27 May ‘People Are Really Over It,’ But COVID Isn’t Over
Dr. Bob Wachter, chair of the Department of Medicine at UCSF, spoke about how and why people should protect themselves from COVID-19 even though they’re “really over it.” (Screenshot captured by Danielle Parenteau-Decker / Richmond Pulse)
By Danielle Parenteau-Decker
While the risk has gone down, COVID-19 is still here.
Three medical experts shared their perspective on the current and potential future state of COVID in “COVID-19: It Ain’t Over Yet, Folks,” a roundtable discussion hosted April 28 by Ethnic Media Services.
“The state of COVID … feels relatively mild compared to what we have seen in the past three years and remarkably stable,” said Dr. Bob Wachter, chair of the Department of Medicine at UC San Francisco.
He said that was largely because of the vaccines, booster shots, Paxlovid treatment and home COVID tests, which all at least “work reasonably well” at preventing serious illness.
However, that doesn’t mean the danger is gone completely.
“COVID has not disappeared,” said Dr. William Schaffner, a professor at the Vanderbilt University School of Medicine. “In the United States on a daily basis, 200-300 people still die of COVID.”
“COVID was still the No. 3 cause of death in the United States in the last year,” added Dr. Ben Neuman, chief virologist at the Global Health Research Complex at Texas A&M University.
>>>Read: The COVID-19 Pandemic Is Not Over
Part of the reason why COVID is still around is because it adapts.
Wachter said a new variant comes along every several months “that is a little bit better at its job of infecting people and evading immunity but not a game changer.”
People’s attitudes and behaviors have also helped COVID stick around, the panelists said.
“The reason we’re in this situation is not because research has failed. It’s because of a lack of willpower … The difference between can’t and won’t,” Neuman said. “We haven’t ever really attempted full-scale vaccine coverage in a short window around the world.”
“We have learned the disconnect between knowing the right thing to do and getting people to do it,” Wachter said.
He said “misinformation and pushback against anything resembling a mandate” are largely to blame.
“The biggest problem,” Wachter continued, “we have these vaccines — they’re unbelievably effective — and the minority of people take them because they have been told things that are mostly wrong.”
Data from the Centers for Disease Control and Prevention shows many people were willing to get vaccinated at first but didn’t keep up with it. As of May 11, 81.4% of the U.S. population has received at least one COVID-19 vaccine dose, and 69.5% completed their primary series. However, only 17% of people in this country have gotten the updated bivalent booster shot, which provides increased protection.
Now “that any rules and restrictions are pretty much gone,” Wachter said, people are pretty much left to weigh the potential risks and benefits of different behaviors.
“It’s very clear that the value to many people … of forgetting about COVID and living life as if it was 2019 is very high,” he said. “People are really over it.”
“Everyone,” Schaffner began, before pausing, then repeating “everyone” with a slight smirk. “A large majority of people are much more relaxed about their personal infection control.”
“People have calibrated their level of fear and, therefore, their … behavior around [the question] ‘Am I going to get very sick and die if I get COVID?’ ” Wachter said, and the “likelihood of that is very, very low” for those not in high-risk populations such as older adults and those who are severely immunocompromised.
However, he said people often fail to take another risk into account: that of long COVID, which Wachter called “a really complicated, naughty problem.”
Long COVID can cause sometimes-debilitating symptoms long after even a mild initial infection has passed. Wachter said there is also “a body of literature that is quite convincing that says each case of COVID elevates your long-term risk of a whole bunch of stuff you don’t want to have: heart attacks, stroke, diabetes, autoimmune disease, cognitive decline.”
So what should people do to protect themselves?
All three speakers encouraged people to get vaccinated, stay up to date with boosters, and wear masks in certain situations, such as being on an airplane or in other crowded indoor spaces.
“We all have to come up with strategies that allow us to live our lives as fully as we can while mitigating the risks in a way that’s practical and sustainable,” Wachter said.
In other words, he agrees with the risk-benefit analysis approach. People just need to be realistic about the risks and benefits.
“Excuse me, the vaccines work,” Schaffner said in response to a woman who said her “confidence was shaken” when she got COVID after getting vaccinated. “You weren’t in the hospital. That’s what they were designed to do. If you expect perfection, you’re going to be disappointed.”
Wachter made a similar point about wearing a mask: “It lowers the chance of getting infected. It doesn’t bring it to zero.”
“Condoms prevent babies. Masks prevent infectious disease,” Neuman said. “You’ll hear a lot of argument about both of them, but that doesn’t mean that they don’t work.”
However, not just anything will do when it comes to masking for your protection.
“The quality of the mask and the fit is important,” said Wachter, who recommended N95 or KN95 masks that can create a secure seal around your mouth and nose.
Schaffner said the issue of keeping people healthy goes well beyond individual behaviors, however.
“We are the last highly developed country that does not provide medical care, both diagnostic and therapeutic care as well as preventive health services, for its entire population from childhood through senior citizenship,” he said. “I’m very frustrated that we haven’t dealt with this issue in a much more comprehensive and humane fashion.”