023 and January 2024 were similar and that they were nearly the same. COVID-19 is here to stay and not growing milder, so we can see that this virus is clearly endemic.

COVID-19 endemicity is distinct from the COVID-19 public health emergency of international concern, which was ended by the World Health Organization on 5 May 2023. Endemic is a frequently misunderstood and misused word outside the realm of epidemiology. Endemic does not mean mild, or that COVID-19 must become a less hazardous disease. Malaria is endemic and that does not mean it is not dangerous and it is sad that it may never end. Some politicians and commentators have conflated what they termed endemic COVID-19 with the lifting of public health restrictions or a comforting return to pre-pandemic normality that guidelines were lifted in early 2022. This was called "the pandemic phase" that restrictions for masks and vaccines were lifted. People may have taken it less seriously, but this is before the pandemic ended. The severity of endemic disease would be dependent on various factors, including the evolution of the virus, population immunity, and vaccine development and rollout, number of deaths. BenSchmidt7439 (talk) 18:43, 20 July 2024 (UTC)

Seasonal pattern
COVID-19 became seasonal in 2023. We noticed that the virus acted strange, as it did have a seasonal pattern. COVID-19 peaks in winter, have a sharp decline in spring, another peak in summer but not as bad in winter, and another decline of cases in fall but not as high as spring. The reason COVID-19 peaks in winter is because we are all inside and gathering and that is why we all catch each other's germs. Also, other germs are going around like COVID-19. The reason it goes up in summer is because of all the traveling and being around so many people outside. And the pool causes a lot of COVID-19 to spread. People generally are around each other less in spring and everything is less crowded. COVID-19 peaks in December through February. Cases start slightly going down in March. COVID-19 has a sharp decline of cases in April and May, peaks again in June through August, and has a decline of cases in September through November. April and May seem to be the months where COVID-19 is the safest. Even though COVID-19 does get high in summer, that does not mean you cannot enjoy life in summer. COVID-19 seems to be at epidemic levels in summer and winter, but it seems to still be overall lower than it was before 2023. But because we know it is seasonal and occurs high in winter and summer, it is not considered an epidemic. COVID-19 seems to be an overall less common virus. In 2022, herd immunity and natural immunity seemed to make COVID-19 less common. In summer and winter, the virus seems to be not common, but not uncommon. Your chance of catching COVID-19 in winter and summer is still low, but not zero. Most people will not catch COVID-19 more than a few times and the quickest anyone has ever caught COVID-19 was in 14 days and you are not likely to get it again until a while. This is not because it provides long-term immunity, but because COVID-19 is not an everyday virus you are around. BenSchmidt7439 (talk) 18:55, 20 July 2024 (UTC)


 * It appears that the enthusiastic new editor has been blocked for Sockpuppetry this time. WhatamIdoing (talk) 00:02, 21 July 2024 (UTC)