PENNSYLVANIA (WHTM) — As COVID-19 cases decline following the omicron spike and Pennsylvania health officials move toward a “new phase” of the pandemic, it feels like the coronavirus is getting close to shifting from “pandemic” to “endemic.”

Experts say there are certain signs that could indicate when the change may be near.

Endemic diseases occur regularly in a population and follow established patterns. One common example of an endemic disease is the flu.

“I think we’re in the transition from this being pandemic to endemic. I don’t think we’re there yet. What I do expect is most of the population gets at least some form of immunity, and probably by the summer this will become a very different disease,” said Dr. John Goldman, Infectious Disease Specialist at UPMC.

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So what signs will indicate the shift to endemicity?

Goldman said next winter, if COVID-19 hospitalizations look like a typical flu season rather than a previous COVID-19 peak, the disease may be moving into endemicity.

With positivity rates and case incidences down, Penn Medicine Lancaster General Health Chief of Infectious Diseases Dr. Joseph Kontra said, “I think the trends that we’re seeing are certainly pointing in that (endemic) direction.”

COVID-19, so far, has been fairly unpredictable, a trait of a pandemic disease rather than an endemic one. New variants like delta and omicron caused unexpected spikes in coronavirus cases, hospitalizations, and deaths. Kontra said this may be changing, though.

“There’s no indication at this point in any of the testing that’s being done that a new variant has popped up yet, so if that continues to be the case, then I think we’ll be in pretty good shape for the summer,” Kontra said as of March 9.

Some places may reach the endemic stage sooner than others, Goldman said.

“I’d be looking at the U.S. to see if it’s nationally endemic or pandemic. I would also be looking locally because there are going to be states that, for example, have less vaccinations, which are going to go into the endemic stage more slowly than states like Pennsylvania that have higher rates of vaccination,” explained Goldman.

Goldman said the shift to endemicity may come depending on what happens next winter. Kontra and Dr. Raghav Tirupathi, medical director of infection prevention at WellSpan Chambersburg and WellSpan Waynesboro Hospitals, said it may come even earlier if the COVID-19 situation stays consistent into the summer.

“There is a possibility that COVID-19 infection could become endemic with steady rates of infection by summer,” Tirupathi said in an email, “but that again also comes with a certain mortality rate from this infection.”

Tirupathi noted that just because a disease is endemic doesn’t mean that it’s not also deadly, explaining “malaria is endemic in several parts of the world but has killed about 600,000 people in 2020 and tuberculosis is endemic in several parts of the world and has killed about 1.5 million people in 2020.”

Even a typical flu season causes tens of thousands of deaths and hundreds of thousands of hospitalizations, Goldman noted.

“The term ‘endemic’ has been used in a lax fashion. Endemic state does not mean stable state as it can still cause periodic surges and disruptions to daily life. The last thing we want is the public letting down guard against this nasty disease. Masking in high-risk situations, vaccination, early testing and treatment should continue to be cornerstones of prevention,” Tirupathi said via email.

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As for who officially designates COVID-19 as endemic, the Associated Press reported in January that most wealthy countries will probably make that decision themselves based on their individual situations, but they may watch for the WHO to switch COVID-19 away from its highest level of alert of global health emergency.