20 The View is reported by Eloise Barry, Leslie Dickstein, and Simmone Shah
THE VIEW OPENER
Along with this wall of immunity,
approaches adopted when we had
few tools to prevent spread are no
longer providing benefits that always
justify their costs of social disruption,
diminished classroom experiences,
and economic drag.
But we’ve been slow to adapt our
strategies to the evolving notions
of risk. The CDC is soon expected
to update its policies, moving away
from national recommendations
and instead tying to measures of
local prevalence its guidance for the
protective steps people should take.
This community-by- community
standard may not be enough. We’ve
turned restrictions on but haven’t
turned them off as conditions changed.
In many cases, it’s because we’re still
relying on the same metrics that we
used at the start of the pandemic.
These concepts for measuring risk
have remained mostly fixed since
that time, even as people acquired
protections from the virus.
At the outset of the pandemic, we
had a shared sense of the threat and
a shared willingness to sacrifice a lot
to deal with it. As the pandemic has
evolved, and its burdens accumu-
lated, that social compact has frayed.
Now we need to shift from measures
adopted collectively, to tactics taken
individually by people who are judg-
ing their own individual risk against
their degree of caution. This means we
must accept more regional and local
variation in measures adopted at the
state level. The government’s role will
be to make sure people have the tools
they need to make those choices.
Steps that were critical in 2020 to
reduce death and health care strain
when we were overwhelmed are no
longer justifiable. But what anchors
that change? Even when actions were
adjusted based on risk, in many cases
it came too slow. Without deliberate
guideposts, it’s hard to gauge why one
posture should give way to another,
and how to make these decisions.
We’ll never go back to many of
the tragic steps we had to take in the
spring of 2020 when we were over-
whelmed by the first wave of the virus.
Take the 45 days to slow the spread
put in place by President Donald
△
A man sits at a bus stop in
New York City on May 7, 2020,
at the height of the first waveTrump to try and mitigate that devas-
tating first wave. Reflecting on those
extreme measures, it’s hard today to
remember how bad it was back then
because we haven’t anchored the de-
bate in a consistent measure of danger
and recovery.
Remember that the CDC had failed
to field a diagnostic test that could
tell us where COVID-19 was spread-
ing, and where it hadn’t yet arrived,
so we couldn’t target our steps to the
cities where the virus was already epi-
demic. We didn’t know where COVID
was, or where it wasn’t. People were
still arguing that COVID-19 was no
worse than the flu, with a case fatality
rate of 0.1%. By July 2020, when that
first wave had subsided, 0.25% of the
entire population of New York City
had died from COVID-19, but only
one-fifth of the city’s residents had
been infected.
The risk from COVID-19’s contin-
ued march was a catastrophic pros-
pect. Our tools to limit its spread
didn’t exist. And our vulnerability
seemed unbounded. We had to slow
the spread and buy ourselves some
time to get our response in place. At
the epidemic’s peak during the winter
of 2020, more than 6,000 people in
the U.S. were dying each week in nurs-
ing homes alone.
That was 2020.Now iN 2022, we need to leave
those 2020 notions of risk behind.
What was judged to be “moderate”
prevalence this time last year, when
we were largely unvaccinated, may be
the new “low” when our vulnerability
has declined. Especially as we
confront a more transmissible but less
severe strain like Omicron.
Since then, more Americans have
acquired immunity through vaccina-
tion and successive waves of infec-
tion. By some estimates, almost 70%
of Americans have been infected at
least once. About 87% of adults have
had at least one dose of vaccine. We
have a growing reserve of therapies
that can treat the sick and substan-
tially reduce the risk of hospitaliza-
tion or death. The U.S. will soon be
producing almost a half-billion “at-
home” COVID tests each month.We’ve also seen dramatic advances in
our care of the sick.
Yet a lot of the other constructs
have stayed in place, even as the Omi-
cron wave has started to subside. Until
very recently, many children were still
wearing masks in schools, with no
agreed- upon standard for when that
will end. When Omicron peaked, some
schools reverted to remote learning.
Offices are closed in many big cities.
Some states and businesses are still
mandating vaccines, trying to coerce
a shrinking pool of vaccine holdouts
at the cost of increasing acrimony,
even as many of the unvaccinated have
probably been infected, some more
than once.
Confidence in public health has
eroded because we’ve been too slow
to adapt the steps we take to changing