What is the end goal for COVID restrictions?
April 25, 2021 3:30 PM   Subscribe

I am a person who follows my local COVID restrictions in my USA community. I wear a mask in any enclosed space with other people, and I wear a mask outside when anyone is nearby me (even >6 ft). I do not go out to eat in person, and have not ventured outside my state in over a year. I received my first vaccine dose the moment I was eligible. I believe in science, and I have had a family member die as a result of COVID. I'm starting to get very concerned that the USA has no end goal in mind for COVID, and I feel like I will not be able to keep up my concern about COVID much longer after vaccination is universally available. Should I? If so, please help me out.

I am not a public health expert, and I struggle to comprehend all of the seemingly contradictory information I receive in the news. I'm stating what I think the broad consensus is about COVID, but I'm posting to Ask MetaFilter because I am not confident in my own understanding.

With all I read, I can't figure out when state governments and the federal government will say COVID is "done" and a return to normality can occur. This worries me - I have been experiencing symptoms of depression for 6 months or so, and I really hate wearing masks.

Question 1 - what criteria is the federal government, at least, using to determine necessity for restrictions? I imagine states are even more random given the range of responses each state has.

I have found myself caring less and less about the safety of others who choose not to take steps to protect their own health. Given every state in the USA has open access to vaccines, it seems to me that by July or so, essentially anyone who is not fully vaccinated is doing so voluntarily (get first dose by end of May, second dose by end of June, and fully vaccinated 2 weeks afterward).

Question 2 - Is that accurate? Is there any part of the United States or group of people in the United States that will have difficulty becoming vaccinated?

There does seem to be a lot of concern about potential unknown long term effects of COVID, and new/rising variants across the world. I haven't read about any effects or variants that seem particularly prominent, and I imagine the pharma companies in the world are already working on new variants. So far as I can tell, COVID vaccines are amazingly effective, and COVID risk post-vaccine is lower than or commensurate with other risks society has previously accepted (like driving)

Question 3 - Is there a risk of COVID post-vaccination that I should be worried about?

After all of this, my thoughts veer towards philosophy - prior to vaccine, I viewed my adherence to COVID protocol as protecting people. I think that was important! But now I struggle to have that same concern. Why should I take effort to protect other people from risks they can protect themselves against? For instance, the flu has always been a deadly disease, and has a much less effective vaccine than COVID (I think?), and no expectation in society existed to protect people against the flu. Shutting down restaurants, closing public places, and decimating performing arts communities seemed appropriate when faced with the death tolls that could exist with COVID widely spreading to vulnerable populations. But... when we have <5% of that potential cost due to vaccine effectiveness, the government's response seems much more disproportionate to me. I hate doing calculus with human lives, but I also feel like the way I used to live my life is valuable!

Question 4 - do I have any moral/ethical obligation to protect other people at my own cost?
posted by sockmypuppet to Health & Fitness (32 answers total) 18 users marked this as a favorite
 
Please keep in mind that elementary school children won’t have access to the vaccine in the US until early 2022. Our area has dropped the outdoor mask mandate, so unfortunately options like the zoo, gardens, etc. that were okay for our family before are questionable now. (I know from personal experience that people are not distancing at these places.) So please consider masking up in public for our little ones until they too have the chance to be protected.
posted by timestep at 3:59 PM on April 25, 2021 [30 favorites]


Oh man, these are great questions and I look forward to reading the other answers. I'm sure you'll get more informed opinions, but I want to answer your questions before making one other point (I also JUST finished listening to The Atlantic's podcast on this called "When Can I Take Off My Mask" that might be up your alley).

1) I'm not privy to these conversations, obviously, but the White House's website says the following: "President Biden will direct the CDC to provide specific evidence-based guidance for how to turn the dial up or down relative to the level of risk and degree of viral spread in a community..." I know that's PR-speak, but it also seems it could likely be true - they're planning to make decisions based on the basic indicators of case numbers, rates of growth/decline, and hospitalizations/deaths. This will likely be related to the number of people vaccinated but it makes some sense to make restrictions stronger or weaker based on what is happening, rather than number of people vaccinated (as unfair as this may sound). I do agree with you that if huge numbers of people choose not to get vaccinated after they are widely available, there will be growing pressure from the rest of us to ease restrictions regardless of case counts.

