RALEIGH, N.C. (WNCN) – From pandemic to endemic.

In other words, a disease that no longer has an end in sight.

“It’s much more likely now that this virus is going to be endemic. And I think we’re going to be dealing with this for not another few months or maybe another few years it might just be forever” said Dr. Paul Cook, East Carolina University professor of Medicine and Chief of the Division of Infectious Diseases.

The problem is not just with countries like the United States where some are choosing to not get vaccinated against COVID-19.

It’s also about availability as some nations remain below 5- and even 2-percent vaccinated. That leads to highly contagious variants like delta and potentially more just like it to come.

“It’s not something that people like to hear but basically we’ve got a short time limit in order to get this done right and I think we’re losing the battle right now and this delta variant is proving how difficult this is going to be,” Cook said.

That includes smallpox, polio, and a 1989 measles outbreak at ECU.

“That year the state basically said you get a measles vaccine or you don’t go to school. Period. And it’s been that way ever since. If you’re in the armed services you get vaccines whether you like it or not,” he said.

But, with a disease that has killed 612,000 Americans and nearly 4 million worldwide, the same sort of mandate is largely non-existent.

So Cook says mask mandates to keep kids in school, social distancing, and working from home should be considered for the long term.

Boosters maybe what we need to stay out of the hospital.

“And I think certain individuals, older individuals, immunocompromised individuals are likely to get boosters. Now whether that happens once or a year or how that happens I don’t know,” said Cook.