Though considerable social distancing and mask wearing measures are widely in plac

If you look into the history of endemic diseases, you will see they weren’t always the low-level annoyances they are today. The initial paths they took were usually quite deadly. The strain of influenza that caused the 1918 pandemic is an excellent example. It infected 500 million people and killed as many as 50 million people worldwide. It is considered the most deadly pandemic of all time. It lasted nearly two years and didn’t come to an end until the summer of 1919. But the 1918 flu pandemic didn’t end because of a vaccine — which wasn’t developed until 1942. It ended because those who were infected either died or developed immunity. Influenza never went away. It is airborne and mutates frequently, which is why we have a new version of it — and thus a new vaccine for it — every year. But that initial strain from 1918 is still around. We just don’t get as sick from it anymore.

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We are starting to see signs of this happening with the SARS-CoV-2 virus. Like influenza, it is airborne and spreads through person-to-person contact. But in specific places where the virus has already peaked, we are seeing a lower incidence. North Dakota, my home state, had surging rates in mid November that are now tapering. Conversely, California, which had a minor peak in July, is now experiencing soaring rates. This trend repeats itself in state after state. While the positive testing rates from the NYS Health website show a similar upward trend in positive cases, the hospitalizations and deaths fell in June and have remained relatively low.

As an ear, nose and throat (ENT) physician in New York City, I have seen these results firsthand. I have been heading Covid-19 Compliance for major TV productions and worked on one of the first to restart. During shooting in September, we tested over 180 people three times a week and another 200 either once a week or once every other week. After nearly three months, the only person who tested positive was someone who had driven to New York from a state that hadn’t yet experienced an infectious peak.

At some point, this pandemic will either die out or shift to an endemic infection.

Yes, we are seeing a rise in Covid-19 infections. But we are seeing that happen mostly in places that haven’t already had a peak. SARS-CoV-2 has been in New York City since last January, and it struck the city hard and early. While it’s still too early to say what will happen in the year ahead, even though positive testing rates are soaring, statistical signs point to downward trends in hospitalizations and deaths in spots that have already been hit.

Even though our rates of infection in New York City aren’t what they were last spring, SARS-CoV-2 hasn’t gone away. Since this virus is airborne, we have to consider that not only people, but places, can also be infected with the virus. Though considerable social distancing and mask wearing measures are widely in place, we are still breathing in the virus if we are in enclosed spaces and places that have a lot of it.