2) Kids come to mind. Even if the evidence is good that vaccines will work for children, they're at least looking at a delayed timeline.

3) Sure, we just don't know enough yet. Pfizer recently said they think it's likely those who have been vaccinated will need a booster shot after a year, and I believe Moderna is preparing booster shots as well. From what I've heard from experts, we aren't sure how much the new variants will play into this need for additional protection.

4) Of course! Like you imply, it's a balance. I think a lot of us, for example, accepted a social compact where others are ethically allowed to put us at a small amount of risk by driving cars responsibly, but are not allowed to put us at a large amount of risk by driving while impaired. You might well be right that at the end of this, we'll decide that running around town to bars and restaurants and movie theaters while COVID was spreading unimpeded was more like driving drunk, but going to in-person school unvaccinated while cases are below a certain level, or resuming life as normal when you and anyone who wants to be in your community is vaccinated, is more like driving responsibly.

Those last two bring me to my larger point - do you have to decide this bigger question (how long do I need to care about COVID?) right now? We are learning more every day, about how effective vaccines are (at both a personal and community level), about variants, about what the uptake rate will ultimately be. By the time most people in the U.S. will have had the opportunity to be fully vaccinated, we may have very different answers to these important questions.
posted by exutima at 3:59 PM on April 25, 2021 [9 favorites]


I was going through the questions one by one but I think it's simpler.

The country won't be locked down like this much past July. Vaccinated people already have restrictions lifted on all sorts of things, like private gatherings. Some restrictions, such as requiring proof of vaccination for airline flights, testing and masking around sensitive areas, periodic updated shots, etc. will probably stay around forever. It is possible there may be local surges and temporary restrictions in the winter.

The exact guidelines are going to be formally worked out in responsible states and federally as we watch trends with more people getting vaccinated. It's going to be a combination of low enough absolute risk (like, flu-like levels) and lack of improvement (no more people getting vaccinated, cases not falling further.)

Note irresponsible states are already basically open.
posted by mark k at 4:00 PM on April 25, 2021 [9 favorites]


For your question #3, we still don’t have enough data to know if those who experience breakthrough infections post-vaccination are just as vulnerable as the unvaccinated to ending up with long haul (all the way to permanent) symptoms/disability from asymptomatic, mild and moderate infections. Until that’s the case, I myself am still going to do whatever I feel is necessary to avoid potential COVID exposure even post vax, given my personal health history.

And yes, that’s depressing me and burning me out. (For what it’s worth, in terms of what is or isn’t allowed for the less risk avoidant, many states are already on track to lift all restrictions by the summer, if they haven’t already.)
posted by blue suede stockings at 4:06 PM on April 25, 2021 [9 favorites]


I'm starting to get very concerned that the USA has no end goal in mind for COVID

I think the reason for that is that there is not going to be one single end point of COVID. There won't be a point where anyone can say "A week from Thursday, COVID will be eliminated from the world and everything is going to be back to just how it was". The "end" of a virus will look kinda like now, but more so, if that makes sense.

Think back to December, when most states were still under very severe restrictions as to what could be open and where and how people could go in public. Now look at how different it is today from just a few months ago. Project that into July, and you'll see things getting more and more 2019-ish, in terms of stores and public gatherings being open and possible, but I would imagine some form of social distancing will be in place for the foreseeable future.

That will be true especially if the rate of vaccination, which is already slowing, falls even further, and the percentage of people who don't get vaccinated is high enough to prevent us as a society from achieving any sort of herd immunity. Without that, COVID won't actually "end" in any meaningful way.
posted by pdb at 4:07 PM on April 25, 2021 [13 favorites]


I don't think there's official answers to your questions, or will be within the next few months. I think literally nobody knows when there will be an "end" to Covid, and there may actually NEVER be an end to it if we have to constantly deal with it "like a flu" and get shots every year to prevent.

#1: fuck if I know, literally everyone is doing it differently and state restrictions are far more restrictive (or not) than anything that seems to be "set" federally.

