The US appears to be in the grip of a “tripledemic” — not only are flu and RSV circulating following a relatively quiet two years, but COVID hospitalizations and deaths are again on the rise. Not to mention nearly all of the US is experiencing high levels of coronavirus spread. So, yes, if it seems like everyone around you is getting sick, they are.
Still, there’s no denying that the US is in a totally different place than it was three years ago. We now have several effective vaccines and treatments that have spared millions from hospitalization, chronic illness, and death.
Around this time last year, 11,000 people on average were dying of COVID each week. In February, the US reached about 17,000 weekly deaths. Now, we’re seeing 2,400 deaths a week on average, or about 340 daily.
However, this year’s holiday season, coupled with the resurgence of other respiratory germs, is threatening that progress. And so the pandemic rages on.
Just last week, the CDC recommended that people wear masks again to protect themselves against COVID and other respiratory viruses. The US Department of Health and Human Services also renewed the public health emergency declaration for COVID in October for the 11th time since the pandemic began. (It’s set to expire in January but could be renewed again.)
No one knows what it will take to finally bid this pandemic farewell, or what criteria politicians will create to formally end it, but one thing is clear: Thinking the pandemic is over makes you part of the problem.
“We've been humbled by COVID many times. This virus is still new to us, and its rate of ongoing evolution is still quite impressive — so in that regard, if we take off the brakes completely and say, ‘We don't need to do anything more,’ that's where we've gotten into a little bit of trouble,” said Dr. Aima Ahonkhai, an assistant professor of infectious diseases and global health at the Vanderbilt University Medical Center. “While many of us have gone back to life as usual, we still have to remain vigilant until we better understand what this virus is capable of over time.”
We asked infectious disease experts for the science behind some of the most common arguments that people use to convince themselves and others that the pandemic is over. Here’s what they had to say.
Argument #1: Everyone in the US has either been infected or vaccinated, so we’ve reached herd immunity.
Herd immunity was the holy grail of the pandemic’s early days, what public health officials touted as one of our only ways out. It occurs when enough people get infected or vaccinated against a virus that it no longer has any (or very few) susceptible hosts to latch onto, decreasing its spread and the chances that unprotected people will encounter it. (Think measles.)
Early estimates suggested that anywhere between 60% and 90% of the US population needed some sort of immunity before reaching it.
In July, Dr. Ashish Jha, the White House COVID response coordinator, said that more than 70% of Americans had been infected with COVID, which has likely increased since. Meanwhile, about 69% of people in the US have received their primary vaccine series; just about 13% have received their bivalent booster.
You might argue that sounds herd immunity–ish, but it’s not. In fact, we will probably never reach it in the US (or anywhere). I know what you’re thinking: They lied to us. But they didn’t; science is always changing and new evidence is coming to light, even more so with a virus that only recently hopped into humans.
Most of these herd immunity promises were made before experts learned how contagious SARS-CoV-2 was and how many immune-evading variants would come of it, said Abraar Karan, an infectious disease doctor and researcher at Stanford University. It also took several months after vaccines rolled out for everyone to learn that vaccinated people could still transmit the virus.
“As soon as we saw that, it didn’t make sense to talk about herd immunity anymore,” Karan said. “We don’t have lifelong immunity to COVID. It’s temporary. So that idea doesn’t hold.”
That’s not to say the US hasn’t benefited from having a large portion of the population protected against COVID. Hospitals are no longer pushing everyone and everything else aside to accommodate COVID patients, for example, in part because, sadly, some of the most vulnerable have already died. It’s also a testament to the vaccines’ ability to protect people from severe disease, Karan said.
Meanwhile, COVID infections continue to be disruptive in other ways, Karan pointed out, like taking people away from work and kids from school, interfering with childcare, and giving thousands physical disabilities due to long COVID.
Argument #2: Thousands of people die of flu every year. There’s no need to make a big deal over COVID cases and deaths.
It’s true that far fewer people are dying from COVID than they were in 2021. Call it an improvement, but the number of people dying today is still horrific. After all, is there an acceptable number of deaths at this point in the pandemic that’ll make it all OK?
For comparison, the 2017–2018 flu season, which was the most severe in the last decade, saw about 5,100 deaths in its worst week, a CDC spokesperson shared with BuzzFeed News. The least severe season in the same period occurred between 2011 and 2012, and that one saw about 1,500 deaths in its worst week. (Adults 65 and older still make up the majority of COVID deaths today.)
Point is, it’s all relative.
