Three years after COVID-19 was declared a pandemic, how cautious are the experts?
Just over three years after the World Health Organization declared COVID-19 a pandemic, masks are becoming a rarity on the T and in crowded public spaces, floor stickers once meant to enforce social distancing are peeling away, and some vaccine mandates are being dropped.
Still, more than 1,800 Americans are dying of COVID each week and nearly 2,800 are being hospitalized — though those figures haven fallen dramatically since their peaks. In January 2021, for example, the country reported more than 23,000 deaths weekly; the following January, it saw more than 21,000 hospitalizations weekly, according to the Centers for Disease Control and Prevention.
So how cautious are epidemiologists and infectious disease experts three years into the pandemic? Some say they’ve loosened up, at least in their personal lives, although they keep an eye on local and national data. The coronavirus was a lesson in the importance of being prepared for the next pandemic, they say, even if COVID is no longer a daily concern.
Francesca Beaudoin, interim chair of epidemiology at Brown University’s School of Public Health and practicing emergency physician
Beaudoin said she still wears a mask in healthcare settings, but tends to shed it in her personal life. Her kids, like most today, go to school unmasked, and she takes them to indoor sporting events without any face covering.
“I’d say it’s sort of a common-sense approach that I’m employing at this point in time, but it’s in line with what the CDC recommends,” Beaudoin said. “The federal emergency is coming to an end [May 11], and I think that makes sense. It does reflect what most people have been doing for a long time.”
Beaudoin noticed that masks were no longer required at her dentist’s office on a recent visit, but that didn’t come as a surprise, she said, especially since transmission rates in Rhode Island, where she lives, remain low. She said a dentists’ office likely carries different risks of transmission than the emergency rooms she works in.
Beaudoin said she keeps an eye on COVID-19 surveillance data, which became “quite robust” during the pandemic, but she is far more concerned with the frequency of serious harm from the disease than factors like community positivity rates.
“We are talking a lot now about pandemic preparedness, because we have to expect and anticipate that this could happen again,” she said. “And I don’t think this should all be about COVID, either. We’ve dealt with influenza and other SARS variants earlier on. What are our thresholds for other respiratory infections [and] other types of infectious diseases?”
Shira Doron, chief infection control officer for the Tufts Medicine system and hospital epidemiologist at Tufts Medical Center
“I would say I’m fully back to 2019,” Doron said. “And I say that as somebody who was always maybe a little more cautious about respiratory viruses in general.”
That means taking “basic” precautions, such as disinfecting her hands after touching high-contact surfaces and keeping her distance from individuals who appear obviously sick. Doron said she has not worn a mask in public since the initial Omicron wave, when she tended to avoid large gatherings if she had an important event coming up.
Doron said she focuses less on preventing an infection than on acquiring and maintaining immunity to COVID-19. She said data indicate that most Americans have already been infected at least once, including those who have consistently worn a high-quality face covering.
“You cannot outrun respiratory viruses,” Doron said. “Everyone is going to get infected with COVID, with the flu, with the common cold over, and over, and over again throughout their life…. You can put yourself into a pretzel and try to avoid it, and change your life and give up things that are important to you to avoid it, but you’re still not going to avoid it.”
Doron said she plans to keep following the data to determine her next steps. But she does not feel that certain guidelines, like annual booster shots — as the Food and Drug Administration proposed in January — are “evidence based.”
Sabrina Assoumou, infectious disease physician at Boston Medical Center and assistant professor at Boston University
Assoumou said she takes a “more conservative” approach to COVID safety. She still often wears a mask, tries to avoid crowded or poorly ventilated indoor spaces, and takes a test if she could have been exposed or is planning on seeing anyone who might be at greater risk of serious illness.
She described her approach as “layered”: the first layer is vaccination, then wearing a mask, then considering the amount of ventilation in a given space — sometimes carrying a portable CO2 monitor to test her surroundings. Depending on the event, Assoumou said, she considers all or only some of those preventive layers.
“Do I really want to get COVID today at the grocery store?” she said, laughing. “No, if I’m going to get COVID, I want to get COVID when I am actually doing something that really matters to me.”
Researchers are still working to determine COVID-19′s impacts on the body and the mechanisms behind it, especially in the long-term, Assoumou said.
“There’s just way too much stuff that’s coming out about long-COVID” and its impacts beyond the respiratory system, Assoumou said.
Still, she is less cautious than she was two years ago, when she tried to avoid indoor spaces as often as she could. She also pays increased attention to local COVID data — especially the Boston Public Health Commission’s COVID-19 dashboard — which has more of an impact on her day-to-day than national trends.
“I keep track of this stuff so closely,” she said. “That’s why I behave the way I behave.”
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