#2: kids can't get vaccinated till later, and then there's the immunocompromised (NYT link) for whom vaccines may just not work to mount an antibody defense.

#3: maybe. I don't think anyone quite knows on this one as to why some people get "breakthrough" infections.

#4: I guess that's up to your own conscience, but how would you feel if someone you know who's immunocompromised dies of Covid because you went mask-free (or whatever)?

I feel like the real question you're asking is, "I'm so depressed and I DON'T WANNA WEAR A MASK ANY MORE, at what point can I just fucking stop having to take precautions already without feeling too bad or guilty about it?" Unfortunately, that one is also going to be up to you and your conscience. If a worst case scenario happens and it has something to do with you, could you live with that?

This whole freaking mess just kind of boils down to "you gotta figure out for yourself what the hell to do for your own safety, and the safety of others if you care about that." If you decide you want to burn your masks and throw all caution to the winds and live a 100% normal life circa July, we can't stop you and many will be joining you. But I don't know if enough people will be vaccinated that we CAN actually do that, or if more restrictions will happen if that doesn't, or what the hell ever. Nobody knows how this is going to go, Fauci included. There's best guesses from the experts and that's the best we can do.
posted by jenfullmoon at 4:24 PM on April 25, 2021 [17 favorites]


This doesn't exactly answer your question about masks, but it will, perhaps, provide some perspective:
I hate that I have to wear a top when I swim laps at the pool ... I hate the pressure it puts on my shoulders when I reach above my head with each stroke. I have a one-shoulder swim top, and my left shoulder adores the freedom it provides. If I had my choice between having to wear a mask in public and having to wear a swim top, I would for sure choose the mask. It makes me sad every time I swim that men don't have to wear a swim top but women do. Masks prevent people from dying. Not wearing a swim top protects people from ... what????
p.s. I also would choose wearing a mask over wearing a bra any day, if I could.

With that said, I hear what you're saying, and I empathize. This has been a long battle and we're weary. No one has solid answers to your questions, yet, but more and more is being learned each day. We'll get there eventually. Hang in there!
posted by SageTrail at 4:38 PM on April 25, 2021 [7 favorites]


People consider driving an acceptable risk, but I don't. There are vulnerable users (people who are biking or walking, for example). If I could get a vaccine to protect myself from getting hit by motor vehicles, I would. Personally, I think most of the driving most people do is avoidable. Most people seem to think it's acceptable that people get killed by cars because the odds are they won't kill or disable anyone. Until they do. I knew someone who killed someone who walked out in front of her car while she was driving. She couldn't have seen the person, and it was probably a suicide. But she still has to live with it for the rest of her life.

There are people who can't get the vaccine because they're allergic to an ingredient in it. There's children. There's people who are getting their information from people who are just plain wrong. I expect I will be following the more conservative guidelines for all of them. I expect that to that mean wearing masks in public until they come out with studies that confirm that vaccinated people aren't spreading the virus.
posted by aniola at 4:39 PM on April 25, 2021 [8 favorites]


I totally hear ya. But as others have said, kids. Kids with asthma. Kids who have no option but to go to school with crowded classrooms of 35 kids and it'sao hard for an 8 year old to properly keep a mask on for 6 hours a day and not rub their eyes, etc, even if they try their best. Also, people who can't get the vaccine for medical reasons. I have a friend who is allergic to so so so many things (including lots of meds) and her immunologists and her whole team of doctors have advised her not to get the vaccine until there are more studies done for people like her.
posted by never.was.and.never.will.be. at 4:39 PM on April 25, 2021 [5 favorites]


As others have said, I'm doing this in a gradual, not a binary, fashion. I am fully vaccinated and now spend time indoors with other fully vaccinated people (mostly my husband, whom I've been living with all along, and our grown son, who comes for visits now). (I know this is taking SOME risk.) A lot of the changes have to do with fear -- e.g. I always went to the park to sit on a bench, but now I'm not scared anymore, or if runners pass me while I'm walking (I'm masked while I'm outside. Who cares. I got used to it).

I've been to the dentist and a couple of doctors un-terrified. I've taken car service to those appointments un-terrified.

