Written by Dr. Joyce Grissom, HNFS Chief Medical Officer
Risk assessment. Risk management. Personal responsibility. We have come to a point in the two-and-a-half-year-old pandemic when the pandemic is no longer a shared public health emergency. In our daily decisions, great and small, we must each decide for ourselves what the proper balance of caution and connection should be. These decisions will have implications for our families, friends and ourselves, as well as those standing next to us at the supermarket or on public transportation.
There are of course examples of extremes. Shanghai, China, a city of almost 25 million people, has been on strict lockdown for weeks in pursuit of a zero-COVID policy. Because of this policy, natural immunity has had less opportunity to occur. By contrast, in other places a combination of vaccines, therapies and naturally acquired immunity have changed the calculation for what the most recent, highly transmissible but less severe version of COVID can do. Norway has become the first European country to remove all internal and travel related COVID restrictions, with no vaccination, testing or quarantine rules on entry and no mask requirements, isolation periods, social distancing, or vaccine passports. There, COVID-19 is just a virus like any other virus.
In the U.S., a judge found CDC-imposed mask requirements on public transportation exceeded the CDC’s authority. (The executive branch has decided to challenge this ruling in court.) People who chaffed at being forced to wear a mask in the first place have thrown them away. The cautious, the high risk, and those with young unvaccinated children retain their masks and stay a bit apart from our unmasked fellow travelers. Solidarity with the vulnerable elderly, immune-compromised, and chronically ill has crumbled. We are no longer all in this together.
Risk assessment. Risk management. Personal responsibility. Globally and domestically, new COVID-related deaths are down. In the U.S., daily deaths are down to 362 a day (7-day rolling averages) compared to 3,000+ a day in early 2021. We see new cases in the U.S. ticking up and it’s likely new cases are underreported with testing readily available at home or simply being skipped. Hospitalizations are now the numbers to watch, but there is a difference between a trauma patient presenting to the emergency room (surprise, you have COVID!) verses being hospitalized for a symptomatic COVID infection. While the raw numbers are not comparable to a year ago, here is where we are at today:
- Cases are up 51% over the last two weeks, increasing in 41 states and Washington D.C.
- Hospitalizations are up 4% nationally over the last four weeks.
- The more contagious, but not as severe BA.2 sub-variant accounts for 86% of U.S. cases.
Hospital capacity (the thing we are trying to protect) varies locally. As individuals, we must pay attention to what is going on in our own communities because that will be what counts for our access to health care and our risk of getting or spreading COVID.
Risk assessment. Risk management. Personal responsibility. Historically, pandemics last 2.5 to 3.5 years. Viruses weaken or mutate, becoming less life threatening and more a part of the acceptable infectious background noise we all live with. As the crisis gradually recedes into memory, hopefully we turn our attention to understanding how we communicated in this pandemic. Messages are powerful weapons in fighting infectious disease – as potent as vaccinations and therapeutics. We should consider how our messages served or failed us in this pandemic because it is inevitable that many of us will do this again.
As you head out the door today, consider local case rates, hospitalizations, and hospital capacity. Consider your own vulnerability and that of the person next to you. Then, take your mask or leave it behind, as risk assessment, risk management and personal responsibility are in your hands.