On Wednesday, the US Department of Health and Human Services (HHS) officially ended its system for hospitals to report COVID-19 deaths daily to the federal government, amid a worldwide campaign to reduce the reporting of COVID-19 deaths and cases.

The end of the hospital death reporting came as the official US death toll from COVID-19 approached 900,000, and at least 60,000 people died from COVID-19 in January.

The same day as the US federal government stopped collecting figures on hospital deaths, the UK government announced plans to end reporting of the UK’s COVID-19 death toll by Easter.

The move by HHS, which was quietly announced on January 6, received no coverage until Dr. Jorge A. Caballero brought it to public attention on January 14. A tweet reporting Caballero’s warnings by this reporter went viral, prompting thousands of people to state their opposition to the move.

The end of hospital death reporting has been met with a wall of silence in the media. But among health experts, there is broad opposition to this measure, which would slash the most up-to-date metrics for assessing the current state of COVID-19 deaths and hospital capacity.

The move is “incomprehensible,” one federal health official told the WSWS.

“It is the only consistent, reliable and actionable dataset at the federal level,” the official said. “Ninety-nine percent of hospitals report one hundred percent of the data every day.”

Responding to claims that the HHS data is duplicative of death data collected by the Centers for Disease Control and Prevention (CDC), the official said, “deaths are reported by the counties/states but the process is very slow and many coroners are actually not wanting to cite COVID as the reason, while hospitals rely on diagnoses.” The official continued, “It is also timely as it is every day and many states have a delay anyway but now many are reporting less often.”

Prior to the ending of the HHS reporting system, there were two ways for COVID-19 deaths to be reported to the federal government.

The HHS system relied on direct reporting by hospitals, meaning that all deaths were reported by trained medical professionals on the basis of medical diagnoses. It was daily, timely and included a broad cross-section of relevant information.

With the end of this system, the only remaining means for the federal government to track COVID-19 deaths relies on the aggregation and reporting of death certificates on the state level. These statistics, which pass through America’s fragmented, archaic and politically manipulated system of coroners and medical examiners, are then aggregated by the CDC.

The office of coroner is a remnant of the Middle Ages, in which the officer’s primary responsibilities had to do with the collection of revenues for royal authorities. A 2009 National Academy of Sciences (NAS) report explained: “On behalf of the crown, the crowner [coroner] was responsible for inquests to confirm the identity of the deceased, determine the cause and manner of death, confiscate property, collect death duties, and investigate treasure troves.”

The report, commissioned by the US Department of Justice, stated that “more than 80 years ago, the [NAS] identified concerns regarding the lack of standardization in death investigations and called for the abolishment of the coroner’s office, noting that the office ‘has conclusively demonstrated its incapacity to perform the functions customarily required of it.’”

The 2009 review found that “About 36 percent of the population lives where minimal or no special training is required to conduct death investigations. Recently, an 18-year-old high school student was elected a deputy coroner in Indiana after completing a short training course.”

As the Economist recently warned, “Coroners reliant on voters who are skeptical about COVID have not been as scrupulous as their medical-examiner peers. One coroner in Missouri candidly told the press that he strikes COVID-19 from the death certificates at the request of the family of the deceased.”

Once the data goes through the coroner/medical examiner system, it will be aggregated by states, most of which do not report daily and are themselves moving rapidly to reduce the frequency of COVID-19 death reporting. Tennessee ended daily reporting in early January, and Pew reports that “experts expect other states to follow.”

The official added that the HHS dataset “is normalized to a specific hospital and can he compared to other data like capacity, number of admissions, ages of admissions, number in ICU, number of ventilated and a death count—not just for COVID but also influenza (which we have never had good insight into at this scale).”

The official said that the official explanation, that the ending of data aims to reduce “burdens” on the hospital system, is not believable, because the system is largely automated through the Electronic Medical Records (EMR) System.

Hospitals operate massive data infrastructure systems, with medical staff spending a substantial portion of their time entering data into these systems.

The HHS worked with major manufacturers of medical records software to automate the system, meaning that close to 85 percent of the data reporting was fully automated.

“The hospitals have been doing this for going on two years,” the official said. HHS “worked with all the major EMR vendors to automate the capture of this data.”

Last year, Alexis C. Madrigal, a co-founder of the COVID Tracking Project, writing in the Atlantic, called the HHS reporting system “America’s Most Reliable Pandemic Data,” writing, “The hospitalization data coming out of HHS are now the best and most granular publicly available data on the pandemic. This information has changed the response to the pandemic for the better.”

Explaining why the system was set up, the official said, “There was no hospital data at the federal level and even at many states. We had no idea who has capacity, who was in trouble, who had supply shortages, who was getting admissions so fast that they would need supplemental meds, who has staffing issues, etc. We also didn’t know anything about the people admitted in a timely manner, such as age.”

The ending of the HHS reporting system will likewise inflict collateral damage on the management of other diseases, including influenza. “The CDC has never really counted cases for things that a lot of people get like the flu,” the official said. “They get data from sentinel sites and then extrapolate what is happening.”