For me, these are HUGE changes (I'm 70 years old). I would hope that when kids are vaccinated, that will be a huge leap too. I HATE, though, that they're talking about reaching limits on adults who wish to be vaccinated NOW! So we will always have to live with some Covid risk -- as we have to live with risk of some other diseases and accidents, etc.

But it's totally worth it, I think, to continue to be cautious NOW. And yes, unvaccinated people will cause transmissions that will allow variants to surface that may ultimately be vaccine-eluding. In 18 months, I tell myself (I know, I know) it'll all be VERY different. For now, though, we have to do our best. (read how Marianne Faithfull is still using oxygen at home, almost died. She says, "DON'T GET THIS!" I'm listening! (as tears go by)
posted by DMelanogaster at 4:40 PM on April 25, 2021 [7 favorites]


(or maybe a year, not 18 months)
posted by DMelanogaster at 4:46 PM on April 25, 2021 [1 favorite]


But... when we have <5% of that potential cost due to vaccine effectiveness, the government's response seems much more disproportionate to me. I hate doing calculus with human lives, but I also feel like the way I used to live my life is valuable!

Doing calculus with people's lives is exactly what all the political fighting over restrictions is all about, and why it's impossible for anyone to know the "correct" decision. Calling it calculus is an understatement - it's trying to predict the health/economic/political impact of any decision when that's dependent on far too many variables to know.

There's no book that says "removing indoor restrictions for restaurants will kill 5% more people but employ 10% more people" or remotely similar. Even if such a book existed, 5% more deaths may seem entirely unreasonable to some people and an acceptable tradeoff for others. We are, and have always been, guessing about the future.
posted by meowzilla at 4:54 PM on April 25, 2021 [7 favorites]


I remember at the end of 2020 when the first vaccine candidates were announced, someone interviewed said something like- 2021 is still going to be tough like 2020 was. But the difference will be, there will be hope.

For what a more "covid normal" looks like (normal, but with covid precautions) have a look at Australia and New Zealand.
posted by freethefeet at 5:14 PM on April 25, 2021 [4 favorites]


From all the news I've absorbed recently, it seems fair to say we are all living in a bit of mass science experiment. Some people are living their lives exactly as they did before the pandemic, others are taking baby steps into normalcy, while still others are still in quarantine-mode. So far, the data looks hopeful that vaccinated people cannot spread COVID, but I see no harm in following the CDC's 2 out of 3 guidance until we know more. (The idea that when among strangers you 2 of the following: outdoors, masks, distancing). I'd imagine by July there will be much more data out there.

If you haven't heard of it already, this period of uncertainty is where I really like the idea of a risk budget. With what I've linked to, you can plug in different activities, your location, and whether you've been vaccinated. So for me (someone a couple weeks past my first shot), 90min eating outdoors is 10% of my weekly risk budget. Based on this, I feel fine dining outside once a week as a reward for this past year.
posted by coffeecat at 5:20 PM on April 25, 2021 [7 favorites]


That risk budget link, microcovid, uses language that focuses on telling you about how dangerous an activity is for you, not the other person. You have to pretend you are the other person to figure out how dangerous any activity would be for them.
posted by aniola at 6:07 PM on April 25, 2021 [3 favorites]


I think the realization that there won’t be one big celebratory, count down from 10 moment as an “end” to COVID is an important one. I would consider creating your own milestones (perhaps it’s having an all vaccinated bday celebration, seeing kiddos who are important to you over the summer, for me it’s when I’ll be able to safely eat at a hibachi restaurant (not that I did that often but there’s a novelty in it that I really look forward to)).

COVID, particularly internationally, will be hanging around for a long time to come. It will likely not be as severe in the USA the way that is has been the last year and a half, but it will be around.

(Also I started having to go into an office in January and found that double masking with a disposable surgical mask and a cloth one was actually more comfortable than just a cotton mask which was surprising for me)

Edit: I work in contact tracing in North Carolina and our staff’s contracts just got extended until March 2022. I think this can be helpful information when considering timelines.
posted by raccoon409 at 6:09 PM on April 25, 2021 [9 favorites]


Is that accurate? Is there any part of the United States or group of people in the United States that will have difficulty becoming vaccinated?

