The WHO has declared the end of pandemic phase of COVID‐19: Way to come back in the normal life

Abstract

The coronavirus disease 2019 (COVID‐19) pandemic has resulted in significant global mortality and morbidity affecting millions of lives. As healthcare authorities worldwide are still paying substantial attention to COVID‐19, other diseases continue to cause more deaths than COVID‐19. The decreasing number of COVID‐19 cases and deaths indicates that the pandemic is close to the end. For effective pandemic management, healthcare facilities worldwide have established COVID‐19 units and testing facilities, instituting infection prevention and control measures, and employing telehealth services. Healthcare professionals have identified some promising treatments for COVID‐19; also, mass vaccinations have improved patient outcomes. Instead of COVID‐19 as a pandemic, it is time to pay more attention to other diseases to lessen their impact on public health. Therefore, the World Health Organization (WHO) has declared the end of the pandemic phase of COVID‐19 considering the current COVID‐19 situation and our preparedness, past pandemic experience, and long pandemic impact on social and economic life on May 5, 2023. In this article, we briefly discussed the present challenges due to COVID‐19, necessary precautions, and future directions to return to life as before COVID‐19.

1. BACKGROUND

The coronavirus disease 2019 (COVID‐19) pandemic represents a global crisis that has caused extensive and far‐reaching impacts affecting millions of individuals worldwide. ¹ , ² , ³ , ⁴ As of May 3, 2023, more than 765 million reported cases of COVID‐19 with nearly seven million related deaths. ⁵ It is worth noting that the World Health Organization (WHO) declared the pandemic on March 11, 2020. ⁵ Following this declaration, the pandemic increased exponentially, leading to a high mortality rate and health burden. The elevated contagion rate led to a staggering more than 183 million cases after 1 year, although the number of fatalities had declined to 396,695. Besides COVID‐19, other deadliest diseases are taking away lives much more than COVID‐19 in recent times. ⁵ , ⁶ , ⁷

According to the WHO, in 2019, ischemic heart disease caused 8.9 million deaths, followed by stroke, with 6.2 deaths. The other causes of death on the list ranged from 3.2 to 1.3 deaths. ⁸ In 2021, the United States faced 695,547 deaths due to heart disease, followed by cancer, responsible for 605,213 deaths, and COVID‐19 for 416,893. ⁹ The COVID‐19 pandemic was responsible for 3.8 million deaths globally that year. However, in 2022, the number of deaths caused by the pandemic decreased to 1.2 million. ⁵ But in the last 3 months of 2023, those diseases, except COVID‐19, caused death even with a higher rate than previous, 2.6 million by ischemic heart diseases, followed by stroke and chronic obstructive pulmonary disease with 1.6 and 0.8 million. The number of deaths related to COVID‐19 has further decreased to around 72,000, which is 16.06 times lower than the number of deaths recorded in 2021. ⁵ This decrease in the number of COVID‐19 cases and deaths is indicative of the possibility that the pandemic may be coming to an end. It is also important to note that COVID‐19 has significantly impacted public health beyond its mortality rate. While the COVID‐19 pandemic is going on, a significant concern has been given to it. It is also essential to recognize that other diseases are responsible for many deaths. With the decreasing number of COVID‐19 cases and deaths, it is important to shift focus toward addressing these other diseases to reduce their impact on public health. The WHO has declared that COVID‐19 is no longer a public health emergency of international concern considering the current situation of COVID‐19 and its impact on global public health. ¹⁰

2. PAST PANDEMIC EXPERIENCES AND CURRENT COVID‐19 CHALLENGES

Pandemics have plagued humanity for centuries. The mid‐14th‐century Black Death or bubonic plague in Eurasia killed 75–200 million people. ¹¹ Fever, vomiting, and enlarged lymph nodes were produced by flea bites on rats. The epidemic devastated medieval civilization, creating economic instability, social unrest, and religious and cultural upheavals. The pandemic ceased in the 1350s. The disease gradually became less prevalent over time, likely due to improved public health measures and a reduction in the rodent population that spread the disease. ¹² , ¹³ Another widespread pandemic was the 1918–1919 Spanish flu. It infected 500 million people and killed over 50 million. ¹⁴ The epidemic devastated worldwide health, society, and the economy. The Spanish flu pandemic also subsided over time, with the number of cases and fatalities gradually decreasing in the years following the initial outbreak. ¹⁵ It is not entirely clear what caused the pandemic to end, but factors such as increased immunity in the population, improved public health measures, and the development of vaccines likely played a role. In 2009, the H1N1 swine flu pandemic occurred. This pandemic was swarmed by disinformation, fast worldwide spread, and vaccination shortages. Several people could not get the vaccine because vaccine manufacture was delayed, and the illness was highly infectious. Public health experts also struggled with misinformation. ¹⁶ , ¹⁷ The virus finally declined. The number of cases and deaths gradually decreased in the following years of the outbreak, and the virus eventually became part of the seasonal flu strains that circulate each year The pandemic ended in August 2010, emphasizing the necessity for global preparedness and response to new infectious illnesses. ¹⁸

