We cannot slam the door on the pandemic

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We must assess the risks based on accurate information and take appropriate precautions.



Summary: Eventually, SARS-CoV-2 will go from a pandemic to a endemic state, but it won’t be like an on / off switch. It may take some time, as many people globally and in the United States remain unvaccinated, thus eliminating the opportunity for a quicker end. We must learn to live with SARS-CoV-2 and the risk of infection. This means evaluating on a daily basis what risks we are willing to take and which ones we want to avoid the most. Most of us who have to work, run the house and go to school have to accept some level of risk. If we have accurate information and take all appropriate precautions, we can feel a certain sense of free will and be comfortable with the discomfort of ambiguity. Some people will need to weigh their risks much more cautiously, such as those who have children too young to be vaccinated, or older people or other at-risk people in the home. But most of us can’t slam the door on the pandemic. We must venture out, however cautiously, managing risk and fear. The virus is everywhere. We must learn to live with it and do our best to outsmart it by getting vaccinated and wearing masks. In the end, I provide a resource for coping with uncertain times from Krista Tippett, creator and host of the “On being“Public radio show and podcast.


Firstly, we hoped for the end of the pandemic, but it hasn’t happened yet.

There was a time when we thought and hoped we could vaccinate to get out of the pandemic. In the weeks after the first two vaccines were cleared for emergency use, we logged into websites and frantically searched for appointments and people like me were willing to drive for hours to get vaccinated (without skipping the line) . President Biden envisioned Independence Day celebrations with the family at a time when 70% or more of the US population would be vaccinated. But somewhere on the way to the herd immunity dream, which we don’t talk about much anymore, something happened. The crowds at the vaccination sites have slowed to a thread. Governors and others have begun offering large and small financial incentives for people to get vaccinated. Slowly, the hikes began in some states, but others stalled. Some governors, such as Florida’s Ron DeSantis and Texas’s Greg Abbott, have banned policies, such as masking and vaccination, that would help prevent the waves their states are now experiencing.

Jonathan Metsch, DrPH, clinical professor of environmental medicine and public health at Mount Sinai Icahn School of Medicine, who treats and post COVID-19 information on a regular basis recently highlighted another state, South Dakota.

The infamous and popular tradition known as the Sturgis Motorcycle Rally will bring together (700,000) motorcyclists as they traverse the countryside from 6 to 15 August. (You see Outsider.com.) Governor Kristi Noem of South Dakota, posting on Facebook, said, “The Sturgis rally is about jumping on a bike and exploring this great country through our open roads. Bikers come here because they WANT to be here. And we love seeing them! There is a risk associated with everything we do in life. Bikers get it better than anyone else. “

Metsch went on to say the pandemic will end, as all pandemics do, but the virus will likely become endemic. Depending on the type of immune response the virus generates, it could become endemic faster, with most cases being mild. We must live with the pandemic until it slips into an endemic state, as described by Jennie Lavine, et al, in Science. It won’t be like watching a movie and seeing The End. We may not be fully aware of the transition, but it won’t happen in the next few months. (So ​​you see statistics.) This means we have to learn to live with it. We have to coexist.

“There is no definition of what ending a pandemic means,” Metsch wrote. (The needle NPR.) “The question of when the crisis will be over is layered – with different answers from local, national and global perspectives.” (The needle National Geographic.)

Reflecting on the global perspective, the New York Times recently reported,

In Spain and Britain, where vaccine stocks are plentiful, cases have started to decline after the Delta variant took the numbers to worrying levels. But in other countries like Malaysia and Thailand, where doses are scarcer, that climb continues. In the United States, with roughly 93 million people eligible for the shots who have chosen not to take them, experts say an increase in cases this winter is inevitable..

Most models foresee increases in cases before they begin to decline in October in the United States

Learning to live with a mortal agent among us

It is not easy to live with a deadly agent who could be anywhere: in a stranger’s sneeze, in a loved one’s cough, in a patient’s breath, or in our tablemate. If we stop and think about all the ways we might be attacked, it’s depressing, threatening and potentially immobilizing. So, we need to use the tools we have: vaccination, masking, valid information, and our own individual risk assessments. Among vaccinated people, the chances of contracting the virus are much lower and the chances of ending up in hospital or dying are incredibly low even though there are some breakthrough infections. Most of us can’t stay indoors until this is over, and it won’t be over anytime soon. We missed that opportunity when the Delta variant took hold in this country due to a substantial portion of the population not getting vaccinated and many people still not wearing masks. I’m not blaming the unvaccinated. Nor am I taking lightly people’s fears about going to offices and classrooms because they have immunocompromised family members or young children at home who cannot be vaccinated. The risks are real. My husband has a condition that puts him at a greater risk of hospitalization or death if he contracts COVID-19. I see.

