If COVID Becomes Endemic, What Will That Look Like?

Key Takeaways
  • Viruses are built to evolve over time – these mutations give them the chance to evade immunity and continue infecting hosts.

  • When COVID-19 vaccines became available, they gave us hope for permanently eradicating the coronavirus, but that window of opportunity may have passed for good at this point.

  • If COVID-19 shifts from a pandemic into an endemic phase, it will still be a thought in the back of peoples’ minds, but communities will be able to tolerate illness from the virus more effectively – much like how we handle common colds and the flu.

While the world has been on edge hoping to rid itself of COVID-19, there seems to be a broad consensus among scientists and medical experts that total eradication may no longer be a possibility. We will, however, likely see the virus shift from a pandemic phase to an endemic one. In this case, COVID-19 will continue to circulate in pockets of the global population for years to come, but the risk level could also decrease over time. The future landscape will depend heavily on the type of immunity people acquire through infection or vaccination, and how the virus evolves.[1]

The COVID-19 Coronavirus is Doing Exactly What It’s Supposed To

At its root, a virus is simply “a piece of information”, and it’s only job is to create more of itself. Viruses gain their power by entering this information into cells — of animals, humans, and bacteria — that send instructions telling the infected cell to replicate. In some cases, like COVID-19, a virus may find a way to reach all corners of the world. What makes viruses so powerful is their innate ability to evolve (mutate) quickly. And with so many hosts available to infect, they become increasingly difficult to fight.

According to Boghuma Kabisen Titanji, a virologist and global health expert, “Viruses are going to evolve regardless of what we do. There are things we can do to slow that down: barrier measures [such as masking], vaccinating. And there are things that we can do that can maybe speed up or aid the evolution of the virus. One is if we’re not doing what we need to do to prevent spread of the virus within the population. Every time a virus spreads, it gets another opportunity to infect a new host, and it gets another opportunity to evolve and change and adapt.[2]

Why We May Never Be Able to Eradicate COVID-19

At this point, it’s unlikely that we will completely eradicate COVID-19 like we did with polio and smallpox. One of the leading reasons why is vaccine hesitancy. Even though vaccines are not new, and they are considered one of the most cost-effective healthcare interventions, negative attitudes toward vaccination creates a huge barrier to protecting entire communities of people.[3] People across the globe would have to exercise their “civic duty” to get vaccinated — even if they feel that they’re at low risk for infection.

Equal access to COVID-19 vaccines would also be imperative to help slow the spread and eradicate the virus. It’s estimated that the number of vaccines produced in 2021 would cover about 70 percent of the global population, however, most vaccines are being reserved for developed countries and, or other vaccine-producing countries are reserving doses so they can ensure that their own citizens get vaccinated first.[4]

Also: timely and accurate COVID-19 surveillance data. This is the cornerstone of any prevention and control measure, and yet there are some key epidemiologic blind spots related to COVID-19, including accurate identification, diagnosis, and under-reporting of infection numbers and breakthrough cases.[5,6]

What will COVID Look Like In It’s Endemic Phase?

“Endemic” may not sound all that optimistic, but failure to eradicate the virus does not mean that we’re doomed forever. Influenza and a handful of coronaviruses that cause common colds are endemic too. Annual vaccines combined with acquired immunity helps societies tolerate illnesses better without requiring lockdowns, masks, and social distancing.

For COVID-19, becoming endemic is likely, but the pattern that it will take is hard to predict. This means that vaccines may need to be reformulated over time. It is also very plausible that COVID testing will remain a necessary tool and gateway for work, travel, and outings with large crowds. Only time, and perhaps attitudes, will tell.


  1. Phillips, N. (2021, February 16). The Coronavirus is Here to Stay — Here’s What That Means. Nature. https://www.nature.com/articles/d41586-021-00396-2
  2. Wu, K. J. (2021, November 27). The Omicron Variant: We Still Know Almost Nothing. The Atlantic. https://www.theatlantic.com/science/archive/2021/11/omicron-coronavirus-variant-what-we-know/620827/
  3. Vanessa Rémy, York Zöllner & Ulrike Heckmann (2015) Vaccination: The Cornerstone of an Efficient Healthcare System, Journal of Market Access & Health Policy, 3:1, DOI: 10.3402/jmahp.v3.27041
  4. COVID vaccines: Widening inequality and millions vulnerable. (2021, September 22). UN News. https://news.un.org/en/story/2021/09/1100192
  5. Holtgrave DR, Vermund SH, Wen LS. Potential Benefits of Expanded COVID-19 Surveillance in the US. JAMA. 2021;326(5):381–382. doi:10.1001/jama.2021.11211
  6. Ibrahim, N. K. (2020). Epidemiologic surveillance for controlling Covid-19 pandemic: types, challenges and implications. Journal of Infection and Public Health, 13(11), 1630–1638. https://doi.org/10.1016/j.jiph.2020.07.019

DISCLAIMER: This article is for general information purposes only, does not constitute medical advice and is not intended to be relied upon for medical diagnosis or treatment. If you are experiencing a medical emergency, dial 911 immediately.