Like it or not, the period of pandemic adventures is ahead of us.
The mandates for masks have fallen. Some free test sites are closed. Whatever parts of the United States were still trying to collectively quell the pandemic have largely shifted their focus from community councils.
Now, even as the number of cases begins to rise again and more infections remain unaccounted for, the burden has fallen on individual Americans to decide how much risk they and their coronavirus neighbors face – and what, if anything, to do about it.
For many people, the threats posed by COVID have dropped dramatically in the two years of the pandemic. Vaccines reduce the risk of hospitalization or death. Powerful new antiviral pills can help protect vulnerable people from getting worse.
But not all Americans can count on the same protection. Millions of people with weakened immune systems do not fully benefit from vaccines. Two-thirds of Americans and more than one-third of those aged 65 and over have not received critical security for booster injections, with blacks and Spaniards at the most alarming rates. And patients who are poorer or live farther away from doctors and pharmacies face steep barriers to receiving antiviral pills.
These vulnerabilities have made calculating the risks posed by the virus a difficult exercise. A recent suggestion by federal health officials that most Americans could stop wearing masks because the number of hospitalizations is small has created confusion in some circles as to whether the likelihood of being infected has changed, scientists said.
“We’re doing a really terrible job of communicating risk,” said Caitlin Jetelina, a public health researcher at the University of Texas Health Center in Houston. “I think that’s why people raise their hands in the air and say, ‘Fuck.’ They desperately need some kind of guidance. “
To fill this gap, scientists are rethinking how to discuss the risks of COVID. Some have studied when people can expose themselves indoors if the goal was not only to protect hospitals from overcrowding, but also to protect immunocompromised people.
Others are working on tools to compare the risks of infection with the dangers of a wide range of activities, finding, for example, that the average unvaccinated person aged 65 and over is approximately as likely to die from omicron infection as someone dying from heroin use. for 18 months.
But how people perceive risk is subjective; no two people have the same chance of dying from a year and a half of heroin use (about 3%, according to one estimate).
And besides, many scientists have said they are also worried about this latest phase of the pandemic, which is placing too much weight on people to make choices to keep themselves and others safe, especially while COVID’s tools remain out. the reach of some Americans.
“As much as we don’t want to believe that,” said Anne Sosin, who studies health justice at Dartmouth College, “we still need a public approach to the pandemic, especially to protect those who can’t take full advantage of it.” vaccination. “
Coronavirus remains new enough and its long-term effects are unpredictable enough that measuring the threat posed by infection is a difficult problem. (Source: The New York Times)
Collective indicators
Although COVID is far from the only threat to America’s health, it remains one of the most significant. In March, even as deaths from the first omicron jump declined, the virus was still the third leading cause of death in the United States, after only heart disease and cancer.
In general, more Americans have died than they would have in normal times, a sign of the virus’s widespread use. By the end of February, 7% more Americans were dying than would have been expected in previous years, in contrast to Western European nations such as Britain, where overall deaths have recently been lower than expected.
How much virus is circulating among the population is one of the most important measures for people trying to assess their risks, scientists said. This remains true, although the number of cases now underestimates real infections by a large margin, because so many Americans test at home or do not test at all, they said.
Although many cases have been missed, the Centers for Disease Control and Prevention now puts most of the northeast at “high” levels of viral transmission. In parts of the region, the number of cases, although far lower than in winter, is approaching the peak growth rate of the autumn version of the delta.
Much of the rest of the country has what the CDC describes as “moderate” transmission levels.
Covid Risk Assessment (Source: The New York Times)
COVID against driving
Even two years after the pandemic, the coronavirus remains new enough, and its long-term effects are unpredictable enough that measuring the threat posed by infection is a difficult problem, scientists said.
An unknown number of infected people will develop prolonged COVID, which will leave them very exhausted. And the risks of getting COVID extend to others, potentially in poor health, who may be exposed.
However, with much greater immunity in the population than ever before, some public health researchers are seeking to make risk calculations more accessible by comparing the virus to everyday dangers.
The comparisons are particularly complex in the United States: the country does not conduct random swab tests needed to assess levels of infection, making it difficult to know what proportion of infected people die.
Cameron Beyrle, an assistant professor of mathematics at the University of Georgia, has built an online tool called COVID-Taser that allows people to adjust age, vaccine status and health to predict the risks of the virus. Her team used earlier estimates in the pandemic of the share of infections that led to poor results.
Her research shows that people have trouble interpreting percentages, Beyrle said. She recalled that her 69-year-old mother-in-law was unsure whether to worry earlier in the pandemic after a news program said people her age had a 10% risk of dying from an infection.
Beyrle suggested to her mother-in-law that if she died once every 10 times when she used the toilet on a given day. “Oh, 10% are awful,” she recalled her mother-in-law’s words.
Beyrle’s estimates show, for example, that an average 40-year-old vaccinated more than six months ago faces about the same chance of being hospitalized after an infection as someone dying in a car accident on 170 trips across the country. . (More recent vaccines provide better protection than older ones, which complicates these predictions.)
In immunocompromised people, the risks are higher. An unvaccinated 61-year-old with an organ transplant, according to Beyrle, is three times more likely to die after an infection than someone to die within five years of being diagnosed with stage 1 breast cancer. And this transplant recipient is two times more likely to die from COVID than someone to die while climbing Mount Everest.
With the most vulnerable people in mind, Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston, worked last month to determine how low cases will have to fall for people to stop masking indoors without compromising those with extremely weakened immune systems.
He imagined a hypothetical man who did not benefit from vaccines, wore a good mask, took hard-to-reach prophylactics, attended occasional gatherings, and shopped, but did not work in person. It seeks to keep the chances of vulnerable people being infected below 1% over a four-month period.
To reach that threshold, he found, the country will have to continue to disguise itself indoors until the show falls below 50 weekly cases per 100,000 people – a stricter limit than the one the CDC currently uses, but says offers a benchmark to strive for.
“If you just say ‘We’ll take off the masks when things get better’ – that’s true, I hope – but it’s not very helpful because people don’t know what ‘better’ means,” Faust said.
This article originally appeared in The New York Times.
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