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By Spencer Bokat-Lindell
Mr. Bokat-Lindell is a staff editor.
This article is part of the Debatable newsletter. You can sign up here to receive it on Tuesdays and Thursdays.
On Nov. 15, 2020, in the United States, as the most devastating wave yet of coronavirus infections was beginning to crash over the country, about 1,148 Americans were dying of Covid every day. A year later, that number is 1,129.
To call the statistic sobering would be an understatement. And yet many parts of the country are not in the same place, epidemiologically speaking, as they were last year. In New York City, where I live, and where 87 percent of adults have received at least one vaccine dose, restaurants and bars and theaters fill with people every night. Cases have ticked up once again in recent weeks, but hospitalization and deaths continue to decline — for now, at least.
At this uncertain juncture, how close is the United States to something we could call a new normal, and how should Americans think about managing the transition? Here’s what people are saying.
‘We need a goal’
At the beginning of the pandemic, the overarching public health imperative Americans were given was to “flatten the curve” of infection: Reducing the number of active Covid cases at any given time, the logic went, would relieve pressure on the health care system and save it from collapsing.
But The Atlantic’s Sarah Zhang argues that case numbers are a less and less useful metric for guiding our pandemic thinking. “With vaccines available, not every case of Covid-19 is created equal,” she writes. “Breakthrough cases are largely mild; 10,000 of them will cause only a fraction of the hospitalizations and deaths of 10,000 Covid cases in the unvaccinated. The more highly vaccinated a community is, the less tethered case numbers are to the reality of the virus’s impact.”
A plausible alternative goal, she suggests, is to focus directly on minimizing hospitalizations. And to do that, it will be crucial to increase vaccinations among older Americans, who are far more vulnerable to severe Covid than children and young adults.
In some parts of the United States, Zhang notes, the percentage of adults over 65 who are fully vaccinated is languishing in the 80s. That may sound like a lot, but “you don’t need a lot of infections in the unvaccinated over 65 to give you a problem,” Bill Hanage, an epidemiologist at Harvard, told her.
‘SARS-CoV-2 could be with us forever’
One way or the other — through vaccination or infection — experts say the coronavirus will eventually become endemic: Outbreaks will be rarer and smaller, and hospitalizations and deaths will decline.
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