If that existed in pandemic terms, it would probably look like 2019: A time when we could go virtually anywhere without questioning our choices — before Covid-19 was part of the public lexicon.
We're not back in that carefree spot yet. We may never return to that place again. But restaurants, stores, theaters and schools are open. Crowds are gathering. Masks are mostly optional, and Covid-19 is often treatable.
Today, more than ever during the pandemic, we can actually feel kind of ... normal?
Right?
"People are going to be able to make some decisions for themselves," said Dr. John Sellick, an infectious disease specialist with Kaleida Health, Veterans Affairs and the University at Buffalo. "The level of risk is such that they're willing to accept it and get back to whatever it is that they like to do."
In this installment of Pandemic Lessons, we explore the state of our yearslong battle against Covid-19 and examine whether we've managed to recapture normalcy.
Is this as good as it's going to get?
Probably not, and that's good news. As time goes on, and our bodies build more immunity against Covid-19, we can do continually better.
But the key word in that previous sentence is time. It will take time — and loads more of the patience that's already been required of us 30 months into the pandemic.
"We've been seeing influenza and building immunity to influenza as a population now for well over 100 years," says Dr. Thomas Russo, chief of infectious disease at UB's Jacobs School of Medicine and Biomedical Sciences. "All of the population, over their lifetime, has had multiple influenza encounters either through vaccination or infection, starting at a very young age. They build up a certain amount of immunity."
That's why flu has often been considered a routine presence in our lives: We have a vaccine. We have medication. When you do get the flu, it's uncomfortable but usually short in duration. It can be acute, even lethal. But it doesn't stop us from living our lives.
You could say all those things now about Covid-19, too: Right now, the majority of infections are mild and limited in duration, with people returning to their daily lives after a week or so of resting and isolating. In many ways, from mode of spread to basic symptoms, Covid-19 may seem like the flu.
But it's not. Not yet, at least, and probably not for a long time. Many more people are getting hospitalized and dying from Covid-19 than from influenza.
"In prior flu seasons, we never had 40 people in the hospital in the middle of summer," Sellick said.
Despite the gargantuan effort to develop vaccination and treatments for Covid-19, our bodies — and our doctors — are still far better equipped to fend off influenza. That's because we've had the one thing that overwhelming resources and scientific genius cannot provide: time. Our immune systems have had less than three years to learn how to fight Covid-19.
"If you're a healthy adult, you've seen 20, 30 years of flu viruses," said Dr. Sharon Nachman, chief of pediatric infectious disease at Stony Brook Medicine. If you get the flu, she adds, "You're probably in better shape immunologically than if you have Covid, and only one or two years of exposure ... I don't think your repertoire of antibodies is quite the same."
As time goes on, will our bodies become increasingly accustomed to recognizing and knocking back Covid-19?
Yes. For most people, it's probably happening already.
"The more exposure you have to variants, the more differential antibodies you make, and the more you'll be protected," said Nachman, who likens this effect on a population level to what many children experience in their first few years of life. "Just think of yourself as a child," she said. "You had respiratory viruses left and right when you were in day care and preschool. By the time you got to middle school, you weren't sick every week ... You had antibodies from those first three years."
OK, but are we even still in a pandemic?
It often doesn't feel like it, but yes, we are officially still in a pandemic. An average of more than 400 Covid-19 patients are dying each day in the United States. That's more than double the figure from July 2021.
Globally, approximately 11,000 people are dying each week from Covid-19, according to the World Health Organization, which is responsible for declaring when the pandemic label is no longer needed.
We are getting closer.
"We have never been in a better position to end the pandemic," the WHO's director-general, Tedros Adhanom Ghebreyesus, said earlier this month. "We are not there yet, but the end is in sight."
But here in the United States, and especially in New York State, which has a relatively high level of population immunity from widespread vaccination and prior infection, medical experts are frequently using the term "endemic" to describe the current state of Covid-19. That suggests it's present, still serious and prone to spikes and drops — but less likely to spiral out of control.
It's here, it's background, we live with it," Nachman says. "We've emerged from the pandemic phase. Now we're in the endemic phase."
Nachman points to three reasons we can live with Covid, rather than run from it:
—Vaccines, which can be updated, have allowed the population to build and maintain a level of immunity that largely provides protection from severe infection. The Food and Drug Administration just approved a new set of booster shots from two vaccine makers, Moderna and Pfizer, that address the Covid-19 variant Omicron and its highly contagious subvariants.
—Tests are readily available to diagnose Covid-19. "If you're sick, you swab, you're positive, I know you have it," Nachman said.
—Treatments are available, including Paxlovid, a prescription pill given in the first few days of infection to people at higher risk, and monoclonal antibodies, which are administered intravenously.
"Taking all that together allows us to move from those surge events" that have happened periodically, usually driven by variants that emerged during the first two-plus years of the pandemic, Nachman says, "to just background stuff."
So, then, are masks mostly gone for good?
Don't go that far.
Mask mandates may be mostly over. Even New York, which has been among the states with the highest level of masking requirements since the pandemic began in the early part of 2020, has dropped most mandates. Gov. Kathy Hochul announced earlier this month that masks would no longer be required on mass transit or in correctional facilities or shelters. Face coverings are, however, still mandated in health care centers and adult care facilities.
"We have to restore some normalcy to our lives," Hochul said.
As of Sept. 13, New York had an average of 20 Covid-19 cases per 100,000 people. That's down from 27 one month earlier. Western New York, meanwhile, had an average of 18 cases per 100,000. That's up slightly from 15 one month earlier. Together, both numbers — which are similar to other regions in the state — indicate that virus spread in New York has stabilized.
None of that means we should toss our masks into the garbage. You may choose to wear them in crowded situations now, and you may need them in the future.
"It depends on the lethality of future variants," Nachman said. "If we hit another strain like the original strain — our first surge — I think masks will become common again. We're wearing them to protect ourselves, and we're wearing them to protect others. It all gets back to: 'How serious is that illness the virus has caused?' "
If we're doing reasonably well, is vaccination still useful?
Yes.
Nachman points out that "study after study" shows that vaccinated patients have fewer symptoms of long Covid, which is a serious and often perplexing condition that doctors are still trying to unravel.
It's true that no Covid-19 immunity — not that derived from vaccination, nor from natural infection — is fully protective for the long term; it will wane in the months following an illness or a shot. But at minimum, vaccination is an added shield against severe disease.
"When driving cars and flying airplanes, we demand the highest level of duplication of safety," Nachman said. "We don't say, 'Oh, you've got a seatbelt? You don't need an airbag.' We don't say, 'Oh, you've got one pilot? We don't need two pilots.' We have duplication of safety for everything that we do."
©2022 The Buffalo News (Buffalo, N.Y.). Distributed by Tribune Content Agency, LLC.
