More and more people are treating the illness like a common cold. Cancelling plans brings with it new and disconcerting criticism from friends: you shouldn’t have gotten tested.
Jason Moyer was days away from a family road trip to visit his parents when his 10-year-old son woke up with a fever and cough.
¿Covid?
The possibility threatened to disrupt the family’s plans.
“Six months ago, we would have gotten tested for Covid,” said Moyer, 41, an academic administrator in Canton, Ohio. This time, they didn’t.
Instead, they found the boy’s cough had improved and his fever gone, and they set off for New Jersey, without bothering to inform the grandparents of the incident.
In the fifth summer of Covid, cases are surging, with the Centers for Disease Control and Prevention reporting “high” or “very high” levels of the virus in wastewater in nearly every state. The rate of Covid hospitalizations is nearly double what it was this time last summer, and deaths, despite being down nearly 75 percent from the height of the pandemic, are still twice as high as they were this spring.
With kids back in school and increased travel over Labor Day weekend, the chances of spread are increasing. But for many like Moyer, Covid has become so normalized that they no longer see it as a reason to disrupt social, work or travel routines. Sales of test kits have plummeted. Isolation after exposure is becoming less common. Masks, once the ubiquitous symbol of a Covid surge, are in short supply even in crowded airports, train stations and subways.
Human behavior is, of course, the reason infections are skyrocketing. But at some point, many reason, we need to live.
“I don’t even know what the guidelines and recommendations are anymore,” said Andrew Hoffman, 68, of Mission Viejo, California, who came down with respiratory symptoms a few weeks ago after his wife tested positive for Covid. He didn’t go to the synagogue, but he did go to the grocery store.
“And since I don’t get tested, I can’t follow them,” she said.
Epidemiologists said in interviews that they did not favor a cavalier approach, especially for those who spend time with older or immunocompromised people. They still recommend staying home for a couple of days after an exposure and getting the newly authorized boosters that will soon be available (despite low uptake during last year’s round).
But they said some elements of this new attitude of let it be were justified. Although the number of Covid cases is high, the lower number of hospitalisations and deaths during the waves is a sign of greater immunity, proof that a combination of mild infections and vaccine boosters is ushering in a new era: not a post-Covid world, but a post-crisis one.
Epidemiologists have long predicted that Covid would eventually become an endemic disease, rather than a pandemic. “If you ask six epidemiologists what exactly ‘endemic’ means, you’ll probably get about 12 answers,” said Bill Hanage, associate director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health. “But it certainly has some sort of societal definition — a virus that’s around us all the time — and if you want to take that, then we’re definitely there.”
Some threats remain clear. For vulnerable groups, the coronavirus will always pose a higher risk of severe infection and even death. Long Covid, a multifaceted syndrome, has affected at least 400 million people worldwide, according to recent estimates by researchers, and most of those who have had it have said they have not yet recovered.
But CDC Director Mandy Cohen called the disease endemic last week, and the agency decided earlier this year to drop its five-day isolation guidelines for Covid and instead include Covid in its guidance for other respiratory infections, telling people with Covid, RSV or flu symptoms to stay home for 24 hours after their fever ends. The updated guidance indicated that for most people, the picture had changed.
Hanage defended the hardline mandates of the early years of the pandemic as “not only appropriate, but absolutely necessary.”
“But,” he said, “it’s just as important to help people get on an exit route — to be clear when we’re no longer tied to the train tracks, staring at the headlights coming at full speed.”
The absence of strict guidelines has left people to manage their own risks.
“I don’t bother testing myself or our kids for COVID,” said Sarah Bernath, 46, a librarian in Prince Edward Island, Canada. “My husband doesn’t get tested either. Knowing if it’s COVID wouldn’t change whether I stay home or not.”
In some social circles, divergent choices can create uncomfortable dynamics.
Debra Cornelius, 73, of Carlisle, Pennsylvania, stayed home from a recent indoor party because she learned that other guests, a family of five, had returned from vacation and tested positive for COVID-19 three days before the gathering but still planned to attend.
“They said, ‘Oh, it’s like a bad cold, we wouldn’t stay home with a cold,’” she said. “I think people’s attitudes have changed considerably.”
But for many others, attitudes haven’t changed at all. Diane Deacon, 71, of Saginaw, Michigan, said she tested positive for Covid three days into a trip to Portugal with her two adult daughters. She isolated herself for five days before flying home wearing a mask.
“Several people asked me, ‘Why did you get tested? You could have just continued on vacation,’” she said.
For Deacon, it was about remembering the refrigerated morgue trucks of 2020 and anticipating the vulnerable people he might see on his flight home — people in wheelchairs or on oxygen, he said.
“I try to avoid making moral judgments on other people who make other decisions,” he said. “For me, it was an inconvenience and it was unfortunate, but it was not a tragedy.”
In a Gallup poll conducted this spring, about 59 percent of respondents said they believed the pandemic was “over” in the United States, and the share of people who said they were worried about contracting Covid has been declining overall for two years. Among those who rated their own health positively, nearly nine in 10 said they were not worried about getting infected.
This could be at least partly due to personal experience: About 70 percent of people said they had already had a Covid infection, suggesting they believed they had some immunity or at least could get it again if necessary.
If the Olympics served as a barometer, the rest of the world seems to have exhaled as well. At Tokyo 2021, there were daily saliva samples, plexiglass dividers between cafeteria seats and absolutely no live spectators; stadiums were so empty that the coaches’ voices echoed. At Beijing 2022, under China’s zero-tolerance policy, conditions were much the same.
But in Paris last month, the organizing committee for the 2024 Olympics offered no testing requirements or processes for reporting infections, and so few countries issued guidelines for their athletes that those that did made headlines.
There were high-fives, group hugs, crowds and plenty of transmission to prove it. At least 40 athletes tested positive for the virus, including several who went on to win medals despite it, as well as an unknown number of spectators, as French health authorities (who had imposed an eight-month-long nighttime coronavirus curfew at the time) didn’t even count them.
In the United States, about 57 percent of people said their lives had not returned to pre-pandemic “normal,” and most said they believed they never would. But the current backdrop of American life tells a different story.
Social distancing signage from years ago is faded and peeling from the floors of a Los Angeles indoor market. Hand sanitizer dispensers at amusement parks have dried up. The summer camp hosted by Chicago’s Lincoln Park Zoo requires children to wear masks — not to protect other children, but the animals.
Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said the new complacency can be attributed to both confusion and fatigue. The virus remains extraordinarily unpredictable — Covid variants continue to evolve much faster than flu variants — and anyone trying to “pigeonhole” Covid into a well-defined seasonality will be baffled to discover that the 10 outbreaks so far recorded in the United States have been evenly distributed across all four seasons, he said.
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These factors, combined with waning immunity, point to a virus that continues to elude our collective understanding, against the backdrop of a collective psychology that is willing to move on. Even at a meeting of 200 infectious disease experts in Washington earlier this month — several of whom were over 65 and had not been vaccinated for four to six months — almost no one wore a mask.
“We’ve decided, ‘Well, risk is OK.’ But nobody has defined ‘risk’ and nobody has defined ‘okay,’” Osterholm said. “You can’t get much more informed than this group.”
Asked how risk perception has evolved over time, Osterholm laughed.
“Lewis Carroll once said something like, ‘If you don’t know where you’re going, any road will get you there,’” he said. “I think in many ways that’s where we are.”
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