The world of mask mandates has gotten murkier IMO. I think prediciting any sort of impact or surge at this point with the variant soup out there is just going to get more and more difficult.
So if a business is negatively impacted by a mask mandate, they’re probably going to question if it’s being done at a particular time by the powers that be, what conditions will cause the removal of the mandate?
So the mandates are going to be limited beforehand as sort of a “feel good” thing, well we did something, it’s not really tied to local conditions if we’re honest with ourselves, but some people wanted us to do something so we did it.
Mostly I think businesses will fight them and win due to an attempt at “emergency powers” being extended into perpetuity.
Because I’m a social human being, and i don’t want to just stay home. I want to hang out, in person, with friends
I went dancing Tuesday, and I’m going to watch a documentary with a group of friends Saturday. Next Tuesday i will volunteer at my Temple’s “meals on wheels” program, and cook. All of these are masked events. All are are a lot more fun than sitting at home.
Or, to take an extreme example, when my mother was dying of covid, i wore a mask. When i got home, i put all my clothes in the laundry and i showered and washed my glasses and my cell phone. It would certainly have been safer to just stay home, and leave my mother to die alone. I’m very happy that i choose to spend that time with her. My three siblings made the same choice. None of us caught covid from her, even though she remained infectious until the day she died.
Anecdotally speaking, I think a mask is somewhat helpful with seasonal allergies (gotta get around to pinning down what pollen it is that gets me). I also simply consider it polite at this point to wear one if I’m having any sort of upper respiratory symptom.
There is nothing particularly prescient about that observation; this is the way every novel epidemic progresses. As for SARS-CoV-2, it is still definitely in an epidemic state, which a new “variant of concern” emerging roughly every 4-5 months that suddenly breaks out and overtakes existing variants, often reinfecting people who have been previously infected and those who have had a full vaccination and booster sequence with a not-inconsequential incidence of severe morbidity and mortality.
Despite claims of some would-be epidemiological ‘experts’, it has not fallen into a ‘seasonal’ infection pattern, has not reached any observable state of ‘herd immunity’, and outside of the developed countries with widescale and effective vaccination campaigns still poses a significant risk to health and well-being. If is certainly not like a typical ‘cold’ respiratory virus and is still far more lethal than any influenza epidemic since the 1918-20 ‘Spanish flu’.
This is nonsense. Epidemiologists don’t just arbitrarily divvy up the data however they please. The CDC has defined categories for reporting deaths by cause (heart disease, cancer, accidents/unintentional injuries, stroke, CLRD, diabetes, P&I, nephritis/nephrosis) so as to make valid comparisons. For the last few months deaths reported as due to COVID-19 have been holding steady at 2.5k/wk to 3k/wk (down from a high of >15k/wk from late January through February of this year) which would put it right about at the same incidence as stroke and CLRD, higher than diabetes (which is routinely characterized as a ‘epidemic), and about three times that of influenza and non-SARS-CoV-2-related pneumonia.
The problem with that hope is that this virus has shown an ability to mutate and adapt to immunological responses that is nonpareil even compared to other well-adapted pathogenic viruses such as Influenza A & B. With most viruses, if you are infected and survive you will develop a robust and effective immune response that will last for many years if not the rest of your life against this virus any any closely related variants; although there is no technical distinction between a ‘variant’ and a ‘strain’, there is generally a wide degree of variation required to distinguish different strains within a viral species. However, SARS-CoV-2 has shown the ability to reinfect a previously infected person within months or even weeks with a closely related variant. It is often asserted that these reinfections are successively more mild but the data is inconclusive at best, and I can personally attest to ‘reinfection’ that was significantly more severe in presentation than the original ‘wild-type’ virus, which argues against an inherent evolutionary weakening of the virus as it mutates.
It has been a general assumption in epidemiology that a novel human pathogen will flame out in an initial epidemic phase and then retreat into a perpetual endemic condition (even though there are ample counterexamples) but SARS-CoV-2 is pretty much putting the epidemiological world on its head with regard to that assumption. I have a friend who is both a virologist and epidemiologist at a leading university who firmly believes—based upon gene sequencing and comparison to the 2002-04 SARS-CoV(-1) outbreak and other pathogenic betacoronaviruses such as MERS-CoV—that we have likely not seen the worst of the SARS-CoV-2 potential and that it could evolve into a pathogen with an infection fatality rate (IFR) in the middle-to-upper single digits instead of 0.3%-0.4% for novel infections. That view is not popular with her colleagues but nobody has really been able to make an argument for why this could not be the case. Even at that it is still less lethal than the original SARS-CoV(-1) with an almost 10% case fatality rate (CFR) rate.
