Is it finally time to stop worrying about the coronavirus? — Harvard Gazette

Is it finally time to stop worrying about the coronavirus?Latest Centers for Disease Control and Prevention This may leave an impression on some people.

The CDC updated its COVID-19 isolation policy in early March. Recommendations For other respiratory viruses, influenza, RSV. This important change reduces the recommended isolation period for people infected with coronavirus from five days to one day after their fever and other symptoms begin to improve.

The Gazette asked Associate Professor of Epidemiology William HanageHe is also an associate director. Harvard University TH Chan School of Public Health Center for Infectious Disease Dynamics, in his opinion. Hanage said that while infection, care and treatment of the new coronavirus has become more commonplace these days, the number of deaths per week across the country this winter has ranged from 500 to 2,000. He pointed out that people are in a vulnerable state. This interview has been edited for clarity and length.

The CDC's actions appear to be a fairly significant change. Do you agree with what they are doing?

This is a big change in some ways, but I also think it's just the guidance catching up with what's been around for a while.

There are no noticeable changes, but over the past year, fewer people are even getting tested even if they feel they may be infected with the new coronavirus. And while some of those people may quarantine, others may not. Others are not even getting tested for fear of being quarantined.

The CDC's role is to provide practical advice that people can use. I think so.

That said, it does not mean the virus is no longer a threat, especially to vulnerable populations. Looking at the number of hospitalizations and deaths, we have seen a steady beat throughout the winter, at lower levels than in the past, but still quite high compared to the number of infections. Respiratory infections that we often see.

And while influenza and RSV are highly contagious, the new coronavirus has been around more or less continuously. This partially reflects the fact that we continue to have many infections in our community and many people who are unlucky enough to become seriously ill if they become infected. You need to focus on that and make sure you get the booster.

Looking beyond the most important points, the CDC did not change its recommendations regarding vulnerable populations or those in health care settings.

This is important to remember because the last thing you want to do is bring this virus or respiratory infection into a nursing home or healthcare setting. We need to communicate that clearly and work to devise ways that people can avoid infecting others if they themselves become infected.

It's much easier if you have adequate sick pay etc. If someone who works two jobs to put food on the table gets sick and their sick pay runs out, they're not going to quarantine, they're going to go to work because they have to. They are also people who may not have access to boosters or tests. The same channels of inequality that make up the American health care system.

I've heard people say that the virus isn't that bad anymore, but what has happened is that we have developed immunity. What would be the outcome if this virus spread among naive people today, as it did in 2020?

That would be absolutely terrifying. It's a little hard to know exactly how contagious it is in nature, but it's certainly more contagious than it was in 2020.

And it is no less toxic. Evidence of this comes from what happened in Hong Kong when BA.2 finally passed through Hong Kong. It was really miserable. And they had the vaccine.

Still, for about a month, things looked a lot like New York when it all started. That reflects how incredibly contagious this virus is.

It also reflects the fact that while it's not a big deal to most people, when you infect a huge number of people, it becomes a big deal for enough people. This combination means we are lucky because we have a vaccine. We are lucky because for many of us there is now a large amount of convalescent immunity gained from infections that occurred after we were vaccinated and gained protection.

We're happy about that, but we, the medical community, will still look at this and think, “Wow, this is a lot of respiratory disease.” I think about it, and I'm glad that most people don't have to think about it, but the fact is that we're not yet at the point where we're back to where we were before.

And it may very well never happen. Because we just added a new respiratory virus, and that has consequences.

The CDC numbers show that the number of people infected is dropping significantly, but this is likely a significant underestimate since no one is testing anymore and many infected people are asymptomatic. ?

If you look at something that's fairly unbiased, like wastewater monitoring, it's clear that there's still a lot of infection and transmission going on in the United States. I don't understand. However, hospitalizations and deaths continue to occur. These are still high by pre-2020 standards, but low by everything we've seen since then.

This risk is concentrated among those who have long been at risk, such as the elderly and those with comorbidities. But the average person on the street doesn't think about coronavirus all the time, and frankly, I don't think they need to.

But I would be so happy if people in that category realized that they can make others who are not as fortunate as themselves sick. And there are many things you can do to reduce that possibility.

I think you are more contagious the day after your fever has subsided than after 5 o'clock. Does it emphasize the importance of things that have not been emphasized before, like masking and fresh air?

There is no need to assume that there is no possibility of infection after the fever has subsided. If you want to be more confident, you can take a rapid test. If you want to be more sure, you can use a mask.

However, many of the symptoms people are experiencing are partially related to their immunity. Therefore, when our immune system kicks in, it causes a variety of symptoms that make us feel uncomfortable.

And there is a link between viral replication and symptoms. What this means is that there are fewer infections before the onset of the pandemic than at the beginning of the pandemic, and fewer infections after the pandemic has subsided. This means you should avoid exposing others when you have symptoms. This also applies to coronavirus and other viruses.

Is this perhaps the final step to normalizing the coronavirus? Does the CDC still need to do anything else in this regard?

I hope they never say that no one needs to pay attention to COVID-19 or whether we're infecting people in nursing homes. But this is arguably a point in the pandemic that shows public health has normalized the pandemic.

We will continue to encourage people to get boosters. We continue to warn people ahead of respiratory virus season to remain vigilant and avoid infecting their vulnerable neighbors. And we will continue to work to find ways to minimize the impact of the virus. This is all going on in the background. And we will continue to do our best to reduce preventable suffering and death. There is still much we can do.

Are you monitoring new variants, including surveillance?

Yes, this includes paying attention to when things might get better, or when things might get worse. We're not going back to the way things were, but even though the virus continues to evolve, even though the virus continues to be with us, there continues to be a significant number of illnesses and deaths. However, it is still far from pandemic level. huge spike.

We need to take a deep breath and be okay with that, but at the same time realize that just because one house is on fire is no reason not to try to put it out.