Winter's nearly over and, with COVID-19 daily case numbers declining, you could be forgiven for hoping the coronavirus pandemic is coming to an end too.
But experts say that could still be a long way off.
Let's unpack why — after a quick look at the latest COVID figures.
Charts show cases on the decline
Australia reported more than 55,000 new COVID cases on July 21, with health authorities warning of more hospitalisations and deaths.
The ABC's Charting the Spread page shows where the daily case numbers are at now:
In the last week, the nation's daily case numbers have hovered between 10,000 and 20,000 cases.
Hospitalisations for the current outbreak peaked on July 26, with 5,571 cases in hospital.
The seven-day moving average has dropped by about 60 per cent since then.
Australia recorded its highest daily death toll on July 29 with 157 deaths.
Back then, the seven-day moving average was 157, on Saturday, it was down to 62.
And Australia's COVID fatality rate is better
Our World in Data, which uses figures from the Johns Hopkins University COVID-19 Data Repository shows Australia's case fatality rate was between 1 and 3 per cent before vaccines.
This month, it's at 0.14 per cent.
Director of Victoria University's Mitchell Institute for Education and Health Policy Maximilian P de Courten put this improvement down to vaccines as well as better treatments and protocols developed as the pandemic went on.
So ... is COVID nearly over?
Probably not, Dr de Courten said.
"One cannot say that this is the beginning of the end because unfortunately this virus has shown that, every six months or so, it's coming up with a significantly different variation that we ride another wave [of]," he said.
"It's a numbers game – it's basically happening as an error in replication and the more virus there is out there, worldwide, the more likely that it's happening somewhere.
"At the moment, there's still a lot of coronavirus out there."
How much longer will the pandemic last?
While daily case numbers are tracking downwards, James Wood from the University of NSW's School of Population Health said that doesn't mean it's all over.
He reckons the global pandemic will stretch beyond the end of the year.
"Definitely we're in a decline phase for the pandemic and, at the moment, I'm expecting that to last until about the end of the year — if not longer — in Australia," Dr Wood said.
"However, I wouldn't be surprised if we see a wave in the Northern Hemisphere winter, so I don't think we'll have the same patterns everywhere over Christmas and New Year.
"A pandemic is normally declared when you have epidemic activity of a novel virus on multiple continents at once, so we won't be out of the situation by then."
What makes COVID-19 a pandemic?
A pandemic isn't an official declaration — it's just a term used to describe a disease spreading across a large geographic area.
World Health Organization director-general Tedros Adhanom Ghebreyesus first described the COVID-19 outbreak as a "pandemic" in March 2020.
This didn't trigger any extra regulations, but it did acknowledge how widely COVID-19 was spreading.
Dr Tedros said "pandemic" wasn't a term to be used lightly:
"It is a word that, if misused, can cause unreasonable fear, or unjustified acceptance that the fight is over, leading to unnecessary suffering and death.
"Describing the situation as a pandemic does not change WHO's assessment of the threat posed by this virus.
"It doesn't change what WHO is doing, and it doesn't change what countries should do."
So what's the WHO's official term then?
A public health emergency of international concern (PHEIC) — which is the WHO's highest level of alarm.
The WHO defines that as:
"An extraordinary event which is determined to constitute a public health risk to other states through the international spread of disease and to potentially require a coordinated international response."
To become a PHEIC, the situation must meet the following criteria:
- serious, sudden, unusual or unexpected;
- carries implications for public health beyond the affected state's national border; and
- may require immediate international action
The WHO declared a PHEIC for COVID-19 in late January 2020.
Typically, a PHEIC is called off once the three criteria listed above aren't met anymore.
Who decides when a PHEIC is over?
Dr Tedros, as he's the WHO's current director-general.
Under the legally binding International Health Regulations, the WHO's director-general has to be advised by the Emergency Committee — made up of experts from around the world — about whether an event still constitutes a PHEIC or not.
Then it's up to the director-general to make a decision to end the PHEIC or not.
When will the WHO declare the PHEIC over?
That's unclear.
The Emergency Committee meets every three months and is due to meet again in October.
But Dr de Courten said the WHO would be slow to end the PHEIC for COVID-19.
He said that's because declaring the emergency over would mean terminating the mechanisms to ensure cheap, equitable distribution of vaccines, treatments and test kits around the world.
Dr Wood reckoned the WHO wouldn't make that call until at least the first or second quarters of next year — but maybe even further into the future.
"I think they will be seeking to make an argument of it being more or less equivalent in population impact to a seasonal virus like the flu, because certainly they won't be able to say that it has disappeared," he said.
"They might want to judge the impact of Omicron and future variants over two to three respiratory seasons [which is] two to three years."
But Dr de Courten said the WHO wouldn't keep the declaration going forever.
"No-one wants to cry wolf if there's no wolf around," he said.
And, as we've seen here in Australia, individual countries have wound back COVID-19 measures despite the PHEIC continuing.
"In practice, I think we will see a lot of countries effectively declare the pandemic over in the last quarter of this year in terms of removing pretty much all pandemic-related measures," Dr Wood said.
How will COVID end?
Dr Tedros weighed in on that after the WHO updated its strategic plan for COVID-19.
"This is our third strategic plan for COVID-19, and it could and should be our last," he said.
He went through the three scenarios for the future:
- Best-case scenario: "Less severe variants emerge, and boosters or new formulations of vaccines won't be necessary."
- Worst-case scenario: "A more virulent and highly transmissible variant emerges. Against this new threat, people's protection against severe disease and death, either from prior vaccination or infection, will wane rapidly. Addressing this situation would require significantly altering the current vaccines and making sure they get to the people who are most vulnerable to severe disease."
- Most likely scenario: "The virus continues to evolve, but the severity of disease it causes reduces over time as immunity increases due to vaccination and infection. Periodic spikes in cases and deaths may occur as immunity wanes, which may require periodic boosting for vulnerable populations."
What would a post-COVID Australia look like?
"I think we will continue to rely on vaccines adjusted to match circulating strains probably once a year, although I wouldn't be too surprised if it was twice in the next 12 months, and that the priority there will be for people at higher risk," Dr Wood said.
"I don't think there will be much appetite for widespread mask-wearing, but in aged care and health care settings I could see this becoming more standard in times of high circulation of respiratory viruses."
Will COVID end up being just like the flu?
Dr de Courten said comparing COVID-19 with influenza was a fallacy.
"If you get the flu, it's bad for you in that period when you've got the flu," he said.
"Once you're out of it, you're out of it.
"COVID has a number of long-term complications … they seem to add up every time you get COVID."
Dr de Courten said we still don't know how long these complications linger after infection, so it was unclear how harmful repeat infections could end up being.
"We are only at the beginning," he said.