You're probably not too far off for what you might call regular participants in everyday society--probably not more than a month or two. There are some vulnerable groups for whom the issues are more an accumulation of barriers than explicit sociopathy. For example, groups of the elderly poor with limited English proficiency who live independently. Think your classic Chinese or Dominican grandma living on a pittance in public housing. These populations are going to need intensive individual outreach, and so far they haven't really gotten it in the rush to get the lower-hanging fruit. (Of course, the moral issue there depends heavily on how likely you are to transmit the virus if you manage to catch it, and so far the answer seems to be: very little. That's been very important in my own individual decision-making.)

But I don't think COVID itself is ever going away. Everybody is going to have to reconcile themselves either to the level of risk or to a permanently constricted existence. State guidelines will affect that, obviously, but they're not the most important thing.
posted by praemunire at 6:25 PM on April 25, 2021 [4 favorites]


The immunocompromised people in my life are terrified about getting overlooked in the rush to get back to normal because everyone will say "screw the people who don't want vaccines". They are already being denied necessary work accomodations under the reasoning that everything's basically fine now. They already have chronic painful illnesses and would likely be particularly fucked up by getting covid, especially if they end up with the long covid issues. They need community spread to come way, way down before they can even think about engaging in some small way in a few bits of normal-ish life.

I don't know how to balance their needs and risks against the real and valid mental health issues others are experiencing as isolation and distance drag on. But if nothing else, please keep people like them in mind when you're doing your personal calculations. It's just not ever going to be as simple as "everyone is basically protected except covid deniers," no matter how easy access to vaccination gets.
posted by Stacey at 7:03 PM on April 25, 2021 [24 favorites]


Great questions.

I just saw my 77 yo mother who is considered high risk for the first time in over a year. She saw her grandson for the first time in over a year. We wore masks while in the car together and kept windows open during the visit in her apartment. We had to pass a temperature check to enter.

I stopped wearing a mask while outdoors >6ft apart some time ago. Maybe that was wrong but I needed some place to feel normal and decided the risk was low enough. I do wear one outside when in the city because things are more crowded but walking from the store to my car or going to the park in the suburbs? No more masks for that.

We all have to balance physical safety and mental health. The fear I had from obsessing over risk levels was not good for me and that made me not good for others in a different way than being a vector.

So regardless of what the science says, if you are totally DONE with masks emotionally, maybe look at that microcovid website and come up with some activities that meet a threshold of reasonableness for you, to find more of a balance between physical safety and sanity. (Not saying that to discount science but to say clearly you're taking this all seriously, so backing away a bit for some activities that have low risk of transmission would be an option to consider.)
posted by crunchy potato at 8:02 PM on April 25, 2021 [4 favorites]


I am not a health expert, but I am a skeptic who had read up on as much COVID info that I can get my hands on. I can't answer 1 or 2 without further research, so I'll address 3.

3) Flu casualty during 2018-2019 flu season is estimated at 34200 deaths.

COVID death toll is currently at 572000, in the US. At its 1-year "anniversary", it has already surpassed 400000 deaths in the US.

It's simply NOT COMPARABLE.

Furthermore, the long-term effects of COVID has not been studied because it's TOO NEW. People have reported major loss of lung functions and other consequences of surviving COVID.

Comparing the flu to COVID is like comparing a small firecracker to a pipe bomb.

4) I can't answer that philosophical question for you. I do ask you to consider those that CANNOT be vaccinated (such as children), even if their parents want them to... It's not available yet.
posted by kschang at 9:13 PM on April 25, 2021 [5 favorites]


I don’t think there is a consensus on this point. But I think there is at least a strong possibility that this will be less gradual than many think.

My suspicion is that just as exponential growth of cases is hard to fathom, so too will be exponential decay when it happens. I believe that by June or so most regions of the U.S. will find that COVID has more or less evaporated. There will be some outbreaks and they will garner attention as if they were as bad as the bad old days, but won’t be. At that point decisions about reopening will probably be clearer, but not self-evident. I live in a very low-transmission ZIP code with high vaccination rates. We haven’t had a case in our community of 11,000 in a few weeks. We’re still very cautious, but there is also a lot of planning for a much more open summer.

