Americans Are Still Living With a 2020 Attitude Toward COVID-19 Risk. It’s MassNews for That to Change
Since the pandemic erupted, most Americans sought out vaccines. The risk of COVID-19 has dropped for many Americans as those who chose not to get vaccinated became infected more often than others. It’s estimated that more than 90% of Americans have some level of immunity to COVID-19 through vaccination or prior infection.
This wall of immunity is not the only thing that has changed. The benefits of approaches used when there were few ways to stop spread of disease are now negligible.
But we’ve been slow to adapt our strategies to the evolving notions of risk. The CDC plans to soon update its policies. It will no longer be recommending national measures but instead will tie them to the local prevalence of its recommendations for protective actions. This community-by-community standard may not be enough. We’ve turned restrictions on but haven’t turned them off as conditions changed. In many cases, it’s because we’re still relying on the same metrics that we used at the start of the pandemic. Although people were able to acquire protection from the virus in many cases, this concept of measuring risk has remained largely fixed.
When the pandemic began, there was a shared fear and willingness to make sacrifices to help it. The social bond that was created by the pandemic evolved and has been burdened has fallen apart. It is time to change from the use of collective measures, to tactics that are taken by individual people who weigh their personal risk against their degree. It is necessary to accept greater regional variation and locality in the state’s measures. The government’s role will be to make sure people have the tools they need to make those choices.
It is no longer possible to justify the steps taken in 2020 when there was so much death and stress. What are the anchors for this change? In many cases, even when the actions were adjusted on the basis of risk, it was too slow. Without deliberate guideposts, it’s hard to gauge why one posture should give way to another, and how to make these decisions.
We’ll never go back to many of the tragic steps we had to take in the spring of 2020 when we were overwhelmed by the first wave of the virus. To mitigate the devastating effects of the first wave, President Donald Trump set aside 45 days for slowing the spread. Reflecting on those extreme measures, it’s hard today to remember how bad it was back then because we haven’t anchored the debate in a consistent measure of danger and recovery.
New York City’s healthcare system was in danger of collapse. In Central Park, there were triage tents set up in Central Park and hospital ships to manage the devastation of illness and death. According to the White House, if American cities fall, then the country would collapse. At the time, one White House official told me that in such a circumstance, the federal government would be tapped out, and wouldn’t be able to give another city the “New York treatment.” It was a reference to the extraordinary support that New York received. I remember the comment.
Learn MoreAlthough the Omicron Wave is receding, it’s far from over.
Remember that the CDC had failed to field a diagnostic test that could tell us where COVID-19 was spreading, and where it hadn’t yet arrived, so we couldn’t target our steps to the cities where the virus was already epidemic. We didn’t know where COVID-19 was, or where it wasn’t. It was a mistake to underestimate the extent of seeding taking place in New York and Seattle. Many people were still insisting that COVID-19 wasn’t worse than the flu with an estimated 0.1 percent case fatality rate. By July 2020, when that first wave had subsided, 0.25 percent of the entire population of New York City had died from COVID-19, but only one-fifth of the City’s residents had been infected.
The risk from COVID-19’s continued march was a catastrophic prospect. Our tools to limit its spread didn’t exist. Our vulnerability was unbounded. We had no immunity. We had no effective medicines. We didn’t know how to properly care for the patients admitted to our ICUs. We needed to reduce the spread of the disease and give ourselves enough time to prepare our response. At the epidemic’s peak during the winter of 2020, more than 6,000 people in the U.S. were dying each week in nursing homes alone.
It was 2020.
In 2022, it is time to abandon the 2020 ideas of risk.. What was judged to be “moderate” prevalence this time last year, when we were largely unvaccinated, may be the new “low” when our vulnerability has declined. Omicron, a less serious but transmissible strain, is something we need to be aware of.
The number of Americans who have become immune to infection through successive rounds of vaccinations has increased over the years. Some estimates suggest that almost 70% have been infected. Nearly 87% of adult Americans have been administered at least one dose. The United States has a large number of vaccines that are effective in treating the sick. This greatly reduces the chance of being hospitalized or dying. The U.S. will soon be producing almost a half-billion “at-home” COVID tests each month. We’ve also seen dramatic advances in our care of the sick.
Many of the existing structures remain in place, even though the Omicron wave is receding. Many children still wore masks to school, even though there was no consensus on when it would end. Some schools switched to distance learning after Omicron reached its peak. Many big cities have their offices closed. Many cities are closed to offices because some businesses and states still require vaccines. They want to control a decreasing number of vaccine-resistant individuals at the expense of increasing violence, while many others have been infected.
Learn More Why COVID-19 Case Counts Don’t Mean What They Used To
Confidence in public health has eroded because we’ve been too slow to adapt the steps we take to changing notions of risk. People are taking their own steps to lower their risk. They wear masks and avoid gatherings and choose to take precautions such as wearing masks and not being in congregated settings. COVID-19 can be extremely dangerous for many people due to their age and other health issues. Anyone who is still worried about the virus should have tools and support. There’s understandable apprehension among parents torn between fears of the virus and the steps to keep kids safe, especially toddlers. Those who are more optimistic about decreasing risks can ask for less from the public. Disruptions can have a cumulative effect. It is exhausting for people. Livelihoods and people’s mental health have been hurt by the diminished lives we’ve had to compromise around. Many children haven’t known a normal school day for two years. Constant disruptions can take their toll. It was never our intention to say that the cost of disruptions could outweigh their benefits. We don’t have a way to measure these trade-offs and no system for turning things off and on.
Let’s not forget the debate about pandemics and endemics. There’s no clear nomenclature for what it will mean when the virus becomes a persistent but manageable risk that doesn’t dominate our lives. Different definitions are offered by public-health officials as to what the term means for when the virus becomes an endemic. COVID-19, however, is considered part of the predictable list of pathogens. It is when the country no longer has excessive infections. COVID-19 begins to settle into predictable patterns that follow the seasons. Many people, including I, feel that we will make that transition in 2022. Some still consider it high-risk that an unexpected variant will emerge and alter the forecast.
However, this will continue to pose a risk. This will mean that we need to be extra vigilant in monitoring respiratory infections, especially during winter, when the pathogens can easily circulate. We’ll need to protect settings where vulnerable people congregate and create incentives for people to stay current with vaccines. We’ll need to improve air quality and filtration in indoor settings. We’ll need to ensure widespread access to testing and create new cultural norms around staying home from work or school when you don’t feel well. It is important to distribute home diagnostic test widely, so people have access to a limited stock. The mask could be voluntary and used for short periods to address epidemic spikes. Innovation is essential. We must invest in new therapeutics to treat sick people and ensure their broad distribution.
But so long as we remain mired in a 2020 doctrine for measuring prevalence and how it correlates with risk, we’re going to be unable to adapt public-health measures to the virus’s ebb and flow, or find a common touchstone for managing risk in our lives.
COVID-19 remains a terrifying virus, which we will have to deal with for the near future. Federal health officials have steered us through one of the hardest periods in our country’s modern history, and helped preserve life, even as we lost more than 900,000 of our fellow citizens.
We’ve gradually found a way to coexist with this virus. Now we need a glide path to what normal becomes and a new math to guide how we adapt to COVID-19 even if we never fully defeat it.