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Blog 4 February, 2022 Back

Turning a cough into calm, COVID-19 update from the Anvil Medical Team

Dr Juliane Kause

Pandemic to endemic

Now is the time to start shifting the health and safety message from extraordinary measures to standard precautions.

As natural and vaccine-induced community immunity to COVID-19 grows, COVID-19 has and will become endemic in many parts of the world.

Organizational resilience will be critical to ensuring that your organisation is able to embrace a new and ongoing protocol focused on continued production with a new endemic illness.

It is important to acknowledge that endemic disease is not always synonymous with mild illness. Many endemic illnesses, including the seasonal flu, have the potential to cause severe illness and death – COVID-19 is similar. Even endemic diseases like flu can cause pandemic outbreaks when new variants of the virus emerge. However, most people who encounter COVID-19 in the years ahead will have some level of immunity, making severe illness less common. Additionally, novel COVID-19 treatments have been created and thoroughly tested over the past two years.

Effective treatment across the spectrum of disease is increasingly available as pills offered in the early stages of disease – sometimes without the need to visit a medical facility.

It is helpful to think of the pandemic in three phases:

Phase 1: Discovery & Learning (March – November of 2020)

During the discovery phase, we became aware of a novel virus, learned about its transmission and how to mitigate spread, and began to test treatments and vaccines. Because so much was unknown, tests were difficult to obtain, and few treatments were known to be effective. This was a time of alarm and extensive “shelter in place” and “lockdown” protocols. The unknown was more than the known.

Phase 2: Vaccination & Variants (December 2020-January 2022)

During this period, vaccines became accessible to those aged five and older. Initially the vaccines provided robust protection against infection and severe illness. Over time, as vaccine-immunity waned and variants developed “escape” characteristics, both the fully vaccinated and previously infected became more vulnerable to infection but remained largely protected from severe illness.

At the end of this period, Omicron’s high transmissibility meant that most people who had previously lacked infection or vaccine induced immunity were exposed to the virus. While a difficult time for many, this widespread infection seems likely to expedite our transition to endemic COVID-19.

Phase 3: From pandemic to endemic (Now)

We are now entering a period where COVID-19 is joining the list of common and expected respiratory ailments that are most prevalent in the winter months. Making this transition will require changing the old narrative to align with a paradigm shift from “avoiding the virus at all costs” to “taking sensible precautions to protect against all respiratory illnesses.”

Creating a new narrative for a new time

Now is the time to take the first step in acknowledging COVID-19 is here to stay, that we can adapt, survive, and even thrive again by mitigating risk without major shutdowns or disruptions.

coughs and coldsWorldwide up to 650 000 people die of respiratory diseases linked to seasonal influenza each year and we have adapted. We get our flu shots, we stay home when sick, and we pay particular attention to hand hygiene in the winter. And if we get the flu and are at high risk, we contact our physician for oral antivirals to potentially reduce its severity.


The new message is: COVID-19 can be severe, but it rarely is in those vaccinated or with natural immunity. The way to keep operating is to focus on mitigating the threat of all respiratory illnesses by emphasizing protective behaviors at the individual level. These include hand hygiene, attention to ventilation, staying home when sick, using respiratory protection in high-risk environments (e.g. caring for a sick friend or relative), and addressing waning immunity with booster shots.

When the pandemic arrived in 2020, we collectively had low immunity, few treatments, and failed to understand how environmental and physical changes can reduce risk. Two years later, most of the global population have immunity to severe COVID-19 and COVID-19 is a treatable and vaccine preventable illness. By replacing extreme measures with standard mitigations for respiratory illness, we can normalize COVID-19 and our collective response to it.

Anvil CMO Juliane Kause has put together a Health Fact Sheet, this is on the Anvil Covid-19 microsite along with our regularly updated travel restrictions and guidance.