not for web
Published 11:00 pm Sunday, December 31, 2000
- rsik
With 30 % of Americans fully vaccinated against COVID-19 and a larger segment that either won’t or can’t yet receive the vaccine, the United States is in an “in-between” place. The Centers for Disease Control and Prevention has issued new, color-coded charts intended to show what people can do once we’ve received our shots, but they are confusing, impractical and overly cautious. The only useful takeaway is that vaccination makes every activity safer.
So how should people navigate this uncertain period? I think we need to acknowledge that there is no one-size-fits-all answer. Though vaccines are extremely effective, they won’t protect us 100 %. Most of us are not willing to wait years for the pandemic to be over to resume our lives, so we need to live with risk and accept the idea that others will make very different choices from us.
I’d encourage vaccinated people to consider three factors when deciding which activities to bring back to your lives: medical risk of your household; personal risk tolerance; and circumstances involved.
First, what’s the risk profile of your household? It’s low if everyone is vaccinated. The exception is if a family member is severely immunocompromised — for example, an organ transplant recipient taking anti-rejection medications. There is a small chance that vaccinated people can still transmit the coronavirus.
Then there are families with unvaccinated members. That does not necessarily mean that the household must take extra precautions. If all adults are inoculated but the children are not yet, and the kids are generally healthy, I’d consider the household to have a low risk profile overall. Children are much less likely to become severely ill from the coronavirus than adults. Since the beginning of the pandemic, 3.7 million children have been diagnosed with COVID-19. Of the states reporting the age distribution of hospitalizations, only 0.8 % of pediatric infections have resulted in hospitalizations. As of April 22, based on data from 43 states, New York City, Puerto Rico and Guam, 296 children have died of COVID-19; in comparison, annual pediatric deaths from influenza have ranged from 35 to 186 in recent years.
Of course, the coronavirus carries the potential of long-haul COVID-19 and unknown long-term consequences, including in children. In addition, breakthrough infections could occur: Out of more than 87 million fully vaccinated people, the CDC received reports of 7,157 COVID-19 infections. Of these, 498 people were hospitalized and 88 died.
This is why the second question really matters: What’s your tolerance of risk? To those who are risk-averse, the possibility of being among the tragic few who die looms large. They are concerned about emerging variants, and they would rather continue hunkering down. Others will see the 0.008% chance of infection and 0.0001% chance of death and decide that they can take off their masks and return to pre-pandemic normal.
Most people are probably somewhere in between. In that case, I’d advise them to move on to the third factor and assess the risk of each activity. An indoor restaurant that follows CDC guidelines for distancing has much lower risk than a packed bar with hundreds of patrons. An outdoor wedding with 50 people where proof of vaccination is required is much safer than an indoor banquet of 200 with guests of unknown vaccination status.
This is how my family would apply the three factors. My husband and I would go to well-distanced and well-ventilated restaurants but not crowded bars; we wouldn’t bring the kids except to outdoor eateries. I’d attend full-capacity church services where everyone is masked. My toddler has playdates, always outdoors, mask-optional. He’s going back to preschool, where masks are required indoors. We’d have no problem with the family taking an airplane for short flights. If a social gathering won’t have masks or distancing, I’d go if it’s outdoors or requires proof of vaccination.
Others with a different risk profile and tolerance will choose differently. Some won’t dine in a restaurant or travel until the level of community transmission is lower. Others will have no concerns resuming all activities as long as they themselves are vaccinated. These are both reasonable decisions. We shouldn’t mock the cautious for taking things at their own pace, nor should we condemn those who engage in activities we might not dare ourselves. After all, vaccinated people pose very little threat to public health; our energy is better spent getting the unvaccinated to get the shots.
Ultimately, getting through this “in-between” time requires that we have tolerance for one another’s individual choices, as we keep making the case that vaccination is our society’s pathway back to normalcy.