…and what do we do until then?
Despite constantly evolving restrictions and debates surrounding mask mandates in schools, we are still under the same public health emergency that was issued in January of 2020. In fact, the emergency was most recently updated in July of this year. Nothing has served as a worse reminder of the ongoing pandemic than the nation’s poor vaccination rates and the recent Delta variant surge. While the CDC initially suggested that fully vaccinated adults could return to life as we knew it, they now suggest that everyone should wear masks in “areas of high transmission,” regardless of vaccination status.
The country is left asking “Is it really over?” and “If not, how do we know when it is?”
Back to Normal Doesn’t Exist
Americans have entered a new, disheartening phase of the pandemic: when they realize that Covid-19 is not disappearing anytime soon. A country that had been waiting for the virus to be over has been forced to recalibrate.Delta surge drives Home painful truth: Covid isn’t going away, The New York Times
The reality is that we cannot return to “life as we knew it.” Our world has been irrevocably changed. Some businesses have returned to work in offices, others have shifted permanently to remote work. Telehealth usage has fallen in recent months, but its new and permanent prevalence cannot be debated. It’s possible that COVID will never fully go away, instead becoming a cyclical threat like the flu.
“I think we’re closer to the beginning than we are to the end…Unless we vaccinate everyone in 200 plus countries, there will still be new variants,” he said, predicting that the coronavirus will eventually become a “forever virus” like influenza.Dr. Larry Brilliant, The world is nowhere near the end of the Covid pandemic, says famed epidemiologist Larry Brilliant, CNBC
That is the formal measure for the end of the pandemic after all, the end of the worldwide spread. And while vaccination rates in the United States are low, they are abysmal or nonexistent in many other countries.
When the worldwide spread of COVID-19 stops, it will no longer be considered a pandemic. “In general, if the worldwide spread of a disease is brought under control to a localized area, we can say that it is no longer a pandemic but, instead, an epidemic,” the WHO told NPR.How we’ll know when the covid-19 crisis is over, NPR
Instead of waiting for a way of life to return that no longer exists, we need to measure success by new standards. There may always be hand sanitizer waiting at the doors of grocery stores. Many of us may always keep a mask in the car, just in case. Our new normal will settle into place when life is no longer hindered by these changes. We will feel safe again when we aren’t worried about hospitals running out of beds. Until then, we need to remain patient, consistent, and ready to adapt.
Herd Immunity May Be Beyond Us
But only about half of Americans are fully vaccinated, and daily vaccination rates have risen only modestly, to about 700,000 doses a day, since the Delta surge began.”Delta surge drives Home painful truth: Covid isn’t going away, The New York Times
Unfortunately, we cannot willfully decide that the pandemic is over because we are tired of being cautious. And low vaccination rates will keep us teetering on the precipice of safety for longer than necessary.
The worst surges have so far been concentrated in Southern states with underwhelming vaccination numbers, but infections have also been rising in places with far better vaccine uptake. Oregon and Hawaii, both of which have relatively high vaccination rates, have set weekly case records in recent days, and daily case rates have more than doubled in recent weeks in highly vaccinated parts of New England.Delta surge drives Home painful truth: Covid isn’t going away, The New York Times
COVID cases aren’t just rising, they’re almost double last summer’s peak numbers. And while vaccinations are critical, it isn’t just unvaccinated regions that are being hit hard by the variant. But the vaccinated do experience less severe reactions to infection, saving lives and keeping hospitals from becoming overburdened.
Last month, for example, 92 people died of COVID-19 in Maryland. All of them were unvaccinated.How we’ll know when the covid-19 crisis is over, NPR
And although the FDA recently finalized their approval of the Pfizer vaccine, vaccine resistance is still raging. The identified subgroups with vaccine resistance are the same subgroups who avoid masking. This means that a specific subset of the nation refuses to participate in the two most effective methods of transmission prevention, almost guaranteeing the continued spread of COVID-19.