I’d say give all this about 8 more weeks and the endgame may show itself.
posted by argybarg at 10:40 PM on April 25, 2021 [2 favorites]


I can't answer 1 or 2 without further research, so I'll address 3...Comparing the flu to COVID is like comparing a small firecracker to a pipe bomb.

I don't understand why this kind of response keeps popping up.

COVID is obviously significantly more lethal than the flu. (Although I'm not sure I'd call half a million hospitalizations and ~34000 deaths a "small firecracker"; influenza and pneumonia are usually reported together in the top ten causes of death in the U.S.! Just goes to show how effective framing is.) So are many other diseases, including other respiratory diseases. But the current vaccines for COVID are far more effective (e.g.) than the ones we have for flu (which change yearly to match the predicted dominant strain, but last year's was about ~45% overall).

It's like people simply can't process that a vaccine exists now, that it reduces the current risk of COVID for the vaccinated to basically the level of background mortality risk we swanned about with beforehand, and that the ethical and practical issues now relate primarily to the unvaccinated. Even there, while the data is not 100% firm yet, the evidence coming in gives a pretty good indication that the vaccine also radically reduces the risk of transmission from vaccinated to unvaccinated.

After a year-plus of lockdowns, of course people are going to have to work with cultivating their own comfort levels about returning to social activity. Anxiety is not at all a rational thing, and I get that. But when it comes to asking what the actual risk is to vaccinated people, these numbers don't leave a whole lot of ambiguity, to the point that I genuinely don't understand how any college-educated person can't get their minds around them. Just because sociopathic idiots were all "herf derf the flu is more dangerous!!!" last May, with no vaccine and treatment itself still in a primitive state, doesn't mean that future comparisons to the flu are automatically invalid.
posted by praemunire at 11:47 PM on April 25, 2021 [27 favorites]


One reason to keep wearing a mask and considering your risk budget is that we have no idea when / if a new variant will arise that fully escapes the standard spike protein vaccines. While covid is still raging around the globe and air travel is resuming with minimal quarantine regulations, we are all still in the middle of an experiment that has not reached steady state yet.
posted by benzenedream at 11:57 PM on April 25, 2021 [6 favorites]


I, for one, am really enjoying the fact that the ONLY thing I've been sick with in the last year was Covid, and that was brought into my home via my grandchild that I provide childcare for, thanks to my son's somewhat careless girlfriend and even more careless people where she works.

I often spend the from October thru March sick with various colds; I always get a flu shot because if I get it, it tends to lead to secondary infections that require antibiotics and sometimes months to fully recover.

I'm one dose of vaccine in, awaiting my second - and I'm seriously considering continuing to mask up for as long as I can get away with it, especially during cold and flu season, no matter how Covid goes. And I suspect that we're going to be having problems with Covid for far long than anyone can currently face thinking about.

But then, I've been thinking that since late January-early February of last year. That very first news article I saw in late December 2019 made me wonder, and by late January, I realized it was already way out of hand and the odds of it becoming a Very Big Problem were exceptionally high. It really boggled my mind how no one else seemed to acknowledge it for so long.
posted by stormyteal at 12:14 AM on April 26, 2021 [3 favorites]


I mean, the vaccine reduces the risk of you getting COVID and the severity if you do but it sure doesn't eliminate it. (It's 90% effective I think?) So there are totally selfish reason to take precautions. Additionally, there are populations that are not anti-vax that cannot have the vaccine.
posted by DarlingBri at 1:19 AM on April 26, 2021 [1 favorite]


Thanks to sockmypuppet for asking these important questions, and thanks to everyone who thoughtfully engaged with questions asked by the OP.

I am ignorant on these issues, but am looking forward to seeing more substantive answers, particularly regarding the criteria that is being used.

OP's mention of "decimating performing arts communities" hits home. Not to put words in OP's mouth, but I wonder whether it would help to make this more concrete. Ongoing restrictions are devastating for musicians, music venues (including employees), and fans.

