Post-Pandemic Challenges: Endemic COVID-19, Vaccine Hesitancy, and Viral Resurgence

Dear Colleagues,

While the pandemic has ended, the virus persists, now in a milder form that continues to circulate. This pattern is not new; it also followed the Spanish Flu, with influenza A H1N1 still taking lives every winter. The familiarity of this cycle is striking.

The aim of this Special Issue is to analyze numerous post-pandemic challenges that are the result of or have become especially glaring due to the pandemic. The first and most natural is dealing with a virus that appears to be becoming endemic. This requires a nuanced approach that neither overemphasizes a virus that is now just one of many respiratory pathogens nor underestimates its potential. If we use the analogy that was frowned upon during the pandemic—"It’s just the flu"—the situation remains concerning, as influenza takes a significant toll every year and occasionally causes spectacular, though less publicized, epidemics like those in 1957 and 1968. The ultimate trajectory of COVID-19 is a crucial question. This also allows for a retrospective analysis of the shift to endemicity, assessing the suitability of the public health measures taken and identifying lessons that could be learned regarding policy lag and the suboptimal allocation of public health efforts.

The second challenge is vaccine hesitancy—not merely in relation to vaccination against this particular virus, but as a broader consequence of the pandemic. Whether one attributes this to the spread of misinformation, public health blunders that damaged trust, or a combination of factors, the issue is acute and warrants thorough investigation.

The third challenge is the viral rebound in an increasingly interconnected world. Pandemic restrictions were effective at suppressing viruses in general, even leading to the extinction of the influenza B/Yamagata lineage. However, once restrictions were lifted, we observed a spectacular and out-of-season rebound among a population with diminished natural immunity due to prior shielding.

Dr. Marcin Walkowiak
Dr. Constantinos Tsioutis
Guest Editors

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• vaccine hesitancy
• COVID-19
• epidemiology
• endemic viruses
• natural immunity