Trends in managing COVID-19 from an emerging infectious disease to a common respiratory infectious disease: What are the subsequent impacts on and new challenges for healthcare systems?

Targeting the 9 countries with the highest cumulative number of newly confirmed cases in the past year, we analyzed the case fatality ratio (CFR) among newly confirmed cases and the vaccination rate (two or more doses of vaccine per 100 people) in the United States of America (USA), India, France, Germany, Brazil, the Republic of Korea, Japan, Italy, and the United Kingdom (UK) for the period of 2020-2022. Data reveal a decrease in the CFR among newly confirmed cases since the beginning of 2022, when transmission of the Omicron variant predominates, and an increase in vaccination rates. The Republic of Korea had the lowest CFR among newly confirmed cases (0.093%) in 2022 and the highest vaccination rate (86.27%). Japan had the second highest vaccination rate (83.12%) and a decrease in the CFR among newly confirmed cases of 1.478% in 2020, 1.000% in 2021, and 0.148% in 2022; while the average estimated fatality ratio for seasonal influenza from 2015-2020 was 0.020%. Currently, most countries are now easing COVID-19-related restrictions and are exploring a shift in management of COVID-19 from an emerging infectious disease to a common respiratory infectious disease that can be treated as the equivalent of seasonal or regional influenza. However, compared to influenza, infection with the Omicron variant still has a higher fatality ratio, is more transmissible, and the size of future outbreaks cannot be accurately predicted due to the uncertainty of viral mutation. More importantly, as countries shift their response strategies to COVID-19, there is an urgent need at this time to clarify what the subsequent impacts on healthcare systems and new challenges will be, including the clinical response, the dissemination of scientific information, vaccination campaigns, the creation of future surveillance and response systems, the cost of treatments and vaccinations, and the flexible use of big data in healthcare systems.