Stating that there existed a “correlation” between the calls for ending COVID-19 data reporting and the drive to make life with COVID-19 the “new normal,” the official warned, “I don’t know any scientists who want to have less data.”

The Omicron wave is now receding in states where the extremely contagious variant arrived later, and some governors are saying it’s time for pandemic-fatigued Americans to try to restore a sense of normalcy and learn to live with the virus.

The United States remains in a precarious position, as hospitals are overstretched and daily deaths are above 2,500 and rising. Case counts are now declining in some interior states, including Arizona, Utah, Colorado, North Dakota, Louisiana and Mississippi, where Omicron swept through more recently, and while new cases are falling nationally, too, they remain far higher than in any other period of the pandemic. And the spread of an Omicron subvariant that appears to be even more contagious has some experts warning that it could take longer than expected for the winter wave to wane.

The daily average of U.S. cases remains about 519,000 a day — more than double the worst statistics from last winter. Hospitalizations, which lag cases, seem to have peaked nationally, though they remain higher than last winter’s peak. Deaths, which lag more, are also at record levels in some states.

In a few states, like Washington and Montana, cases are still rising.

A few state leaders said Sunday that while more variants and, inevitably, another surge remain a threat, Omicron has brought the country closer to the endemic stage of the virus.

“We’re not going to manage this to zero,” Gov. Philip D. Murphy of New Jersey, a Democrat, said to Chuck Todd on NBC News’ “Meet the Press” on Sunday. “We have to learn how to live with this.”

Public health experts say the next phase of the virus in the United States will depend on what variants emerge and whether a sluggish vaccination campaign picks up speed. Herd immunity to the coronavirus, experts say, is unlikely to be achieved.

The spread of an Omicron subvariant is yet another reminder of the unpredictable path the pandemic could take next.

Scientists warn that the new member the Omicron viral family, known BA.2, could drag out the Omicron surge in much of the world. So far, BA.2 doesn’t appear to cause more severe disease, and vaccines are just as effective against it as they are against other forms of Omicron. But BA.2 does show signs of spreading more readily.

“This may mean higher peak infections in places that have yet to peak, and a slowdown in the downward trends in places that have already experienced peak Omicron,” Thomas Peacock, a virologist at Imperial College London, told The Times’s Carl Zimmer.

Dr. Anthony S. Fauci, the chief Covid adviser to President Biden, recently offered words of cautious optimism, saying he believed outbreaks could become much more manageable in the coming months — to a point where “they’re there, but they don’t disrupt society.”

As Omicron declines, Gov. Asa Hutchinson of Arkansas, a Republican, said the United States should move toward treating the virus as if it’s endemic, but remain vigilant. He acknowledged that more variants are inevitable and called on the federal government to help states ramp up testing capacity and access to treatments.

“That’s where the federal government needs to step up,” he said on “Meet the Press.” “Let’s take advantage of this going down to be prepared for what’s around the corner.”

Roni Caryn Rabin, Carl Zimmer and Maggie Astor contributed to this report.

The WHO has said calls to treat the coronavirus as endemic are premature as cases in parts of the world remain high.

On March 11, 2020, the World Health Organization declared COVID-19 a pandemic – a new disease that has spread around the world, affecting a large number of people.

The term pandemic comes from the Greek word “pan” meaning “all” and “demos” meaning “people”.

In comparison, an endemic – with the prefix en- meaning “in or within”-  is the constant presence of a disease within a region, making its spread more predictable.

Many experts expect COVID-19 will not be eradicated, and the disease will become endemic and stay with us, in a milder form.

While the conditions to reclassify COVID-19 as endemic are not precisely defined, many countries – particularly in Europe – have begun lifting restrictions as they move towards living with the disease.

Last week, Spanish Prime Minister Pedro Sanchez called on European officials to treat COVID-19 as endemic due to falling death rates.

Classifying COVID-19 as such could mean that fewer resources would be allocated to combat the disease and people would be subject to less testing as it would likely no longer be considered a severe public health emergency.

But the World Health Organization (WHO) has said it is too early to treat the coronavirus as endemic as cases in parts of the world remain high.

Comparing endemic diseases

Endemic diseases are all around us, from the common cold to more severe diseases including HIV, malaria and tuberculosis.

Epidemiologists, scientists who study the spread of diseases, consider a disease endemic when its levels are consistent and predictable. Endemic diseases are constantly present in a population within a particular region.

Below we compare the number of cases and deaths per year from endemic diseases.

For COVID-19 to become endemic, several factors would need to be considered, including how the disease continues to evolve as well as the type of immunity people acquire through infection and vaccines.

The dominant Omicron variant

Like all viruses, the SARS-COV-2 coronavirus has been mutating since it emerged in late 2019.

Mutations – changes in genetic code – in a virus’s spike protein can affect its ability to infect cells.

Omicron, a more transmissible variant first detected in November 2021, has now been detected in at least 165 countries and territories worldwide.

It has pushed COVID-19 cases to record highs around the world with at least 100 countries recording their all-time highest daily confirmed cases since the start of 2022. There are also an unknown number of people who may have been infected with Omicron but were not tested.