The Continued Case for Telehealth
While COVID infection rates are rising, there are none of the expected lockdowns or mask mandates. It seems unlikely that governors will issue state-wide mandates again, after the first round of lockdowns became highly politicized. We cannot look to state or even national lockdowns to drive our behaviors as infection persists. Instead, we need to remain vigilant at the individual, organizational, or even city-wide level. That means continuing to embrace digital solutions while employing the lessons we learned during previous surges.
New York will become the first big U.S. city to put into effect a vaccine mandate for indoor activities, requiring people to show proof of vaccination on a new app or their paper vaccination card. Incoming governor Kathy Hochul (D) is reportedly considering a statewide mandate, saying Sunday that she is “open to all options.”New York, D.C. to require health-care workers to be vaccinated, The Washington Post
Part of our new normal is utilizing the digital whenever possible. The most effective of these measures is telehealth. Telehealth helps minimize transmission in healthcare both by reducing visitors onsite and protecting care teams with solutions like telequarantine and telesitting.
But recently telehealth usage rates have fallen as emergency permissions for virtual care expire and Congress is left debating what role telehealth has to play in the system. More than 400 healthcare organizations recently signed a letter to Congress, urging them to act quickly in favor of digital resources.
The groups also called on Congress to get rid of arbitrary restrictions regarding where patients can use telehealth services, to remove limitations on telemental health services, to authorize the Secretary of Health and Human Services to allow additional telehealth “practitioners, services and modalities,” and to help ensure that federally qualified health centers, critical access hospitals, rural health centers and providers like them can furnish telehealth services.As ‘telehealth Cliff’ Looms, hundreds of healthcare Orgs urge Congress to act, Healthcare IT News
Pandemic or no, telehealth has proven to be an extremely useful tool for connecting patients and providers. As we look prepare for the new world shaped by COVID-19, we must make room for the technologies that have made a difference. Now that we’ve acclimated to telehealth, we can build upon earlier implementations to further the impact that virtual care platforms have made on the way we give and receive care. The end of the pandemic may be distant and unknown, but we have the tools to weather the storm.
Adela Suliman, K. N. (2021, August 17). New York, D.C. to require health-care workers to be vaccinated. The Washington Post. https://www.washingtonpost.com/nation/2021/08/16/covid-delta-variant-live-updates/.
Bosman, J., & Smith, M. (2021, August 16). Delta surge drives Home painful TRUTH: Covid isn’t going away. The New York Times. https://www.nytimes.com/2021/08/16/us/covid-delta-variant-us.html.
Centers for Disease Control and Prevention. (n.d.). When you’ve been fully vaccinated. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html?s_cid=11406%3Acdc+guidelines+vaccinated%3Asem.ga%3Ap%3ARG%3AGM%3Agen%3APTN%3AFY21.
Hensley, S. (2021, August 23). Pfizer’s COVID Vaccine gets full approval from The FDA. NPR. https://www.npr.org/sections/coronavirus-live-updates/2021/08/23/1030251410/pfizer-covid-vaccine-fda-approval.
Lee, Y. N. (2021, August 9). The world is nowhere near the end of the Covid pandemic, says famed EPIDEMIOLOGIST Larry Brilliant. CNBC. https://www.cnbc.com/2021/08/09/covid-epidemiologist-larry-brilliant-on-delta-variant-vaccinations.html.
Mayo Foundation for Medical Education and Research. (n.d.). U.S. COVID-19 vaccine tracker: See your State’s progress. Mayo Clinic. https://www.mayoclinic.org/coronavirus-covid-19/vaccine-tracker.
Miliard, M. (2021, July 27). As ‘telehealth Cliff’ Looms, hundreds of healthcare Orgs urge Congress to act. Healthcare IT News. https://www.healthcareitnews.com/news/telehealth-cliff-looms-hundreds-healthcare-orgs-urge-congress-act.
Public health emergency declarations. phe.gov. (n.d.). https://www.phe.gov/emergency/news/healthactions/phe/Pages/default.aspx.
Wamsley, L. (2021, July 10). How we’ll know when the covid-19 crisis is over. NPR. https://www.npr.org/2021/07/10/1014374383/covid-19-coronavirus-pandemic-when-its-over.