Among the Covid experts I communicate with on a regular basis, Dr. Robert Wachter is one of the more cautious. He is worried about “long-term covid” and believes that many people should get boosted. He says he can wear a mask in supermarkets and on airplanes for the rest of his life.
Yet Wachter, head of the Department of Medicine at the University of California, San Francisco, also worries about the shortcomings of organizing our lives around Covid. In recent weeks, he began to think about when most of the rhythms of life should return to normal. He increasingly believes that the answer is: Now.
This belief stems from the fact that the virus is unlikely to ever go away. Like most viruses, it will likely continue to circulate, with cases sometimes increasing and sometimes decreasing. But we have the tools – vaccines and an emerging group of treatments – to turn it into a manageable virus like seasonal flu.
Given this reality, Wachter, 64, has decided to resume his old activities and accept the additional risk associated with them, just as we accept the risk of an accident when driving in vehicles.
He started eating in closed restaurants again and playing poker without a mask with his grafted friends. He took planes to visit relatives. He held a medical conference in downtown San Francisco, attended by several hundred masked and vaccinated people.
“I will still be thoughtful and careful.” Watchman told The San Francisco Chronicle… But “if I’m not going to do this now, I’m probably saying that I am not going to do this in the next couple of years, and I can say that I will not do this forever.”
Hospital admissions statistics in highly vaccinated communities help explain Wachter’s attitude. In Seattle (which publishes (See details), daily Covid hospitalizations for vaccinated people were slightly above one in a million. By comparison, the U.S. hospital admissions rate for influenza is more than double the annual rate. For most vaccinated people in a place like Seattle or San Francisco, Covid already looks like another virus.
The risks are also low for unvaccinated children because Covid tends to be mild for them. (In addition, any child 5 and older can now be vaccinated.) Younger Children – Covid looks like a regular fluif not easy:
Long Covid is real, but rare. This is also not unique. Influenza and other viruses also cause mysterious, long-term problems in a small minority of people. studies show…
The bottom line is that Covid now poses a risk to most vaccinated people that we thoughtlessly accept in other walks of life. And there won’t be a day when we wake up to headlines proclaiming that Covid has been defeated. In many ways, the future of the virus has already arrived.
All of this raises the question of which precautions should be discontinued – now or soon, and which ones – to become permanent.
Should the offices remain mostly empty? Should schools require children and teachers to wear masks? Should the classes become deleted again when they reveal a new case of Covid? (In Boston, school K-8 closed for 10 days starting Wednesday due to the outbreak.) How long should people organize their lives in fear of Covid?
Most of these issues are complex, and several factors can influence decision-making, epidemiologists say.
1. Local distribution
The lower the rate at which Covid spreads in the community, the lower the risk for everyone. The CDC defines a low transmission rate, among other things, less than 10 new cases per 100,000 people per day. Most of the country is well above this threshold, but parts of San Francisco, Atlanta, Dallas, Houston, Los Angeles, Miami, New York, and Washington are below this threshold. (You can find your parish here.)
Nevada has taken an approach that experts such as Julia Raifman of Boston University praised: The state will remove mandates for the mask after the case count drops below a certain level. Joseph Allen of Harvard, criticizing the other approach in many other places, said: “We sleep in politics because we do not set goals.”
One complication: Nationwide, the number of new cases has increased slightly in recent weeks, although they are still well below late summer levels. If the number of new cases increases as it gets colder and indoor activity increases, this may require caution.
2. Disease, not cases
However, as vaccines are widely available and treatment becomes more popular, the number of cases is not as important as it used to be. They are “becoming less and less useful,” notes The Atlantic’s Sara Zhang. wrote… More indicative measures are hospitalizations and deaths.
Treatment of people who have contracted Covid is especially important here. The Pfizer pill regimen, which appears to be particularly effective, reduces the risk of hospitalization. more than 80 percent… These treatments are another step towards making Covid a common virus rather than the one that dominates life.
Different people face different levels of Covid risk. For most vaccinated people and children, the risks are extremely low. But for some people with weakened immune systems – for example, those who have received organ transplants – the risks are higher. It’s the same among people in their 80s and 90s…
For vulnerable people, stricter precautions are appropriate. They will also find it especially helpful if rapid testing for Covid ever becomes widely available in the US, allowing them to communicate more confidently.
There is a downside to this point: the cumulative statistics of coronavirus deaths and hospitalizations exaggerate the risk for most Americans, because a disproportionate share of serious illnesses occurs in people with certain medical vulnerabilities.
4. Cost vs. benefit
The janitor told me that he can always wear a mask when he goes to the grocery store or on the plane, because the cost of a closed face and a deaf voice in such conditions is practically zero. He usually doesn’t try to talk to anyone. And a mask can help protect him from all kinds of respiratory viruses.
Unfortunately, the cost of most Covid interventions is higher. Masks interfere with communication, especially for young children and hearing impaired children. (Wachter also says he expects conferences to end up without masks.) The remote school has failed… Working in a remote office interferes with collaboration. Social isolation causes mental health problems.
When the Washington Post recently asked Jennifer Nuzzo, an epidemiologist at Johns Hopkins University, when the pandemic would end, she answered: “This is not the end. We just stop caring. Or we don’t care. ” She added, “I think for most people it just fades into the background in their lives.”
I realize this answer may sound harsh, but the alternative – a society that is constantly dominated by Covid – is also unpleasant. In the end, the costs of organizing our lives around the virus will outweigh the benefits. In some cases, we may have already reached this point.
Programming note: Next week I will go on assignment and my colleagues will be writing Morning. I will return to you on Tuesday, November 23rd.
Other great stories
Aristotle was right: Imagination is amazing, is talking David Brooks.
Seeing the world through rice
“Before there was bread or pasta, let alone meat or fish, there was rice,” Hanya Yanagihara writes in T magazine. Although rice comes from both Asia and Africa, it’s hard to find a culture that doesn’t make food its own: fried, mashed, fried, baked, scorched. So, in the issue of “Ty” about winter travel, the writers explored the world through the grain. Some highlights:
Senegal, which consumes more rice per capita than almost any other African country, is trying revive domestic varieties…
Mansaf, lamb and rice dish, is the national symbol in Jordan and a taste of home for suburb of Detroit Arab American Diaspora.
V Mexicorice arrived through the Spanish conquest, which made his presence there inseparable from colonialism…
And when browned at the bottom of the potrice becomes a treasure prized by food crops in Iran, Vietnam, Philippines and more. – Sanam Yar, Matinee Writer