Varying worldwide immunity levels

The WHO predicts more than half of the people in Europe could catch Omicron by March which, coupled with high vaccine rates, should lead to higher levels of immunity.

Herd immunity occurs when a large proportion of a community becomes immune to a disease through infection or vaccines, halting the disease from spreading.

As variants become more infectious, the herd immunity threshold increases. This is why the threshold percentage has gradually been increasing from about 60-70 percent during the original strain to 85 percent with Delta and upwards of 90 percent with Omicron.

Meanwhile, many poorer countries that are still waiting for vaccines may be a long way from seeing the end of the pandemic.

Only 5 percent of people in low-income countries are fully vaccinated according to the latest figures by Our World In Data.

Scientists and health officials around the world are keeping their eyes on a descendant of the omicron variant that has been found in more than 50 countries, including the United States.

This version of the coronavirus, which scientists call BA.2, is widely considered stealthier than the original version of omicron because particular genetic traits make it somewhat harder to detect. Danish scientists reported this week that preliminary information suggests it may be 1 1/2 times more contagious then the original variant.

But scientists say there’s a lot they still don’t know about it, including whether it causes more severe disease.

WHERE HAS IT SPREAD?

More than 18,000 genetic sequences of BA.2 have been uploaded to GISAID, a global platform for sharing coronavirus data, according to data collected by Scripps Research labs. The strain has been detected in at least 54 countries and 24 U.S. states.

“Thus far, we haven’t seen it start to gain ground” in the U.S., said Dr. Wesley Long, a pathologist at Houston Methodist in Texas, which identified three cases as of earlier this week.

The mutant appears much more common in Asia and Europe. In Denmark, it has spread quickly and become the dominant variant, according to State Serum Institute, which falls under the Danish Ministry of Health.

“Preliminary calculations indicate that BA.2 is one and a half times more contagious than BA.1,” the original omicron, the institute’s Dr. Tyra Grove Krause said in a press release earlier this week. If it is more contagious, “it may mean that the wave of infections will be higher and will extend further into February compared to the previous projections.”

WHAT’S KNOWN ABOUT THIS VERSION OF THE VIRUS?

BA.2 has lots of mutations. About 20 of them in the spike protein that studs the outside of the virus are shared with the original omicron. But it also has additional genetic changes not seen in the initial version.

It’s unclear how significant those mutations are, especially in a population that has encountered the original omicron, said Dr. Jeremy Luban, a virologist at the University of Massachusetts Medical School.

For now, the original omicron BA.1 and its descendant BA.2 are considered subsets of omicron. But global health leaders could give it its own Greek letter name if it is deemed a globally significant “variant of concern.”

Scientists at the UK Health Security Agency found that vaccine effectiveness against symptomatic disease appears similar for BA.1 and BA.2. Looking at all vaccine brands combined, scientists found they were about 70% effective against symptomatic disease from BA.2 two or more weeks after a booster shot.

An initial analysis by scientists in Denmark shows no differences in hospitalizations for BA.2 compared with the original omicron. They are also looking into how well current vaccines work against it. It’s also unclear how well treatments will work against it.

Doctors also don’t yet know for sure if someone who’s already had COVID-19 caused by omicron can be sickened again by BA.2. But they’re hopeful, especially that a prior omicron infection might lessen the severity if that happens.

The two versions of omicron have enough in common that it’s possible that infection with the original mutant “will give you cross-protection against BA.2,” said Dr. Daniel Kuritzkes, an infectious diseases expert at Brigham and Women’s Hospital in Boston.

Scientists will be conducting tests to see if antibodies from an infection with the original omicron “are able to neutralize BA.2 in the laboratory and then extrapolate from there,” he said.

HOW CONCERNED ARE HEALTH AGENCIES?

The World Health Organization classifies omicron overall as a variant of concern, its most serious designation of a coronavirus mutant, but it doesn’t single out BA.2 with a designation of its own. Given its rise in some countries, however, the agency says investigations into its characteristics “should be prioritized.”

The UK agency, meanwhile, has designated BA.2 a “variant under investigation,” citing the rising numbers found in the U.K. and internationally.

WHY IS IT HARDER TO DETECT?

The original version of omicron had specific genetic features that allowed health officials to rapidly differentiate it from delta using a certain PCR lab test because of what’s known as “S gene target failure.”

BA.2 doesn’t have this same genetic quirk. So on the test, Long said, it looks like delta.

“It’s not that the test doesn’t detect it; it’s just that it doesn’t look like omicron,” he said.

WHAT SHOULD YOU DO TO PROTECT YOURSELF?

Doctors advise the same precautions they have all along: Get vaccinated and follow public health guidance about wearing masks, avoiding crowds and staying home when you’re sick.

“The vaccines are still providing good defense against severe disease, hospitalization and death,” Long said.

The latest version is another reminder that the pandemic hasn’t ended.

“We all wish that it was over,” Long said, ”but until we get the world vaccinated, we’re going to be at risk of having new variants emerge.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.