It definitely feels like we’ve been here before. Nationwide, the number of coronavirus infections is the highest since early 2021. Hospitalization rates are increasing dramatically in almost every state. Young children — many of whom are still not eligible for immunizations — are preparing for another pandemic school year. And even as SARS-CoV-2 continues to change shape, we are still struggling to get more shots. Summer is starting to look like a long and hard winter that many are sure they have left behind.
Last week, the CDC played what seems to be one of the clearest cards left in hand: asking fully vaccinated people to once again wear masks in public indoor spaces, where the virus is spreading. The recommendation echoes a suggestion the agency made controversially in May – and has clearly made Americans immune to a serious case of wearing a déjà vu mask. “It was a sudden 180,” Helen Chu, an infectious disease physician and epidemiologist at the University of Washington, told me, and for many people, “that makes it difficult.”
Over the past week and a half, I’ve talked, texted, emailed, texted, and tweeted with dozens of sources, readers, friends, family members, and complete strangers about the CDC announcement. My correspondence is a mixture of many emotions. Some are relieved that the CDC has officially reunited vaccines and masks, a scientifically strong pairing that many experts say should never be broken up. But I also heard frustration, bewilderment, even betrayal. There is a sense that we are in a quagmire, worried that we will never get rid of the pandemic behaviors that were initially “temporary” to us..” In America’s version of the pandemic, flimsy masks have been forced to take on a lot of symbolism. Now, they carry another weight: the awareness that the precautions we have placed in our lives may never end.
“A lot of the messages in the past were ‘Wear a mask until we develop a vaccine’ or ‘until we get vaccinated,Gretchen Chapman, a psychologist who studies vaccine decision-making behavior at Carnegie Mellon University, said. Masks are a stumbling block, and taking them off is a bonus for rolling up our sleeves. “Now,” Chapman told me, “it seems to some people that that reward is being taken back.”
To be clear, we do not exactly where we have stayed in previous hikes. Nearly 60 percent of the country has been vaccinated at least partially, and the shots are still against all known forms of SARS-CoV-2. Vaccinated people are still less likely to catch pathogens, transmit diseases, or especially get sick.
A variant like Delta does somewhat obfuscate the odds – it’s probably the most evil version of the virus to date and can dodge certain immune defenses. It stubbornly builds up in the airways of sick people, finds a way to spread itself more effectively, and there is growing evidence that it may also be easier to get people to the hospital. And a truly amazing amount of this variation is popping up around. Even excellent defenses can be beaten when they are constantly pushed forward.
By limiting the entry of the virus into the human respiratory tract, the mask can establish a successfully immunized immune system. And they help protect vulnerable people in the vicinity, by fixing the problem and limiting its spread. “I always thought the real power of vaccines was to keep you from getting very sick,” Chu told me. “The mask works on the other end of the spectrum.” It makes sense for them to return to the front lines of the pandemic.
Chapman said. Many people seriously covered their faces while waiting for their footage, then threw their masks aside because the government said they could – just to reel from the blow of the week’s movie transition. before. The guidelines for the unvaccinated (i.e., continue to cover the face) have not changed, while vaccination once again called to action. Lindsey Leininger, a public health policy expert at Dartmouth, told me: “Ask people to cover their faces again is going to cause a lot of emotion. “You can’t tell people that those feelings are invalid.”
Masking, at least on a pandemic level, doesn’t feel sustainable in the long run either. While a vaccine that offers protection against disease is expected to last for months, if not years, with one or two brief punctures, masks require reinvestment and constant vigilance. They falter when we don’t wear them properly; they vary greatly in quality; they may tear or break or fall off; they can be forgotten at home. Chapman told me, “You have to do it right all the time. “People love the set-and-forget approach, where you only have to intervene once. Long-term behavior change is often a very conundrum.”
