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Epidemiologists
Discuss The Meaning Of Living With COVID-19
Fewer Right
Answers Apply Universally Now
Much of the media
coverage in recent days has focused on when the end of the COVID
pandemic will happen and what this new state of affairs will entail,
that is, the “new normal”. Pinpointing the end of the pandemic
involves making predictions about the epidemiology of SARS-CoV-2, and
few epidemiologists or other experts claim to be certain about this
future evolution. Nevertheless, there is no shortage of views of what
the new landscape will look like.
Reporters recently
contacted over a dozen epidemiologists to ask how they are approaching
the next phase of the pandemic, regardless of what they believe that
next phase will bring (NYTimes). In short, what are epidemiologists
thinking about when they think about living with the “new normal”?
Multiple
Considerations
What is striking from
the interviews is the number of different considerations that emerged
in what turn out to be risk/benefit decisions being made by
epidemiologists and others. Some of these considerations have to do
with realities about the virus, some with what human activities are
being contemplated, and others with what control measures are possible
or available. Some of the factors being considered in the decision
making are:
Realities:
♦ The
impossibility of SARS-CoV-2 virus eradication
♦ The ongoing
need to reduce personal risk
♦ The ongoing
need to reduce community risk, especially for more vulnerable persons
♦ The level of
community risk at any particular point in time
♦ The wide
variety of existing control measures to choose from
♦ The approaches
we use in making risk/benefit decisions for other viruses which
circulate
♦ The need to
accept the reality of a new level of risk in our lives
♦ The varying
circumstances of our individual lives
♦ Current
capacity of the health care system locally
♦ Vaccination
status of children
Control measures:
♦ Vaccinations
♦ The use of well-fitting masks
♦ Testing for virus at home
♦
Quality of building ventilation
Impacted Activities
♦
Dining indoors
♦
Traveling by air
♦
Socializing with elderly persons
♦
Attending movies,
theater, and concert events indoors
♦
Visiting other persons in their homes
More Individual
Decisions
Whether due to fatigue
with the pandemic or a better appreciation of the negative
consequences of control measures, it appears that the risk/benefit
decisions to be made during the “new normal” will be more individually
tailored than earlier in the pandemic. In short, there will be no
right decisions that apply universally in this phase of the pandemic
as many thought there were in the earlier phase of the pandemic (e.g.,
lockdowns, school closures, ban on mass events, etc.)
Deaths Still Above
Expected Level
This change in
thinking is taking place even when deaths are still occurring in
excess of the expected threshold. The latest excess deaths data from
CDC indicate that deaths in late January were still 10.5% above the
expected number per week. And CDC and the White House are not calling
for a relaxation of control measures in the way that some states are
doing for example with masking requirements.
How Pandemics End
As pointed out in a recent Washington Post
commentary, “the end of respiratory pandemics has never been clear
cut...the key to ending the pandemic, therefore, isn’t biological. It
is social…At the end of the day, it is not the virus that makes the
timeline---it is us. The pandemic will be over when we say it’s over.”
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