September 21, 2022 – President Joe Biden Say the epidemic is over. The World Health Organization says the end is in sight. Many of us would rather talk about almost anything else, even New York City has dropped most of its COVID protocols.
Biden’s statement (to reporter Scott Paley on Sunday 60 minutes) caused controversy Coronavirus disease It broke out again, although he has now tried twice to soften it. It has disrupted an already divided public, promoted widespread TV news coverage, and caused experts to step aside.
But for many people, a Pandemic “End” cannot be declared when the U.S. alone is averaging more than 71,000 new cases and more than 400 deaths per day, while the world sees 500,000 daily cases and nearly 2,000 deaths.
Biden’s comments have divided medical and public health experts.Some strongly disagree that the pandemic is over, pointing out that COVID-19 remains a public health emergency in the U.S., the World Health Organization still considers it a global pandemic, and most importantly, the virus still kills more than 400 people a day in the U.S.
Others point out that, at least for now, most of the country is protected from vaccination, infection or a combination. Now, they say, is the time to declare the pandemic over and acknowledge that the majority of society has made a decision.This feeling may be controversial new New York’s COVID health slogan: “You Do You.”
In fact, media site Axios and its partner Ipsos released a new poll on September 13, found that 46% of Americans Say they’ve returned to their pre-pandemic lives — the highest percentage since the pandemic began. Meanwhile, 57% said they still have at least some concern about the virus.
“How can a country say the pandemic is over?” asked Eric Topol, MD, executive vice president of Scripps Research and editor-in-chief of Medscape, WebMD’s medical specialty sister site.
In Topol’s view, this is far from over and a balance must be struck between protecting public health and allowing individuals to decide how to live based on their risk tolerance.
“You can’t just give up on the public and say, ‘It’s all up to you.'” He sees this approach as abdication of responsibility that could cause an already reluctant public to forget to get the latest booster, the available bivalent The vaccine came out earlier this month.
Topol coined the term “COVID surrender” back in May, when the United States was in the midst of a wave of infections of the BA.2 variant. coronavirusAfter the White House said a COVID-19 vaccine would soon become an annual requirement, he used the phrase again this month, like the annual flu shot.
Topol now sees hope, but is tempered by recurring realities. “In terms of spreading the virus, we’re going down,” he said. “We’re going to have a quiet few months, but then we’re going to cycle again.” He and others are watching for emerging variants, including the sub-variant BA.2.75.2, which is more disseminated than BA.5.
The White House acknowledged this back in May when it warns With infections reaching as high as 100 million this fall, the death toll is likely to rise significantly. The group warns that the Institute for Health Metrics and Evaluation at the University of Washington expects about 760,000 people in the U.S. are currently infected with COVID-19, and that number will exceed 2.48 million by the end of the year.
A new stage?
“From a public health standpoint, we’re clearly still in the midst of a pandemic,” said Dr. Katelyn Jetelina, a health policy expert who publishes “Your Local Epidemiologist”, a scientific newsletter for consumers. “The question is, ‘What stage of the pandemic are we in?’ This is not an emergency, Navy roll on the boat [as it did to help hospitals cope with the volume of COVID patients in 2020.]”
“The biggest problem with this review [by Biden] Yes, are we normalizing all these deaths? Are we willing to make SARS-CoV-2 the third leading cause of death? I’m disappointed with that comment,” she said.
Even as people move from a public health perspective to an individual decision-making model, most people still need to consider others when determining their COVID-19 precautions, Jetelina said. In her personal life, she has been thinking about how her activities affect those around her. For example, she said, “We’re going to see my grandpa, and everyone was doing antigen tests.”
While younger, healthier people may be able to relax protective measures safely, they should still be aware of those around them who are at greater risk, Jetelina said. “We can’t just put the blame solely on the vulnerable. Our layers of protection are not perfect.”
Like Topol, Jetlina advises considering the situation. She recommends taking small steps to collectively reduce transmission and protect vulnerable populations. “Wear a mask” before entering a high-risk environment and “do an antigen test before going to a nursing home”.
The worst behind us?
“The mission is not done,” said William Schaffner, an infectious disease specialist and professor of preventive medicine at Vanderbilt University in Nashville.If he could rewrite Biden’s comments, he said, “he could have said ‘the worst is over,'” while referring to the new vaccine Raise your enthusiasm for this and commit to continuing to make progress.
Schaffner also acknowledged that large parts of society have somehow decided to end the pandemic. “The vast majority of people have taken off their masks and are going to concerts and restaurants again, and they want to play a role in society,” he said.
He understands this, but suggests that a public health message should be to remind those who are particularly vulnerable, such as adults over 65 and those with certain medical conditions, to continue to take extra steps to wear masks and maintain distance, Especially upwards during flu season.
Schaffner said public health messages should alert others to vulnerable segments of the population, so those who continue to wear masks aren’t upset by those who have given up.
Focus on the most vulnerable
Paul Offit, MD, an infectious disease specialist and director of the Center for Vaccine Education at Children’s Hospital of Philadelphia, said Biden’s statement “could have been better expressed.” But, he said, things are different now than they were in early 2020.
“We are in different places. Most people are now protected from serious diseases [either by vaccination, infection, or a combination]. “
The effect of this protection has come into play in demand or lack thereof, Offit said.At the start of the pandemic, “we asked for COVID vaccines in our hospitals [for employees]”Now, hospitals will not mandate new bivalent vaccines.
He agrees that the future focus should be on the most vulnerable. Beyond that, he said people should make their own decisions based on their personal circumstances and risk tolerance.
An important and looming question, Offit said, is for scientists to find out how long people are protected from vaccination and/or prior infection. Preventing hospitalizations and serious illness is the goal of vaccination, which in his view is the only reasonable goal, not eliminating the virus, he said.
Biden ‘is right’
Dissenting was Leana Wen, MD, MD, a professor of health policy at George Washington University and a frequent media commentator, who said Biden should not shy away from his comments that the pandemic is over. “He was right.”
The U.S. has entered an epidemic phase, she said, as evidenced by social measures (many people returning to school, work and travel) and policy measures, with mandates and other requirements being relaxed or lifted in many places.
She said there was disagreement on the scientific measure. Some say more than 400 deaths a day are still too high to be called an epidemic. “We’re not going to eradicate the coronavirus; we need to live with it, like HIV, hepatitis and the flu. Just because it’s not an epidemic [in her view] It does not mean that the level of illness is acceptable, or that COVID is no longer with us. “
Wen doesn’t see it as an either-or healthy choice from a public health standpoint versus an individual standpoint. “Just because something is no longer an epidemic doesn’t mean we no longer care about it,” she said.but i think [many] People live in the real world. They see family and friends coming back for dates, going to restaurants, and not wearing masks. Like many other risks they encounter in life, the coronavirus has become a risk. “
Wen said the tension between public health and personal health has always existed and will not go away. It works for all health problems. The shift from broad public health concerns to individual decisions “is something we expect to happen and should happen”.
She also pointed to the costs of measures to combat COVID, including closing schools and businesses and their impact on mental health and the economy, as well as another less discussed cost: the impact on public health trust
Continuing to demand measures against COVID-19 when cases are falling could further erode trust in public health authorities, she said.New York State recently announced public health emergency After the polio virus was found in sewage samples, Wen wondered: “What would happen if we said, ‘Get your kids vaccinated against polio?'”