When does the pandemic end?

As definitively not a doctor and not a medical professional in any way, I have been thinking about and trying to define criteria that must be met in order to declare an end to this pandemic. I think that there are several scales on which this must end and can be broadened or shrunk respectively depending on how fast a given population wants to return to “normal life”. I am defining my “super official, totally legit” pandemic exit criteria as follows:

Locally:

“Locally” is very subjective and could be as small as a household or as large as a state. I would say that these criteria can apply to any of those population ranges. Of course our world doesn’t exist in such a way that somewhere like California can call the pandemic over while it still rages on in some other state. So taken together, a true “end” can’t just be local but if these guidelines are met, it seems reasonable for a given locale to remove restrictions and return to normal life. These criteria are roughly in priority order

  1. Transmission rate (R0) below 1

    1. Meaning that for every infected person they spread it to less than 1 person. Aka, the virus spread has been arrested

    2. Someone more qualified than me: https://wwwnc.cdc.gov/eid/article/25/1/17-1901_article

  2. Hospital bed vacancy above 20%

    1. We need capacity to avoid people being treated in hallways and parking lots

    2. The higher the vacancy the better but 20% is reasonable here considering hospitals are designed (in a lot of cases) to meet demand and make money. They aren’t set up to constantly have huge vacancies

    3. Some data: https://www.aha.org/statistics/fast-facts-us-hospitals

  3. Vaccination of the population above 70%

    1. Pretty hard to put a number on this one but with all the non-sense out there, even this number could be hard to achieve

    2. “Herd Immunity” varies by disease. 70% is an estimate for COVID

    3. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/herd-immunity-and-coronavirus/art-20486808

Beginning with these criteria at a local scale, certain cities, counties, maybe states could lift restrictions and preventative measures. Things like social distancing, cleaning requirements, and masking could be reasonably removed once these are met.

I have purposefully omitted things like case rates and death rates here because I would define those as a function of criteria #1 and #2. Less transmission, less cases and likewise more medical resources, less death.

Of course a wild card here is virus mutations that could drastically alter criteria #1. This is more of an ongoing while loop where world events could un-check the box on one of these criteria. To definitely put a check on a box in pen (rather than have it erased in pencil), we need to also meet these local criteria on a global scale.

Globally:

This is when a true end to the pandemic could be declared. It takes the same principles as the local declaration above but expands to the entire human population. Not only do we need to meet the criteria above but freedom of travel and freedom to work must also exist.

  1. Vaccine abundance achieved, >6 vaccines per human

    1. A full shot regime for every person on Earth plus margin for vaccine expiration, etc. (you always have to have margin)

    2. This goes to achieve criteria #3 which in turn helps to achieve criteria #1

  2. Vaccine related travel restrictions lifted

    1. Let’s not dive into the world of political embargoes and restrictions but at least people should be allowed to travel freely within the confines of their country’s world-wide relationships

    2. This also means that a quarantine period is no longer necessary no matter the “from” or “to” on your plane ticket.

To emphasize again my lack of medical credentials, take a look at my professional page. So all this is just informed speculation out of a desire to have some sort of goal to strive for. Without an end in sight or any sort of definitive criteria, the pandemic feels like a never ending disaster. My stress levels seem to have such a high baseline anymore that simple perturbations drive me to the brink of collapse. Writing out some of these ideas helps to see some sort of end. Let’s hope that light at the end of the tunnel keeps getting brighter.

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