Is keeping shows shutdown actually protecting anyone? Who? And how much? How do we know? Is the benefit justified by the costs? What criteria need to be met in order for live music to resume, and how will know when the criteria is met?
posted by lumpy at 7:40 AM on April 26, 2021 [2 favorites]


Question 1 - what criteria is the federal government, at least, using to determine necessity for restrictions? I imagine states are even more random given the range of responses each state has.

It's not official policy guidance, but in interviews Fauci has used the criteria of maintaining national cases well under 10,000 as the marker of when restrictions should ease. At the state level, it seems much more like an iterative process of finding the level of opening that keeps hospitals just under maximum capacity.
posted by Dip Flash at 8:05 AM on April 26, 2021 [3 favorites]


I think you are right that we will reach a point very soon where everyone (except for children) who wants a dose and has access to the most basic healthcare has access to one. For instance, in California a majority of the 1200 CVS Pharmacies are reporting doses available. That does leave some people out. I am grateful to the Vaccine Queens who dosed my parent and hope that such outreach continues. I don't think anyone here is trying to throw immunocompromised people under a bus. Only 7% of the U.S. population has an autoimmune disorder, and many of those are multiple sclerosis (MS), lupus, and Type I diabetes, none of which, according to a cursory Google, contraindicates an SARS-CoV-2 vaccination.

As a consequence of (among other things) our federal system of government, a New Zealand or China-style lockdown was impossible. So what we're seeing here is a consequence of slow opening up in a barely controlled fashion. To answer your question 3, I feel like the risk of mixing with other vaccinated people, even unmasked, is less than the flu. We have numbers on this in the real world: breakthrough Covid is rare, and even rarer with serious injury, and apparently lightning-strike rare to cause death. A variant could change this, and as the richest nation we should be working on getting the rest of the world vaccinated, even if solely out of self protection.
posted by wnissen at 10:50 AM on April 26, 2021


and as the richest nation we should be working on getting the rest of the world vaccinated, even if solely out of self protection.

The US us not the richest nation in the world, and doesn't even make the top 10 by many calculations. It's barely in the top ten for percentage of population vaccinated. What it leads in is military spending and weapons export.
posted by DarlingBri at 1:50 PM on April 26, 2021


The US is frequently referred to (accurately) as the richest country in the world by total wealth, and as that link demonstrates we’ve administered the most vaccines of any country despite being lower %wise (we’re neck and neck with China). For supply and logistical reasons it would be very unrealistic to think we could lead in % population vaccinated. Nonetheless, the US is doing a good job and should start thinking globally even as we continue to prioritize our own population.
posted by stoneandstar at 2:26 PM on April 26, 2021 [7 favorites]


I think the end goal in general, is that Covid becomes at worst a mostly mild illness for which there is a programme of regular booster vaccines. The level of impact at a population level being roughly akin to the flu. As a result, people are able to go about their normal lives and mix without restrictions. Mask use indoors may be encouraged and/or become as prevalent as it was in say east Asia in 2019.

To get to this point, Covid needs to be not spreading like wildfire, and not overwhelming our healthcare systems (and not likely to do so).

Vaccination helps us achieve both of these goals, but is a means rather than an end. I think the expectation is that once 75%+ of a population has been vaccinated, then the number of cases will be low enough that we can remove restrictions without being likely to need to reimpose them again later. Again, there may need to be an ongoing booster programme, which would have its own challenges.
posted by plonkee at 5:15 AM on April 28, 2021


I know this question wasn't about masks specifically, but I just want to say that, several years ago, I took a trip to Japan, and saw a lot of people of all ages wearing masks outside, in the subways, etc. It's culturally supported so it is not a big deal. They were not gasping for breath, they did not seem miserable in their masks. It's annoying to wear a mask if you're not used to it, but, for the vast majority of people, the problem is simply that you are not used to it and it is not our cultural norm.

I don't like wearing my mask. What I mostly don't like is that when I look down I don't see as much, so I have to adjust my head (like getting used to bifocals). And sometimes I do feel that I'm not getting the same amount of air as without a mask, and sometimes certain masks are too tight. BUT many many other things we have to do are uncomfortable but we take them for granted. If I have to continue to wear a mask for "the duration," well, that's how it is.
posted by DMelanogaster at 11:26 AM on May 3, 2021 [1 favorite]


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