Each of us must carry out daily risk assessments to determine what risks we will tolerate. I shop in person (disguised) rather than have them delivered, but I haven’t been to a restaurant except for the takeaway since March 2020. This week I was on a retreat with masked people and the other day I have. talked to students (wearing masks) in a classroom. Some people may have gone to the restaurant or the beach, but they are uncomfortable in the classroom. We make all kinds of compromises every day.

Data can help us obtain better information on reasonable and unreasonable risks. Except for a small number of people with medical contraindications, being unvaccinated is one of the biggest risks of contracting COVID-19. Or turn it upside down: getting vaccinated is one of the best protectors (see CDC chart below, based on COVID Tracker data as of July 24, 2021).

Licensed vaccines aren’t perfect, but they’re really good. The combination of vaccination and indoor mask offers great protection, but again, nothing is 100%. At our school, we’re taking extra steps to put more oomph on the COVID ledger avoidance side. For example, we are following CDC’s advice on managing meetings and events to minimize virus transmission (see this link).

UNC-Chapel Hill recently raised expectations for faculty and staff by informing the Carolina community in a Letter of 6 August the requirement to certify vaccination and upload CDC COVID-19 vaccination registration cards or to undergo regular testing. The students had already been required to do so. This policy will help create a safer environment for all of us. It’s not a mandate, but it has some elements of a mandate: it’s Mandate Lite.

With relocate Other welcome events already underway on our campus, a vaccine mandate now may not prevent bunches of infection this month and next. One week before the start of in-person classes on August 18, approximately 85% of students, 92% of faculty and 64% of staff had certified that they were vaccinated (see NO).

Along with vaccination, the best defense against infection, according to David Weber, MD, MPH, who spoke to the Gillings community in a Web seminar August 12 [beginning ~27:52 on video], is for everyone – vaccinated or unvaccinated – when out and about constantly wear a tight-fitting mask indoors at all times and outdoors when a 6-foot distance cannot be maintained [~49:30 on video]. Dr. Weber is Sanders Distinguished Professor of Medicine and Pediatrics; Professor of Epidemiology; Associate Chief Medical Officer and Medical Director of Infection Prevention, UNC Medical Center. Dr. Weber advises not to eat with others indoors or in close proximity to the outdoors due to the need to remove the masks to do so. [~1:18:20 on video].

While consistent mask use is highly effective for prevention, we also recognize that within our community there are faculty, staff and students who must seek housing to forgo certain in-person activities to protect themselves or members of their own. family from infections (for example, those who cannot safely wear a face mask or be vaccinated). We all must do all we can do – and respect the needs of others to do what they need to do – to protect ourselves and others in our families and communities.

Finding equanimity in the midst of chaos and fear

How can we continue to live with a virus that disrupts our lives? Somehow, we have to learn to achieve equanimity. On Sunday mornings, as I walk, I listen to NPR’s “On Being” program with Krista Tippett as a sort of spiritual update for the week ahead. On August 8, he spoke with author and meditation teacher Sharon Salzberg. They talked about finding their way into the world during the pandemic and about finding out equanimity. I encourage readers to read the transcription or listen to the podcast. It is quite uplifting. Here is an excerpt:

Sharon Salzberg: Of course, if I had heard the word “equanimity” a long time ago, I would have thought, it would be truly bizarre. What does it mean? And many times, we think it means indifference, but in reality it doesn’t. It is such a great capacity of our heart to see what we are going through, to see what others are going through, and to just have this perspective, there is change in life, and there is light in the dark and dark in the light. And we don’t avoid pain, because some things just hurt. This is crucial. But we’re holding it back in a way that’s like love is stronger than pain, too. And then we can really be with things in a very, very different way.
Barbara

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