'I do feel like we are maybe actually moving toward a true endemic phase'

September 02, 2022
Translucent bubbles mix with red and gray coronavirus particles in an illustration of the virus.
Creative rendition of SARS-CoV-2 virus particles. Credit: National Institute of Allergy and Infectious Diseases

About 2 ½ years into the COVID-19 pandemic, are we finally seeing an important shift? Julie Hirschhorn, Ph.D., director of the Molecular Pathology Lab at the Medical University of South Carolina and associate professor in the College of Medicine, thinks so.

“I do feel like we are maybe actually moving toward a true endemic phase. An endemic phase is classified by having a season and determine an acceptable level of transmission,” she said. “As COVID-19 moves to an endemic phase, the increases in cases need to become consistent, like flu season, and determine what a reasonable level of disease in the population is for COVID-19 that does not significantly disturb our daily lives.”

Her assessment comes as MUSC prepares to close some COVID-19 testing sites due to decreased demand and Hirschhorn’s team gets ready to close its sequencing lab. The lab has been looking at the genetic makeup of COVID cases to see which variants have been circulating, but federal funding for that work has run out. Hirschhorn is looking into other possible ways to keep the lab going.

The sequencing lab’s work began in the winter of 2020, giving medical experts and the public an idea of how the coronavirus was mutating. In what may be its final reportthe lab found that the highly transmissible Omicron subvariant BA.5 maintained its dominance in August. 

That’s no surprise to Hirschhorn, whose team first detected BA.5 in May. The subvariant spread so quickly that it pushed up the positivity rate, meaning the percentage of people who tested positive for COVID-19. That’s finally slowing.“I think we're in our second week that I've seen a decline in the positivity rate,” Hirschhorn said.

Something else that’s declining: the staffing level in the Molecular Pathology Lab. The lab, which handles testing of all kinds for MUSC Health, dramatically increased its staff during the peak of the pandemic as MUSC became the first hospital/medical center in the state to do its own COVID-19 testing. Now, the lab is almost back to its pre-COVID level of employees. But Hirschhorn said it can quickly gear up again if needed.

“We've met a lot of challenges over the years and have learned how to deal with them. And so now as we move toward an endemic phase, where boosters may become a regular thing, we're just trying to figure out the best way to adapt without losing that infrastructure that we built from this pandemic. That way, we'll be prepared if something does happen here.”

Hirschhorn is glad for her team to get a little breathing room. “All of the COVID testing that we did was on top of all of the lab testing that we already do because there's so many reasons why we perform testing and for different patient populations. It's kind of nice to get a moment to think about what kind of tests we need to offer to meet the needs of our clinicians and our current patient population.”

But she predicted we’ll see another COVID wave this winter. “Now we have to hope that a new variant doesn't arise that causes the change in the severity of disease course or evasion of treatment for vaccine status or a switch in the virus that makes it not detectable by our diagnostic tests.”

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