The recent pandemic, COVID‐19, has significantly impacted public health, the economy, and society. This pandemic caused widespread sickness, mortality, economic hardship, social isolation, and political turmoil. Due to increasing travel and interconnection, COVID‐19 has spread globally faster than previous pandemics. ¹ , ¹⁹ This makes virus control harder. Symptomless COVID‐19 carriers make it harder to detect and isolate sick patients. Mask‐wearing and social alienation have become commonplace isolation and loneliness cause depression, anxiety, and other mental health issues. ²⁰ , ²¹ Pandemic‐related social isolation and economic hardship have produced these concerns. COVID‐19 has caused extensive job loss and company closures. The pandemic highlighted and worsened social and economic inequities. ²² While progress has been made in mitigating the impact of the pandemic, it continues to be a global health threat. Despite the challenges of pandemics, they have also led to significant public health and medicine advancements.

3. THE GLOBAL PREPAREDNESS AGAINST COVID‐19

The ongoing COVID‐19 pandemic has created an unparalleled global healthcare burden, resulting in an urgent need for healthcare facilities to treat infected patients. The surge in demand for COVID‐19 care has prompted healthcare systems worldwide to rapidly adapt their existing infrastructure and establish new facilities to manage the pandemic effectively. ²³ Now every hospital has well‐equipped COVID‐19 units that can accommodate many patients. ²⁴ Additionally, many healthcare facilities have established dedicated COVID‐19 testing centers to facilitate widespread testing and help identify infected individuals. Telehealth services also play a vital role in managing COVID‐19. With physical distancing measures in place to limit the spread of the virus, telehealth services have enabled patients to consult with healthcare providers. ²⁵ , ²⁶ It has also been used for COVID‐19 screening, enabling healthcare professionals to assess patients for COVID‐19 symptoms and provide guidance on the next steps. Again, healthcare facilities have implemented several measures to control COVID‐19. These measures include enhanced cleaning and disinfection protocols, using personal protective equipment, and implementing physical distancing measures in waiting areas and patient rooms. ¹⁹ , ²⁷ , ²⁸

Researchers have identified several promising treatments for COVID‐19, including monoclonal antibodies, antiviral drugs, and corticosteroids. These treatments have been shown to reduce the severity of illness and improve patient outcomes effectively. ²⁹ , ³⁰ , ³¹ They have also made significant progress in understanding the severe acute respiratory syndrome coronavirus 2 virus and pathophysiology of COVID‐19. ³² , ³³ This has helped to inform the development of vaccines, treatments, and diagnostic tests and has provided insights into how the virus spreads and affects the body. They have developed new and improved diagnostic tests for COVID‐19, including rapid antigen tests and more accurate polymerase chain reaction tests. These tests have helped to identify cases and prevent the spread of the virus. ³⁴ , ³⁵ It is also possible to quickly identify the variant of COVID‐19, along with its spreading and mortality rate. Doctors also have gained much knowledge about COVID‐19 since the start of the pandemic, which has been crucial in the fight against the virus. ³⁶

International organizations have played a critical role in coordinating efforts to combat the COVID‐19 pandemic. In partnership with other international organizations, WHO has led efforts to distribute COVID‐19 vaccines to countries worldwide. ³⁷ International organizations including the WHO, Centers for Disease Control and Prevention, and European Centre for Disease Control and Prevention have shared information and best practices on COVID‐19 with countries worldwide. They have been coordinating and funding research on COVID‐19, including studies on the efficacy and safety of vaccines and treatments, as well as research on the impact of the pandemic on mental health, social inequalities, and other issues. They have also provided humanitarian aid to countries severely impacted by the pandemic, including medical supplies, financial support, and technical assistance. In addition to that, they have been advocating for global cooperation and solidarity in the fight against COVID‐19, emphasizing the need for countries to work together to develop and distribute vaccines, share information, and coordinate public health measures. ³⁸ , ³⁹

