Flirting with Normalcy in Year 3 of the Pandemic

Americans’ desire for normalcy is beginning to outweigh fear of the virus. But as we loosen the belt, we need to do so strategically. A guiding principle is to loosen the belt during refractory periods between variant waves and tighten the belt as variants spread like wildfire to “flatten the curve” on explosive growth to keep medical systems intact. The CDC’s recent misfire on the shortened quarantine/isolation recommendations was a case study of how not to do it, loosening policies just as omicron tore through the nation, which flew in the face of common sense and enraged everyone except airline CEOs.

Masks

Where to tighten the belt: Quality matters (especially during omicron). We’ve graduated from the early days of wearing drippy cloth masks and bandanas everywhere we go. If you’re going to wear a mask, use it properly and strategically in high risk settings. Tip: to avoid counterfeit N95 and KN95 masks shop at a reliable source like the non-profit projectn95.org.

Where to keep the belt tight: High risk environments. Wear masks in indoor public places (e.g., while shopping, public transit, airports, church, etc.) As a rule of thumb, wear a mask if you’re indoors around people whose names you don’t know, especially if you can’t socially distance.

Where to loosen the belt: Follow the rest of the world when it comes to young children and masks. Every morning I drop my 3-year old son off at preschool where kids ages 2-5 run around outside wearing masks. The kids are good sports; most keep their masks on. But you wouldn’t observe a scene like this in most of Europe, or most other countries. Do masks reduce transmission? Sure (Probably.) (When worn properly.) (When quality is high, especially against highly transmissible omicron.) But the World Health Organization does not recommend masks for young age groups, reasonably weighing COVID-19 risks for young children against the costs of lost empathy and socialization that comes with learning to read faces at early ages. Most small children realistically can’t wear N95s or KN95s anyway. My son Bjorn is resilient and highly social and will likely bounce back from a short delay in acquiring social skills. But I prefer not to gamble with my son’s future unless it’s absolutely medically necessary. I surreptitiously slip off my mask to sneak tiny Bjorn a goodbye kiss and flash him a big smile before I leave him for the day. It’s against the rules and the strict teacher Megan scolds me. She’s trying to maintain order and safety. But we’re outdoors, 6 feet from other kids, and it’s the last genuine smile Bjorn will see for 8 hours. If a liberal, COVID-wary, science-driven mom like me (who never stopped wearing masks in grocery stores, even in July when everyone else shed them) thinks the mask mandate for young children is a bit draconian, and may do more harm to my child than good, Democrats should brace for a bloodbath at midterm elections.

Where to loosen the belt: Outdoors.

Vaccines

a

Where to tighten the belt:

– Update CDC definition of “fully vaccinated” in light of omicron. Less than 50% of Americans considered “fully vaccinated” have had a booster.

America, the country that pioneered mRNA vaccines, lags countries like Vietnam and Uruguay in vaccination rates.
This UK data is mostly on the AstraZeneca vaccine and is not fully translatable to the US, but the overall patterns are similar.

– Increase booster uptake by correcting misleading narrative that omicron is “mild.” The death rate from omicron is higher than delta in the US.

So much for omicron being “mild”

Isolation and quarantine.

Where to tighten the belt: Isolating at first sign of cold symptoms, especially during variant waves: Back in 2020 the key COVID symptoms were fever, cough, shortness of breath, loss of taste, but omicron symptoms have shifted to common cold symptoms like runny nose, headache, fatigue, sneezing and sore throat. Isolating (hard and early) is even more important for omicron, where transmission occurs at earlier stages of infection. Your sore throat is also not likely to be not flu. Other respiratory viruses like influenza have continued to be repressed during the pandemic. In fact, one of the 4 influenza virus strains in the quadrivalent flu vaccine (B/Yamagata lineage) seems to have gone extinct globally simply because people move around less, reducing opportunities for transmission.

Influenza continues to be in retreat during the pandemic’s 2nd winter

Where to loosen the belt: I agreed in spirit with the CDC’s recent decision to shorten the isolation period for asymptomatic infections from 10 to 5 days. The policy change was partly based on science (omicron has a shorter incubation period) and partly an effort to keep America operational. During omicron many businesses (notably airlines) lost so many staff to isolation and quarantine they could barely operate. The CDC was trying to be practical and be so not knee-jerk in “safely” picking the most conservative path, to balance disease control with societal functionality. But the timing was awful. Doctors and nurses already felt like sacrificial lambs as omicron cases skyrocketed, overwhelming hospitals. Optically, in tampering with a core component of outbreak control CDC seemed to be favoring business interests over the medical system. It makes sense to shorten the isolation period, but control the tsunami of infections first.

Plus, the CDC protocol has holes. For example, which of these scenarios do you think poses less risk to others?

(A) An unvaccinated person isolating for 5 days and then going to a large indoor concert on Day 6 (wearing a mask).

(B) A vaccinated person isolating for 5 days and then on Day 6 going for a solo run/walk in an uncrowded park (not wearing a mask).

The answer is B.

And which scenario violates CDC protocol?

B again.

This is nothing compared to the flowchart on whether Novak Djokovic could enter Australia.

L

0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply

Your email address will not be published. Required fields are marked *