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723 epidemiologists on when and how the United States can fully return to normal

 


Covid-19 cases are declining in the United States and masks are no longer needed everywhere, but the pandemic is not over and will not be until young children can also be vaccinated, epidemiologists said in a new New York Times survey.

The real end of the pandemic when it is safer to resume most activities without precautions will come after at least 70% of Americans of all ages are vaccinated, they said. Teens just started getting vaccines this week, and those for children under 12 are yet to be approved.

Children are key to ending the pandemic, said David Celentano, president of epidemiology at Johns Hopkins University and one of 723 epidemiologists who took part in the survey this month.

They are optimistic it will happen, although not as quickly as many Americans hope. In five years, they expect Covid-19 will look more like the flu, circulating at a lower rate and with a few deaths each year, but no longer a public health crisis requiring lockdowns.

It feels like there’s a light at the end of the tunnel, said Gretchen Bandoli, assistant professor of pediatrics at the University of California, San Diego. We have the tools we need to make it happen, and it seems close at hand.

Yet it is still unclear whether the United States can achieve this level of vaccination. And even though cases are declining nationally, the global Covid-19 toll is increasing in regions of the world that have not had the same access to vaccines.

Americans are already starting to be able to do things they have been advised to avoid in the past 14 months. The Biden administration said Thursday that fully vaccinated people no longer need to wear masks in most places. (The investigation was conducted over the past two weeks, before the mask was announced.)

In the survey, about 85% of those polled said it was likely that Americans would be able to safely gather for the July 4 barbecues this summer, as President Biden requested. A slightly higher proportion said it was likely that schools could be fully open in the fall and families could safely gather indoors for the winter break.

Yet the campaign to immunize more Americans cannot stop until children are protected, they said. Half of those polled said that at least 80% of Americans, including children, would need to be vaccinated before they can safely do most careless activities. Although children are less likely than adults to develop severe cases of Covid-19, scientists said their immunity was important because they could be hosts for the virus and a means for it to continue to circulate or to spread. develop new variants.

Children cannot be left out of the equation when it reopens, said Corinne McDaniels-Davidson, director of the Institute of Public Health at San Diego State University. The idea that they cannot transmit Covid or are immune to the disease is ubiquitous among the lay public. We need education here.

To assess when the acute phase of the Covid pandemic could be considered over, they said vaccinations were more relevant than other metrics such as new cases, hospitalizations or deaths (because a vaccination campaign effective would reduce these rates, they said).

The country is not there yet. Nationwide, 36% of Americans are fully immunized and the pace of immunizations has slowed.

Of the 723 epidemiologists who participated in the survey, 35 percent work for governments. The rest are mostly academics. The questionnaire was distributed to two major professional groups, the Society for Epidemiologic Research and the Council of State and Territorial Epidemiologists, as well as to some scientists.

The decision to reopen states is based on many factors, including decisions of governors and considerations of business owners, and may not correspond to the recommendations of survey respondents. Even before the CDC’s announcement, about half of the states had already dropped mask requirements or lifted capacity limits for large groups, and more could follow in the coming days. In addition, many public health professionals fear that such a high vaccination threshold, sufficient to achieve so-called herd immunity, may not be reached.

Update

May 15, 2021 at 10:06 a.m. ET

But responses to the group of scientists’ survey suggest that a full reopening without high vaccination rates may be associated with continued outbreaks of the virus, in the United States and around the world.

The lack of capacity to effectively vaccinate globally could continue to haunt us, said Cynthia Morris, an epidemiologist at the Oregon University of Health and Sciences.

Americans’ reluctance to accept vaccines is the biggest threat to ending the pandemic, scientists said. They were also concerned by the rise of new virus variants or by a too rapid return of the prepandemic routines of populations. A substantial 22% feared that the politicization of public health would hamper the fight against the virus.

The more people refuse vaccinations, the longer Covid will stay, said Ethan S. Walker, an epidemiologist at the University of Montana.

Scott Bartell, epidemiologist at the University of California at Irvine, said: I hope one day Covid-19 will look more like measles, mostly eliminated but not eradicated, with sporadic outbreaks and clusters mostly among people not vaccinated.

Even if the spread of Covid-19 diminishes enough to allow most activities to return, there are some aspects of pandemic life that epidemiologists believe will persist for much longer.

In particular, they say masks are a standard that should continue, even though that view puts them at odds with new CDC guidelines. Over 80% of them say people should continue to wear masks when they’re indoors with strangers for at least a year, and outside in crowds.

They would love to see the sequel to what they consider to be the rare silver liners from last year. They hoped that people would have to travel less often for their work. They wanted grocery delivery and take-out food options to continue, along with telehealth visits for routine medical appointments. Many buildings have improved their ventilation, upgrades that will pay off for other respiratory illnesses.

They also hoped people would stick to habits that would make them healthier in general: avoiding things like going to work when sick, shaking hands, and even blowing out birthday candles.

I can’t believe we celebrate birthdays by eating a cake that someone blew all over the place, said Brian Labus, an epidemiologist at the University of Nevada in Las Vegas.

Over the past year, epidemiologists have suddenly found themselves in the spotlight. One of their challenges, they said, has been communicating to the public a complicated truth of their profession that there are rarely clear answers, right or wrong, when it comes to the risks and benefits.

As epidemiologists, we are constantly faced with uncertainty, and it is quite familiar to us, said Kevin Martinez-Folgar, a doctorate in epidemiology. student at Drexel University. We need to create better ways to communicate this uncertainty to the public to avoid all of the misinformation issues that we currently have.

More importantly, they said, they wish they had done a better job of communicating as science evolves and by definition health advice will change as scientists learn new things.

Asked what public health practitioners should have done differently during the pandemic, David Abramson of the NYUs School of Global Public Health said he wanted them to have reinforced the daily changes in science, and with it the recommendations for protective actions.

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