Former U.S. Surgeon General and Indiana state health commissioner Dr. Jerome Adams says a winter COVID-19 surge in Indiana isn’t a matter of “if” but “how bad.”

Adams advised Hoosiers to get vaccinated if they are unvaccinated, and receive booster shots if they are eligible — especially ahead of the holiday season.

But according to Adams, the state — and country — will have to learn to live with COVID.

“It’s not going away anytime soon, when you look at over 40 percent of the United States population not vaccinated and a much greater percentage of the rest of the world not fully vaccinated,” he said.

But Adams said the country isn’t yet moving towards the virus becoming “endemic”, which means it will be regularly found in the population for the foreseeable future.

For that to happen, Adams said COVID transmission has to first be more tightly controlled.

“We are not in an endemic state yet by definition. Endemic means you settle down in a low and acceptable rate,” he said. “We still have 1,000 people dying every day from COVID. We’ve got new cases that are as high as they’ve been at any point during the pandemic. We are not there yet.”

Adams said COVID has underlined deep healthcare inequities that – if unaddressed – will only continue to worsen.

“We are at a point where things could go terribly, terribly, in the wrong direction if we don’t start to repay that debt and start to fix the broken systems underlying those health inequities brought to light in the midst of COVID,” he said.

As of Friday, the Indiana Department of Health had reported just under 4,000 new confirmed COVID cases.