“Continue to mask” seems like a pretty obvious departure from the original face mask selling points. These accessories are designed for deployment until Something better has emerged, and the most confusing aspect of the CDC’s new mask requirement may be the uncertainty it comes with. This time, there are no good ramps. Vaccines are here; they were made available to most Americans. We’ve hit the milestones we’ve set and still feel stuck.
This week, I asked nearly a dozen infectious disease experts if they’d set a new standard – the next bell to signal to the vaccinated that they can divorce themselves with cover-ups. pandemic level. Everyone agrees on only one thing: There is still no clear answer.
At this stage of the pandemic, the goal is not to stop all infections but to prevent as many cases as possible from turning into chronic or life-threatening illnesses. “The result here is to prevent people from dying in large numbers and find out who [highest-risk] Yvonne Maldonado, pediatrician-infectious disease and vaccine specialist at Stanford, told me. Achieve that goal maybe means reaching “low” transmission rates, such as 10 new coronavirus cases per 100,000 people over a seven-day period, as the CDC prescribes. Or it could mean that vaccine intake is insanely high — a percentage in the 80s or even the 90s, to account for Delta’s viral eagerness. (That final choice depends on expanding immunization eligibility to 50 million Americans under the age of 12.)
However, it is still too much to define those statistics. Immunity is heterogeneous among people and not static among individuals. While the vaccine’s effectiveness appears to have suffered a bit since Delta emerged, experts still don’t know how often people who are vaccinated catch the virus and transmit it. It’s also unclear when or how quickly our immune cells’ memory of the virus will begin to fade. If people are going back to vulnerability, the threshold is “high enough” Vaccination will be difficult to determine. The virus will also continue to change and could one day endanger even those whose immune defenses remain intact. As bad as Delta is, “it’s not the scariest thing you can imagine,” John Moore, a virologist at Cornell, told me.
Humans can also sharpen their weapons. Several experts, including Kanta Subbarao, a virologist and infectious disease specialist at the Doherty Institute in Melbourne, are hoping for a next-generation vaccine that could be delivered not as a shot. injected into the arm as a nasal spray. That could better manipulate immune defenses in place, specifically in the airways, to block the virus at its point of entry, potentially making it less likely to infect and transmit.
But we don’t need a perfect vaccine to end the pandemic. We’ve got all the extra tools we need: masks, ventilation, testing and more — strategies that have side effects when used together. Recent modeling work supports this logic. To quell outbreaks, we need not only vaccines, but measures to prevent exposures that stress our bodies in the first place.
Some of these tactics — including masks — have proven themselves so effective that many people may never give them up. The shortcut many people imagine may simply not exist. While pandemic-sized masking won’t be widely accepted for long, Stanford vaccine expert Maldonado thinks we’re headed for a “light stop” on masking and thinking Society’s rethinking of face coverings. She told me: “I think people will feel uncomfortable without a mask for a while. Masks can slip seasonally or socially, when people move in and out of public spaces, or when temperatures drop in winter. Public health officials may also recommend intermittent use of face coverings during outbreaks or as a method to ward off people between boosters. “If people were smart, they would continue to wear masks if they were in high-risk situations,” at least for a while, Maldonado told me, and perhaps not just for SARS-CoV-2 but for other respiratory viruses. Those practices have long since become commonplace elsewhere, and if the United States and many other Western nations had not previously joined in, perhaps they would now. Subbarao, a Melbourne-based vaccine expert, told me that “Australians have “really come full on masks”. “I don’t see much of a hitch about it.”
Instead of thinking of masks as a pandemic Band-Aid, perhaps we can consider them an obvious fixture for our future, even beyond the global reign of SARS-CoV- 2. After all, the end of this crisis is not really the end of precautionary behavior such as covering our face or staying away, but the end to the worst part of our relationship with this virus. Adopting new strategies is not admitting defeat, nor dismissing old ones. We can and should expect masking to remove hair and fade away at risk wax and wanes. “We have to learn and adjust our strategies as needed,” Subbarao told me. “This is just one more example of that.”