Dr. John Ioannidis: Transition from Pandemic to Endemic Now Happening

Dr. John Ioannidis, a graduate of the Medical School of the University of Athens, says that Greece and other Western nations are likely transitioning out of the pandemic and into an endemic phase of the coronavirus.

Although many countries are still grappling with high hospitalization rates, that is most likely due for the most part to the lingering effects of the Delta wave, he states.

“Omicron has the characteristics of an endemic wave,” the medical professor states, telling Greek Reporter in an exclusive interview that this includes “seasonal appearance, high rates of transmission, disproportionately low death burden in a setting where there is very high background immunity due to prior infection and/or vaccination.”

Ioannidis: pandemic to endemic transition already happening

Ioannidis states to Greek Reporter “Omicron is very difficult to stop and it has indeed replaced Delta. In many places, the transition to Omicron is practically complete and Omicron represents almost 100% of the new infections by mid-January; other places are getting there more slowly.

“Omicron also seems to offer good immunity against Delta,” he notes, while acknowledging “We still see in some countries, including several states in the USA, in Greece, and several European counties a substantial number of deaths.

“This reflects probably both the earlier infections from Delta (death follows several weeks after the original infection), some of the clinical burden of Omicron itself (given the extremely high number of infections), the lack of high vaccination coverage in the elderly and vulnerable people, and the continuous stress on healthcare systems.”

Vaccinations, booster shots are still important, Ioannidis says

The Stanford University medical professor then states categorically “For countries that have achieved very high vaccination rates in the elderly and that have functional healthcare systems (e.g. almost all of the western European countries), the transition from the pandemic phase to the endemic phase most likely has already happened.”

Pfizer CEO Albert Bourla echoed this assessment, saying on Monday as reported by The Times of Israel that although the “most likely scenario” is that the coronavirus will be in the population for many years, he believes the current wave will be the final one that requires restrictions on our movements.

Bourla, speaking with French news channel BFM TV after the announcement of a new deal to produce Paxlovid in France, praised the efficaciousness and safety of coronavirus vaccines in fighting the pandemic, but added that he thinks the public will continue to need booster shots as time goes on.

“It’s important that people receive the three-dose regimen of Pfizer’s coronavirus vaccine, and will likely then require annual boosters — although the immunocompromised could require them every four months,” Bourla stated, adding “Children must be vaccinated in order to protect them. Its effectiveness in children is very, very, very good.”

The Pfizer CEO stated that his firm’s anti-COVID-19 pill, Paxlovid, “changes everything,” in the ongoing fight against the coronavirus. When it was authorized for use by the US’FDA in December, the company stated that Paxlovid pill reduced hospitalizations and deaths in this most at risk by an incredible 89 percent.

However, the production of the pill has been lagging, with only limited amounts of Paxlovid available to states as they continue to battle the lingering effects of the pandemic. As part of his Monday interview, Bourla said Pfizer had inked a deal involving a 520-million-euro ($593.7 million) investment including a partnership with the French firm Novasep to develop another pill treatment to battle the virus.

“Probably more than half of the USA population has been infected with SARS-CoV-2”

Stanford professor Ioannidis states that “Prior immunity may not suffice to stop transmission, but it is sufficient to curtail the burden of deaths” a great deal as nations around the world begin to see the ramifications brought about by the Omicron variant.

However, he hastened to point out that vaccination is still vitally important, stating “For countries and locations that still have large numbers of vulnerable/elderly people who are unvaccinated and have problematic health systems with limited resources, exiting from the pandemic will take longer and will be more painful.”

Greek Reporter asked Dr. Ioannidis for his opinion on double masking or using an N-95 mask at this point, when many establishments are requiring the use of these for entrance.

“We have two randomized trials assessing whether masks work or not… both show roughly a 10% relative risk reduction for infection in real-world circumstances.

“This means that if one had, say, a 5% chance of being infected, a strategy of wearing masks would decrease this to 4.5%. This may seem like a small benefit, but when extrapolated to millions and billions of people, it can be substantive” he explains.

“At the same time, one wants to improve on these numbers, if possible, to get a bigger benefit,” Ioannidis urges. “Masks are not used as they should and/or they are used erratically, and this erodes whatever modest benefits they might have.

“Severe disease from the pandemic is exceedingly rare” with Omicron

“Moreover, many people falsely assume that masks are extremely effective and they may expose themselves in extremely congested situations, thinking that masks would protect them 100%, while this is clearly not the case. Double masking and N-95 masks may improve the efficacy of the protection by a modest amount, but we have no real-world large, randomized trials comparing different types of masking,” the medical professor cautions.

“Nevertheless, the same principles apply. Masks are not a panacea and the ink and animosity that have been spent on debates about masks is not worth it… Especially with an extremely transmissible variant like Omicron, avoiding highly congested circumstances during the epidemic wave is the best thing one can do.

“Even then, with or without masks, a very large segment of the population is unavoidably infected, almost always with minimal or no symptoms. Since the beginning of the pandemic, probably more than half of the USA population has been infected with SARS-CoV-2, and many people have been infected more than once.

“Re-infection seems to be even more common now during the Omicron surge, although it almost always leads to no or few symptoms,” he pointed out.

Asked if there are any supplements the public can avail themselves of to bolster their overall immunity, Ioannidis said that Zinc had given in combination with other treatments in COVID-19 patients; however, the results are “difficult to interpret because the studies are small and/or non-randomized.

“The randomized trials show no obvious benefit for time to recovery, although one trial found faster recovery of smell and taste. Vitamin C (either oral or intravenous) has been assessed in a substantial number of published randomized trials of COVID-19 patients, but all of them are pretty small in sample size. Putting their data together, there is no evidence for a clear benefit for major outcomes, like mortality or length of stay in the intensive care, but we need large and better studies to have a conclusive statement, a small benefit cannot be excluded.

“So, I am not sure there is much benefit to taking treatments that are not certain to do good – even though neither zinc nor vitamin C are going to cause much harm either.

“Overall, one needs to consider that the overwhelmingly vast majority of people infected with SARS-CoV-2 will do perfectly fine, regardless of whether they take any of these treatments or not, he states, adding “Bad outcomes were rare even before the advent of Omicron, especially in non-elderly people.

“With Omicron, which typically has no symptoms at all or feels like a minor cold, the probability of an excellent outcome is even higher; severe disease is exceedingly rare.”