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What Will the Next Few Months Look Like? Your Covid Questions, Answered.

We need to maximize control of the virus while minimizing harm

Photo: Gabriella Clare Marino / Unsplash

Covid has changed the world as we know it, and virulent variants such as Delta have upended early hopes of a clearer-cut “back to normal.” Unfortunately, achieving herd immunity may now be an impossible dream, but we can limit death and disruption as we get to a new normal.

Although the Delta-fueled wave in the United States is receding, Covid continues to spread globally and in many unvaccinated parts of the U.S. The reality is that many places around the world will continue to struggle with clusters and outbreaks until vaccine production is ramped up substantially. Until we can vaccinate the world, it’s up to us to deploy simple protection measures to control spread. I recently wrote in the Wall Street Journal about how we need to maximize control of Covid while minimizing its harm to our societies and economies.

The good news, at least in the U.S., is that just over 186 million — 76% of those eligible — are now fully vaccinated against SARS-CoV-2. This means that most of us have more freedom to do things that we used to do. But the truth is that the “new normal” will be different. This includes the way that we socialize and travel, the precautions we take, and how we move in public settings.

I’ve tried to address some of the most common questions about what the next few months and years may look like. One caveat: no one knows with certainty what will happen with Covid, and with our response to it. It’s conceivable that the virus could become less deadly and the pandemic could fizzle globally. It’s also conceivable that vaccine-escape variants could emerge and spread, setting the global fight back a year or more. Some questions can be answered, at least as of what we know in mid-October 2021, so here goes.

Should I get a booster shot?

Boosters are likely to benefit those for whom they’re recommended, including those at higher risk for severe disease such as the immunocompromised and elderly. We still don’t know if the Delta variant causes more severe disease, or whether immunity wanes significantly enough over time to warrant a third dose. Only time will tell if a third dose will be part of the full vaccine regimen for the entire population.

But it’s important to note — the reason we continue to see so many hospitalizations and deaths is that there are still nearly 70 million people in the U.S. who haven’t yet started their vaccination series.

The issue of booster doses also raises questions of vaccine equity. In many countries including the U.S., people will get their third doses long before healthcare workers and at-risk populations in Africa and elsewhere are able to receive their first. It’s another reason we need to ramp up production and distribution globally, and fast.

Do I still need to wear a mask, and for how much longer?

I previously wrote a Medium piece on masking. In short, there are three factors to consider about masking: who you are, where you are, and what you’re doing. Much as we may dislike it, continued masking is important for certain people and in certain situations. Those who are at higher risk for severe disease or live with those who are at higher risk, live in an area with high spread, or are taking part in a risky activity should consider masking up to protect themselves and those around them.

Consider upgrading to an N95 or KN95 mask, especially if you’re at high risk of severe Covid disease, are around someone who is, or around a lot of unvaccinated people. Not all masks are created equal, nor do they protect against Covid equally.

It’s likely that masking will be with us for the long run for certain situations. This doesn’t have to be a bad thing. Masking helps control the spread of other infectious diseases, including the seasonal flu which kills tens of thousands each year. Wearing a mask doesn’t just have to be a pandemic practice — it could become a social norm, as it is now in parts of Asia, that helps control the spread of various diseases and keeps us all healthier.

Photo: Matteo Jorjoson/Unsplash

When will it be safe to resume normal activities such as taking public transit, or going to restaurants and the gym?

The truth is that every action we take has risks associated with it. Even something as basic as drinking a glass of water can present a risk. Some activities are riskier than others.

If you’re fully vaccinated, there’s a lot you can do safely now, with a few exceptions. Ultimately, it comes down to the levels of spread in your community and the risk to yourself and those you live with.

If you are vaccinated and need to take the subway to get to work, there’s a risk — we don’t know how high a risk — of infection. You’ll be safer and can minimize the risk by wearing a higher-grade mask such as an N95/KN95. But if you live in an area where there is a high incidence of Covid, you could well get infected if you go into a crowded gym or restaurant.

The best way to feel confident about resuming normal activities is to get vaccinated. Even with breakthrough infections, those who are vaccinated have much less severe illness. To minimize risks and be on the safer side, consider employing additional layers of protection, such as ventilation, masking, and distancing.

Is gathering for family events and holidays like Thanksgiving going to be safe?

Risks associated with gatherings such as Thanksgiving have to do with how likely participants are to have been infected, how vulnerable people are, and what they are doing. The CDC has provided recommendations on what we can all do to make Thanksgiving safer. Just as with any activity, the best way to minimize risk is to make sure that you and those around you are vaccinated, then take extra precautions to reduce further possibility of infection.

Wearing masks when not eating (including N95/KN95 masks for anyone older, vulnerable, or simply worried), opening windows to increase ventilation, and limiting exposures in the days before any gathering can reduce the risk that Covid is an uninvited guest to your Thanksgiving get-together.

The Biden Administration recently announced it would spend $1 billion to increase the supply of at-home rapid tests. Encouraging anyone who’s had a lot of potential exposure (such as college kids, those who work in high-risk settings, or people who have recently travelled) to test beforehand will act as another tool in our arsenal to minimize risk.

It’s really about risks and benefits — and we have the tools to decrease the risks.

What’s next? How long will the pandemic continue?

The honest answer to this question is: no one knows.

One likely scenario is that we continue to see flare-ups and outbreaks, especially in places with high-risk populations such as nursing homes, prisons, homeless shelters, and camps. But with vaccines and, to a much lesser degree, therapeutic treatments, the virus will be tamed and won’t cause nearly the death and destruction it causes now.

A better scenario would be much lower transmission; worse would be a new variant that evades immunity. In any case, there are important layered protection measures on top of vaccination — including masking, testing, ventilation, and distancing — that we can take. People with compromised immune systems may want to be even more rigorous about taking these precautions.

Unfortunately, Covid is likely here to stay. What doesn’t need to be here to stay are the restrictions and the fear we’ve been living with. By adapting our individual and societal behaviors, we can protect ourselves and our communities and advance into a vaccinated, safer new normal.



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Dr. Tom Frieden

Dr. Tom Frieden

President and CEO, Resolve to Save Lives | Former CDC Director and NYC Health Commissioner | Focused on saving lives. twitter.com/drtomfrieden