An increase in COVID-19 cases as winter approaches is starting a debate about whether a new era for living with the virus has arrived or whether greater restrictions and precautions are still needed.
Cases in the US have risen to more than 80,000 a day as the weather in much of the country turns colder. According to figures from the Centers for Disease Control and Prevention (CDC), about 1,000 people die every day from the virus, largely among the unvaccinated.
At the same time, the wide availability of vaccines and boosters has made many people’s individual risk much lower.
The result is a sometimes confusing picture in which individuals and localities are trying to figure out what level of risk to accept.
Washington, DC, for example, announced Tuesday that it will lift its mask mandate.
“We are learning to live with COVID,” said LaQuandra Nesbitt, director of the DC health department. She said the virus is becoming “endemic,” meaning it is becoming a fact of life on the back burner. “It’s really my way of trying to emphasize to people that we have drifted away from this goal of getting to zero cases,” he said.
However, other experts were concerned that the measure was premature in the face of winter and with cases and deaths still at a high level.
“In my opinion, this is the last part of the crisis phase,” said Walid Gellad, professor of medicine at the University of Pittsburgh. He said it would make sense to wait a few more weeks to allow more children under 12 to be vaccinated and to allow time for powerful new antiviral treatments from Pfizer and Merck to be licensed.
DC’s move, he said, could be like “taking your foot off the gas just before crossing the finish line.”
However, many experts said that at least changing the way of thinking about the virus a bit is warranted given the strong protection of vaccines, especially once people receive their booster shots, and the fact that the virus does not spread. will eliminate completely in the short term.
“Now I am approaching it as if it is now a reasonable version of what the future is likely to be,” said Bob Wachter, chair of the department of medicine at the University of California, San Francisco.
He said that if someone is unwilling to do a certain activity now because of COVID-19, one is “making a statement that they will not do it next year or the following year.”
“It’s not a short-term sprint anymore,” he said, although he noted that it might still be wise to wear masks in crowded public areas where it’s unclear if everyone is vaccinated.
Ashish Jha, dean of the School of Public Health at Brown University, said it’s “reasonable to start thinking about mask-lifting mandates.”
But, he said, “if you can postpone the lifting of these restrictions until early January, I think it is better.” That would give time to get over any vacation spikes and for more kids to get vaccinated.
Jha said a similar timeline could work for school mask mandates, which have been a major source of controversy.
“I’d probably keep those masks on for the holiday season,” he said. “Once all school-age children have had a chance to get vaccinated, I think it’s totally reasonable to lift the mandates.”
Of course, many parts of the country abolished their mask mandates months ago.
Jha said that for people who are vaccinated and have received a booster, the risk of severe illness from COVID-19 is generally on par with the risk of the flu.
Health officials in the Biden administration are not yet ready to give the green light to relax restrictions and enter a new phase in dealing with the virus.
CDC Director Rochelle WalenskyRochelle WalenskyOvernight Health Care – Presented by Emergent Biosolutions – 2.6 million children vaccinated in first two weeks Moderna requests emergency authorization for a booster dose for all adults Gottlieb sends ‘confusing’ CDC booster messages MORE He told reporters Wednesday that his agency is still recommending that localities be at low levels of COVID-19 transmission for several weeks “before releasing mask requirements.”
He noted that more than 85 percent of counties in the US still have “substantial” or “high” transmission, meaning the CDC recommends masking indoors in public.
Anthony FauciAnthony FauciOvernight Health Care – Presented by Emergent Biosolutions – 2.6 million children vaccinated in first two weeks Fauci: COVID still severe, not yet endemic The Hill’s Morning Report – Presented by ExxonMobil – House Democrats expect big vote about the Biden measure MORE, the director of the National Institute of Allergy and Infectious Diseases, also said that cases and deaths are not yet low enough to accept the virus as “endemic” and a fact of life.
“We want control, and I think the confusion is at what level of control they will accept it in its endemicity,” he told reporters. “And as far as we’re concerned, we don’t really know what that number is, but we’ll know when we get there; it’s certainly much, much lower than 80,000 new infections per day and it is much, much lower than 1,000 deaths per day and tens of thousands of hospitalizations. “
Another consideration, even for vaccinated people, is that there is still the potential for persistent “long-term” COVID-19 symptoms due to breakthrough infection, although that risk is substantially lower than for unvaccinated people.
Wachter said there are no completely accurate figures, but he estimated that the likelihood of prolonged COVID-19 is about half for vaccinated people who have breakthrough cases compared to unvaccinated people, and it could be about 1 in 10 cases of Advance.
“It is risk enough that if you told me I have COVID now, even though I am fully vaccinated, I would say that at least I am not going to die, but I would still be quite unhappy,” he said.
But as the overall COVID-19 situation improves, with vaccines, boosters and now new antiviral treatments, the appropriate level of caution is turning into a situation in which, he said, “reasonable people might disagree.”