Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA.
Eur J Clin Invest. 2022 Jun;52(6):e13782. doi: 10.1111/eci.13782. Epub 2022 Apr 5.
There are no widely accepted, quantitative definitions for the end of a pandemic such as COVID-19. The end of the pandemic due to a new virus and the transition to endemicity may be defined based on a high proportion of the global population having some immunity from natural infection or vaccination. Other considerations include diminished death toll, diminished pressure on health systems, reduced actual and perceived personal risk, removal of restrictive measures and diminished public attention. A threshold of 70% of the global population having being vaccinated or infected was probably already reached in the second half of 2021. Endemicity may still show major spikes of infections and seasonality, but typically less clinical burden, although some locations are still hit more than others. Death toll and ICU occupancy figures are also consistent with a transition to endemicity by end 2021/early 2022. Personal risk of the vast majority of the global population was already very small by end 2021, but perceived risk may still be grossly overestimated. Restrictive measures of high stringency have persisted in many countries by early 2022. The gargantuan attention in news media, social media and even scientific circles should be tempered. Public health officials need to declare the end of the pandemic. Mid- and long-term consequences of epidemic waves and of adopted measures on health, society, economy, civilization and democracy may perpetuate a pandemic legacy long after the pandemic itself has ended.
目前,尚无广泛认可的、针对新冠疫情等大流行结束的定量定义。一种新病毒引发的大流行的结束和向地方病过渡,可能是基于全球很大一部分人口对自然感染或疫苗接种具有一定免疫力来定义的。其他考虑因素包括死亡人数减少、卫生系统压力降低、实际和感知到的个人风险降低、限制措施的取消以及公众关注度降低。到 2021 年下半年,全球 70%的人口接种疫苗或感染病毒的阈值可能已经达到。地方病仍可能出现大规模感染和季节性高峰,但通常临床负担较轻,尽管某些地区仍比其他地区受到的影响更大。到 2021 年底/2022 年初,死亡人数和 ICU 入住率也表明已经向地方病过渡。到 2021 年底,全球绝大多数人的个人风险已经很小,但感知到的风险可能仍然被严重高估。到 2022 年初,许多国家仍在实施高度严格的限制措施。新闻媒体、社交媒体甚至科学界的巨大关注应该得到缓和。公共卫生官员需要宣布大流行的结束。大流行浪潮和所采取措施对健康、社会、经济、文明和民主的中长期后果,可能会在大流行本身结束很久之后,继续留下大流行的遗产。