“Monkeypox was all over the news, and we had very few deaths. We’re now talking about more COVID deaths in a day than we have for the entirety of the monkeypox outbreak in the US,” Karan said. “Everything is relative. That’s just how people’s brains work. Things can be relatively better than before but absolutely still not good.”
Even though we can say fewer people are dying from COVID now, Karan said the statement is “biased” because many of the most vulnerable, including people who were unable to or didn’t get vaccinated, are already dead from the disease. With all the tools we have to reduce the risk of infection and severe disease, including vaccines and treatments like Paxlovid, any death today is a potentially preventable one.
How we define COVID deaths in the US also varies dramatically between hospitals and even individual doctors, which doesn’t help put the pandemic into perspective, Karan noted. The problem is determining the exact cause of death when people go into the hospital with one problem and end up testing positive for COVID. (The same nuance has been used to undermine the number of COVID hospitalizations.)
“If someone died from a blood clot they got soon after COVID infection, then yes, I think it’s related; if COVID tipped them over the edge, I would say that counts,” Karan said. “It's complicated. People oversimplify this all the time, but we know that COVID has so many other effects and most of these people already have medical problems.”
We also now know that catching COVID over and over again negatively impacts your body.
Studies show that each time you test positive you increase your risk of developing long COVID, no matter how mild or severe your infection. Your odds depend on your vaccination status, previous infections, health conditions, and many other factors.
Put simply, “getting hit with a baseball bat once is better than getting hit five times,” Dr. Ziyad Al-Aly, chief of research and education service at the Veterans Affairs St. Louis Health Care System, told us in September.
Argument #3: Masks and vaccines can’t stop me from getting infected, so there’s no point in using or getting them.
There’s actually quite a lot of evidence at this point that shows masks and vaccines reduce the chances you catch COVID.
Then there’s this study on face masks and this one and this one and this one and this one and this one and this one — it just doesn’t make sense to say the evidence doesn’t exist: whether or not you want to believe in it is a different story.
The emphasis here is on the reduction of your risk of infection, not the prevention of it.
“That's true for everything we do. We reduce our chances of getting sick by cleaning and washing our food and hands,” Karan said. “We still get sick with things, but we don't just do nothing because we can get sick eventually.”
How sick someone gets and how much a vaccine or mask helps them depends on a myriad of factors: health status, general lifestyle habits, the kind of mask you wear, the circulating variant, the societal preventive measures in place where you live, the number of times you’ve been infected, where you work. The list goes on.
“Those are complicated things that we analyze, and obviously people without the expertise aren't going to be able to appreciate all those factors,” Karan said, “so they come to their own conclusions.”
The US saw this happen in real time when federal and local governments purged their mask and vaccine mandates, Ahonkhai said. Americans began to veer toward an individual risk assessment approach over a public health one.
For example, there are people who don’t care about getting sick because they fared pretty well with their first infection and figure they can handle another one. There are also those who opt to wear masks only in certain settings, like a crowded indoor mall or at the doctor’s office.
The problem is that it’s not all about you. Your neighbor, the person sitting next to you on the bus, or your coworker may not face your same odds if they get COVID.
“If we look at this from a public health perspective, we're not in the same place. But that's a moving target,” Ahonkhai said. “If cases do rise or if there's significant concern that they may, then we have to pull back and pivot the messaging to more of a public health approach.
“Those conversations don't necessarily begin and end with an individual. They begin with family, a community, anyone you may want to protect from illness,” Ahonkhai added. “All we can do is try and bring evidence-based recommendations to the table.”
What do experts recommend now?
The experts we talked to suggested that at this point in the pandemic, it makes sense to continue to wear high-quality masks like N95s in riskier scenarios, such as crowded indoor settings and intimate gatherings with immunocompromised guests (and even in low-risk settings to ensure the safety of others around you), stay up to date with your vaccinations, and stay home when sick, even if you don’t think you have COVID.
It’s extremely uncomfortable not knowing what the future holds, and even more so making changes in your life that may or may not guide you in the right direction. But it goes without saying that we all need to be considerate of others along the way; we’ll never reach a point at which “COVID is just another flu” if we take care of only ourselves.
“Messaging changes as we enter different phases and stages of the pandemic,” Ahonkhai said. “We have to find better ways to communicate when there are rapid changes in our understanding of novel viruses because this won’t be the last one. There are lessons to learn about how we can do that much more effectively and try to maintain rather than erode trust in the process.” ●