The frustration is palpable. We were supposed to be done with this, back to normal, able to travel, gather with friends and family, and go out to nightclubs and movies and restaurants without fear. What happened?
There’s a lot of blame going around: politicians who went too far or didn’t go far enough; schools that closed for too long or opened too early; mask mandates that are overly protective or not protective enough; the vaxxed acting impervious or the anti-vaxxed being stubborn.
It’s confusing, and the truth is, we don’t fully understand. But saying that doesn’t mean we don’t know anything. We know enough both about the coronavirus and about human behavior to postulate some very good theories about why we just can’t seem to shake this pandemic, and to reinforce the recommendations that truly work.
Reason 1: Vaccines effective but not a magic shield
The fights between the vaxxed and the unvaxxed are exhausting. Accusations fly back and forth. So let’s step back from the emotion and look at the facts.
The vaccine is highly effective but not 100 percent. In New Mexico, for example, about 80 percent of cases and over 90 percent of deaths are among the unvaccinated. Where I live in Santa Fe, over 80 percent of folks are fully vaccinated. In a county of 150,000, that means almost 30,000 residents (and many of our tourists) are unvaccinated. An unvaccinated person is more likely to spread to unwitting vaccinated folks who might be sitting next to them on a bus or in a restaurant or theater. If Santa Fe is now having 40 to 50 positive cases a day, that means 30 to 40 are among unvaccinated folks and only 10 or so among vaccinated.
Reason 2: Delta is dangerous
As has been widely reported, the delta variant is both more transmissible and likely causes more severe disease than earlier versions of the virus. When you are infected with the delta variant (and almost all of the virus in the U.S. is the delta variant right now), the virus reproduces much more rapidly in your body, creating a higher viral load and increasing the chances you will infect others.
We heard about the “R naught” early in the pandemic — that’s the number of people a person with COVID-19 will infect, on average. For the original virus, that number was about two. Delta is twice as contagious, so without precautions like vaccines or masks, a person with the delta variant will pass the virus to four others, and case numbers rise more quickly.
Reason 3: Immunity is waning
Those who had COVID-19 early in the pandemic may believe they are already protected, and some have even refused the vaccine for this reason. Likewise, those of us who were vaccinated in the first waves may think we have nothing to fear.
Recent research shows that both groups are at risk. Although variables like different vaccine types and emerging variants make it hard to predict exactly when an individual’s immunity will wane, it seems clear that six months to a year after either infection or vaccine, susceptibility to new infection rises markedly.
Reason 4: Gathering in risky environments
We are worn down from the pandemic and craving connection, whether that means in-person school or work, relaxed get-togethers, or hugs with family and friends. Guidelines and mandates vary from state to state, making it hard to sort out what is safe and what is risky. Even the extremely easy-to-follow and low-risk recommendation to wear a mask in public places, especially in schools, ignites heated debate.
When one of my patients tests positive, I ask if they know where they caught the virus. Almost always, the moment of transmission can be traced back to being indoors, in close quarters, for a long period of time, with folks who were unmasked. I believe the combination of all of these factors is leading us back to high case numbers the likes of which we haven’t seen since the beginning of 2021.
The situation may seem dire, but all is not lost. There are fairly easy and risk-free things you can do to protect yourself and your friends and family.
Protection 1: Get vaccinated
The No. 1 most effective way to protect yourself is to get vaccinated. Even if you contracted the coronavirus in the past, especially if your positive test was over six months ago, a vaccine will ensure you have the highest possible immunity to future infection.
Those who are skeptical about the vaccine have many rationalizations and reasons for their fear, but the undeniable fact is that this group of vaccines is the safest and most widely analyzed of any vaccines in history. Over 3 billion people worldwide have gotten vaccinated, almost 200 million in the United States. Never before has a set of vaccines been rolled out to such a large population and monitored in real time via modern internet technologies.
Rates of severe adverse effects to the vaccine are extremely rare, on the order of just 3 to 4 per million vaccines given. For the vast majority of us, the risk of long-form COVID-19 (occurring in at least 30 percent of those with symptomatic disease) is far, far higher than any risk from the vaccine.
Protection 2: Masks work
I continue to be baffled about the controversy over a very effective and in-no-way-risky intervention that all of us should be using routinely: masks. A recent study from South Korea showed wearing masks on public transportation prevented over 90 percent of infections. Over and over, masks have been shown to be highly effective, with N95 and surgical masks giving the best protection. Good double-layer cloth masks also work well.
Protection 3: Gather responsibly
We are all tired of lockdowns. The mental health toll of the pandemic has been significant, and much of that stems from the sense of isolation and confinement that most of us experienced. I believe there are ways we can gather responsibly. Important factors to consider in any gathering are vaccination status, ventilation and time. An outdoors party with a group of fully vaccinated loved ones is far less risky than a long indoor family gathering with unvaccinated folks in the mix.
When in doubt, limit your time at indoor gatherings and wear a mask.
Protection 4: If you are sick, get tested and isolate
It’s hard to think this advice is still necessary two years into the pandemic, but if you are sick, even with a little sniffle, stay home, isolate from others and get tested. Astoundingly, there are still employers who are stingy with sick time and don’t seem to care if their employees or patrons contract COVID-19. Right now, fewer than half the states have mandatory paid sick time. New Mexico’s law affecting every employer passed this year, but it won’t go into effect until July 1.
If all of us followed these four simple guidelines, and if our society supported them as well, I’m confident we’d see a drastic reduction in cases, hospitalizations and especially deaths in just a few weeks.