According to the latest vaccination report of COVID‐19, as of April 30, 2023, more than 13 billion vaccine doses have been administered worldwide. Among the vaccine recipients, more than 5.5 billion individuals have received at least one dose, accounting for a percentage of 71.07 per 100 population. Moreover, more than 5.1 billion people have completed their primary vaccination series by receiving the last dose, which represents 65.44 persons fully vaccinated per 100 population. Additionally, 31.39 persons are boosted per 100 population worldwide. ⁵ The data suggests that the global vaccination drive against COVID‐19 is progressing steadily, with a substantial number of people receiving their primary and booster doses. As public health organizations, governments, and other groups have launched education campaigns to inform people about COVID‐19 and how to protect themselves and others, people have become more knowledgeable about COVID‐19 and how it spreads. ³⁶ , ⁴⁰ This has led to increased adoption of public health measures such as wearing masks, social distancing, and practicing good hygiene. They are also getting vaccinated, seeking necessary medical care, and following public health guidelines.

4. THE WHO DECLARES COVID‐19 IS NO LONGER A GLOBAL HEALTH EMERGENCY

The COVID‐19 pandemic has caused immense disruption and hardship for people worldwide. ²⁰ , ⁴¹ , ⁴² It has resulted in countless cases, deaths, and significant economic and social impacts. While the situation has been challenging, there is a reason for hope. Now, a maximum number of people are vaccinated, we have proper facilities to combat COVID‐19, doctors and the public are well aware, and numerous research have shown positive results. The pandemic should not be continued any longer. Therefore, the WHO declares COVID‐19 is no longer a global health emergency on May 5, 2023. ¹⁰

Monitoring post‐COVID symptoms has become an increasingly important aspect of the pandemic response, as many people who have recovered from COVID‐19 are experiencing COVID‐induced symptoms. ⁴³ , ⁴⁴ These post‐COVID symptoms, also known as “long‐COVID,” range from mild to severe mainly as respiratory, cardiovascular, and neurological symptoms. These include fatigue, shortness of breath, chest pain, coughing, brain fog, headaches, muscle and joint pain, and gastrointestinal issues. These symptoms can persist for weeks or even months after the initial infection, sometimes leading to long‐term health problems. ²¹ , ⁴⁵ , ⁴⁶ To monitor post‐COVID signs, healthcare providers may use various tools and techniques, including physical exams, blood tests, imaging studies, and questionnaires or surveys. They may also collaborate with specialists in multiple fields, such as pulmonologists, cardiologists, and neurologists, to evaluate and treat specific symptoms. Many healthcare providers are offering rehabilitation programs for patients who have recovered from COVID‐19 and are experiencing post‐COVID symptoms. These programs may include physical therapy, respiratory therapy, and occupational therapy, among other interventions. To effectively manage post‐COVID symptoms, healthcare providers may need to work with a team of specialists from various fields. For patients with post‐COVID symptoms, connecting with others going through similar experiences can be helpful. Further research should be conducted to better understand post‐COVID symptoms and their underlying causes, along with clinical trials of long‐term treatments for COVID‐19, including medications, supplements, and other interventions.

5. CONCLUSION

The COVID‐19 pandemic has profoundly impacted our lives, and the declaration of the end of the pandemic phase allows many people to come back to a pre‐COVID‐19 normal life. While the situation remains challenging, the development of effective vaccines and continued efforts to promote public awareness and adherence to public health guidelines provide reasons for optimism. As we are moving forward into the new era, individuals and governments need to continue to work together to combat the spread of the virus and to support those who the pandemic has impacted. By remaining vigilant and committed to our shared goal of a pandemic‐free future, we can look forward to a brighter and more hopeful year ahead.

AUTHOR CONTRIBUTIONS

Rapty Sarker: Conceptualization; writing—original draft. A. S. M. Roknuzzaman: Conceptualization; writing—original draft. Nazmunnahar: Conceptualization; writing—original draft. Mohammad Shahriar: Writing—review and editing. Md. Jamal Hossain: Writing—review and editing. Md. Rabiul Islam: Writing—review and editing.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

TRANSPARENCY STATEMENT

The lead author Md. Rabiul Islam affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Sarker R, Roknuzzaman ASM, Nazmunnahar, Shahriar M, Hossain MJ, Islam MR. The WHO has declared the end of pandemic phase of COVID‐19: way to come back in the normal life. Health Sci Rep. 2023;6:e1544. 10.1002/hsr2.1544

DATA AVAILABILITY STATEMENT

Data are available on request from the authors.