There remains, of course, the concern about ‘long covid’ even in those people with mild infections but lingering and often debilitating effects. The experience with post-polio syndrome is a cautionary tale in assuming that only the primary pathogenesis is of concern (and this issue has long been understood by researchers of post-respiratory and post-influenza effects as potential causes of idiopathic chronic inflammatory syndromes such as fibromyalgia). So, even if we are confident that ‘Covid’ won’t evolve into a worse pathogen we should still be concerned about the potential effects of regular reinfection from a virus that is poorly understood and that current vaccines provide only limited protection. This is as far from being ‘just another cold’ as global climate change is from just a bad hurricane season.
But then, there are many people who refuse to acknowledge either issue and they all have ‘opinions’.
So as has been made abundantly clear, Covid is objectively not “over.” It’s the follow up questions that are debatable and looming large, e.g. what does and should this mean for public and personal health policy? Staying home and not coming into contact with other people if not in life or death need is absolutely the most sure way to protect yourself (and others!) from Covid, but that’s like abstinence-only sex education: it simply factually won’t happen in practice. “So now what?” is the real question.
I’m going with masking and testing, personally. That is, if i want to eat with people, or otherwise hang out unmasked, indoors, we all do an antigen test. For casual hanging out, shopping, etc. I wear a kf94 or N95 mask.
It’s a valid question with no ready answers. Obviously, as you note, avoiding personal contact to the extreme isn’t feasible, and even expecting people to publicly mask in perpetuity is neither reasonable nor practically enforceable. The enforced distancing has had manifest effects on childhood development and certainly isn’t healthy even for fully developed adults. “Test and trace” has been a failure, both because of the transmissibility of this virus and because people have resisted public health measures in general, and that certainly isn’t going to change. I think the best general tracking we have of community spread is and will continue to be wastewater surveillance (which despite having propped up in the public consciousness of late is actually an old but highly effective method), but it will always be a lagging indicator of infection spread, as is hospitalization.
I think maintaining obligate masking on public and commercial mass transit would be wise but you can see how well that has gone over, even on short duration transits such as buses and subways, and it is a lost cause on air travel and cruises. Prioritizing modern ventilation in public buildings such as schools, municipal buildings, et cetera is one measure that should be pursued although I don’t see anyone willing to pony up the costs for that even for new construction.
Personally, I am avoiding mass gatherings (even outdoors), minimizing air travel to the extent possible (for multiple reasons), and in general avoiding restaurants and other venues which I do not feel to be adequately ventilated. Even with that, I managed to catch an Omicron variant, and I don’t foresee that any practical measures are going to prevent continuous circulation of SARS-CoV-2 variants for the foreseeable future short of a broadly acting Betacoronavirus vaccine or effective antiviral therapies, and while work is being done on vaccines that target the somewhat more stable E-protein rather than the highly mutable spike protein, I doubt there is anything on the near horizon that can promise better efficacy than the current mRNA vaccines offer.
I have pretty much lost all confidence in the ‘lateral flow’ antigen tests, both in terms of sensitivity (for emerging variants) and specificity. Even when they do provide a true positive result it seems to occur days after a someone may be infectious, and the CDC guidelines on how long to quarantine after a positive result are so ungrounded in reality as to be absurd. I’m not sure what more to say about that other than I’ve been looking for better tests to emerge but since the government is no longer paying for tests there is little incentive for companies to spend money developing better diagnostics for at-home testing.
Which is why I don’t feel bad getting vaccinated and otherwise going about my life as normal as possible. (which involves a lot of working from home, but no other real measures). If we’re all going to keep getting it, we might as well enjoy the ride as long as we can. Half measures like “I stay away from restaurants” simply deprive you of something you want to do and perhaps delay the inevitable. Like most of us, I spent a lot of time wearing a mask (without complaint) but I also still got COVID in the Fall of 2021. I’m done, even if COVID isn’t “over.”
