As the word “quarantine” first echoed through every household in the U.S., the emerging feelings of confusion and fear were quickly masked by the prospect of wearing pajamas all day and the joy of skipping school. However, the excitement soon wore off as two weeks became two months and two months turned into two years. 

This March marks the two year anniversary of the world shutting down as COVID-19 crept into the U.S. Since then, over 875,000 people have passed away due to COVID-19 in just the United States alone. With the rapid development of mutations, we will likely see this number continue to rise.

Despite this, some countries have begun calling for COVID-19 to be treated like an endemic disease and not a pandemic — just like the seasonal flu. The CDC classifies an endemic as “the constant presence of a disease in a population.”

However, sources from the World Health Organization (WHO) have warned that prematurely naming COVID-19 an endemic disease could be dangerous.

“We still have a huge amount of uncertainty and a virus that is evolving quite quickly, imposing new challenges,” WHO’s senior emergency officer for Europe, Catherine Smallwood said. “We are certainly not at the point where we are able to call it endemic.” 

Yet, on February 1st, Denmark became the first EU country to lift all of their COVID-19 restrictions— despite having the second-highest infection rate in the world. They lifted mask mandates, the requirement of “Covid Passes” for entry into public areas, and self-isolation when testing positive. 

Denmark is not alone in this decision. Other European countries have begun lifting COVID-19 restrictions as well— including Norway, France, and Sweden.

These decisions bring up the question of whether the U.S. will be moving towards similar action in the coming months. While there is no solid answer to this, the decision will likely be made on a metric of transmission.

The CDC tracks the spread of COVID-19 in each county of the U.S. and ranks them by their levels of transmission.

“It’s based on new cases per 100,000 persons in the past seven days. Low is less than 10. Moderate is another range, substantial another, and high is another.” chief executive officer of NACCHO, Tremmel Freeman said.

As of January 31st, every county in the U.S. is in the highest level of transmission, except for four counties. This means that they have at least 100 new cases per 100,000 people each week. As long as transmission rates remain this high, it is unlikely that the U.S. will be removing COVID-19 restrictions anytime soon.

For example, in Columbus, Ohio, the city’s mask mandate will not be lifted until they are in the moderate transmission bracket for four consecutive weeks. 

Similarly, in North Carolina’s Mecklenburg County, their indoor mask mandate will lift as soon as their percent positivity rate hits 5% or below for seven consecutive days.

So, until the amount of cases per week drops below 10 cases per 100,000 people in each county, we can expect to see restrictions sticking around in the U.S. To reach this point, most health experts agree on one thing: vaccines are the best option for ensuring this pandemic becomes endemic. 

Every RNA virus will eventually mutate to adapt to its surroundings, allowing the virus to overcome treatments. By getting vaccinated, infection can be prevented, which will in turn help lessen the possibility for COVID-19 to mutate.

“Viruses don’t mutate unless they replicate,” Chief Medical Advisor Dr. Anthony Fauci said. “And if you can suppress that by a very good vaccine campaign, then you could actually avoid this deleterious effect that you might get from the mutations.”