I understand the sentiment, and to an extent share it, but I have also had several acquaintances suffer from ‘long covid’ effects, including one (relatively young and completely healthy) who started from a fairly mild case but experienced progressively worse and eventually debilitating symptoms including renal failure, microvascular angina, and finally a stroke that killed her. The long term syndrome concerns me far worse than the initial pathology because while there are treatments for ‘Covid’ (albeit of decreasing effectiveness) there isn’t even a clear set of criteria or diagnostics for ‘long covid’, much less a treatment regime. I’ll take reasonable measures to avoid that even if it means mostly avoiding inside dining, concerts, and flying.
Makes sense to me. Appreciate your informed analysis. I don’t want to get COVID again, but I think I’ve given up. I’m certainly not alone in that view, that’s for sure.
“Epidemic” has an objective, factual meaning, which covid has not met since this spring. Of course the disease still exists, but it is no longer an epidemic.
Actually, the definition of epidemic is not as “objective” or rigorous as you might prefer believe. The CDC, for instance, defines an epidemic as: “Epidemic refers to an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area.” What is “normally expected” will vary between diseases and populations but given the rate of spread of new variants which are infecting (and often re-infecting) members of the population well in excess of the established viral pneumonic and influenza threshold, it is entirely reasonable to identify the spread of SARS-CoV-2 as ‘epidemic’, and the vast majority of epidemiologists classify it as such. Endemicity is defined in terms of predictability of spread (i.e. seasonal respiratory infections), stability and efficacy of immunogenicity in vaccinated or previously exposed people, and a fatality rate that is well below other health epidemics (infectious or lifestyle). SARS-CoV-2 meets none of these criteria even in a highly vaccinated country such as the United States, and it is certainly still a global pandemic around the world in nations which have yet to attain anything like broad immunization. There are, of course, actual physicians on this board trained in infectious disease and with at least basic coverage of epidemiology in their medical training who can weigh in on this issue.
Definitely anecdotal, but I have a very large network of friends, colleagues and family, mostly in the NY area. I cannot think of anyone (who is isn’t medically compromised) who is avoiding any social events, masking at these events, or even bringing it up. Testing is unheard of. I know a medical worker who knew she had COVID, but didn’t bother getting tested. She took sick days until she was better, just as she would with a flu to cold.
Sure, but mostly through things that are still visible or audible with your face covered. You can still hear people (though they may have to speak up a bit) and any facial expression you make shows in your eyes, crinkling of the mask, and voice.
The main issues with masking is just the annoyance. The glasses fogging up, the making sure it doesn’t fall. The occasionally feelings like you can’t breathe even though you know you can (particularly with N95 masks). Stuff like that.
So it’s not as good as not wearing one. I agree with you that it’s on the continuum with lockdowns. But it’s most often not as bad as not going at all. Sure, in a work situation, I can see working at home being better than being present and mask. And, honestly, church at home is pretty nice, especially if you weren’t planning on shaking hands and hugging people after service anyways.
But there’s a whole world of stuff out there that it would be a better experience to be there and masked than to not be there at all.
Nobody I know is staying home, nobody is avoiding social gatherings. The idea of testing before meeting people is laughable. Compared to, say, 2018 I do see more compliance with the idea of not going out in public while actively sick with a respiratory infection, COVID or otherwise. But that’s the extent of COVID’s impact on mindshare and public behavior in my county.
In my travels I do see some other countries where a hefty fraction of the public are taking obvious personal precautions. But with the notable exception of China, damn near every destination we serve around the world has dropped all their masking, testing, etc., requirements for air travel passengers, their general publics, and for their airport workers.
Some of my flights 180 people get off and 4 of them have masks. Other flights to/from other countries, it’s more like 100 of the 180.
That sounds so 2020 to me. Your choice of course, but it’s as if you and others who think as you do have not rethought your decisions in a very long time.
I think that there are plenty of people who have been forced into making decisions based on the decisions of others and I think that’s fine, and we shouldn’t be passing judgement.
Let me be clear. @puzzlegal is welcome to her opinions and her actions. She and I have an ongoing PM convo and I think we understand each other pretty well and get along well.
I may have said it indelicately, and thank you for pointing that out in such a gentlemanly fashion. But my overall point was really that those opinions are heavily in the minority now and ever-increasingly so.
Might widespread masking and social isolation make a big comeback with some new variant of COVID or some unrelated future disease? Sure.