Thanks you for the conversation last Thursday. One thing I thinks is clear, is that different people are having different experiences in different parts of the country. I live in city that has been held up as paragon of low death rates during the pandemic. More people have died of overdose during the pandemic in San Francisco than Covid. The Bay Area was one of the first to shut down in March of 2020, and we’ve continued to “take this seriously” ever since. San Francisco Unified School District was also one of the last to return to in-person learning, and when we did, our students got far less time in classrooms than their peers even in other parts of the Bay Area. People here are still very cautious – most people wear masks while walking around outside, and even in large open spaces like parks or the beach. My call for us to start talking about “off ramps” is very much in response to my lived experience here in the Bay Area. I would probably not be so worried about managing an eventual “return to normalcy” if I lived in an area where things already were starting to feel normal. Where I live, they are not.
Which brings me to some of the backlash surrounding this conversation, which generally seems to be around timing. I do want to reiterate that my post was not a call to end any and all restrictions RIGHT NOW. I know that, at least where I live, it’s going to take a LONG time for us to come out of this mentally and emotionally. If we start talking about it now, maybe when mask mandates are relaxed, those people who stop wearing them won’t get dirty looks from those who are continuing to wear them, and may continue to wear them indefinitely. We have a long way to go where I live, and we need to start having the conversation at some point. Starting these conversations now seems reasonable to me, even if it will be a few months, at least, before we could actually start relaxing restrictions. If we start talking about this stuff now, maybe we could put metrics in place for changing behaviors.
So, shall we engage in some light whataboutism? Why not.
Why not wait until the 5 and unders can be vaccinated?
It looks like vaccines might be available for our youngest cohort soon, maybe even in the next month. Of course their pending arrival is not being met with elation of past approvals, and currently only 25-30% of parents intend to vaccinate their children under 5 years old. But I understand that for those families who fear the worst outcomes, vaccinating their under 5 year olds is necessary for a return to normalcy. I’m so glad that those parents will have that chance soon. I know a huge weight was lifted off my shoulders when my kids were vaccinated, and even though I was never that fearful of them catching Covid. So I do think this milestone is necessary for us to move on, but only so the families who want to vaccinate their younger kids can feel safe. If the rate of vaccination for 5-11 year olds is only 25% at this point, I don’t think can expect vaccinations for younger kids to help us reach the level of “immunity” required to hasten community spread significantly.
But what about the crazy high rates of hospitalizations and deaths!
Obviously omicron is still raging in the United States. Sure we’re on the downward slope of the wave, but the wave was massive and our daily case rates are still much higher than what they were during the worst of the Delta wave. And hospitalizations rates and deaths are also very high in most of the country. The thing is, the vast majority of those hospitalizations and deaths are among the unvaccinated. These are people who have had almost a year to get vaccinated and are still not, for whatever reason. If we are changing our behaviors to keep people from being hospitalized and dying, and the vast majority of people being hospitalized and dying are unvaccinated, then we are asking everyone to change the way they live so that the people who aren’t vaccinated don’t get severely ill and die. And we’re asking them to do that, knowing that the unvaccinated are the last likely to be changing their behavior themselves – they are the least likely to mask, and rapid test before seeing others, or quarantine when they feel ill.
At this point it’s clear that the US will continue to have a much higher rate of severe illness and death than other large, wealthy nations because we have so many people who are not vaccinated. We say that “this is a pandemic of the unvaccinated” but at some point do we say that “this is a crisis because of the unvaccinated”? Or is that not fair? Or does it not matter either way?
I realized driving to work this morning that I wrote my last post not because I think public policy should change right now, or even in the next few months. I wrote this post because *I* personally need to start changing my own thought process around this. In my personal situation, where I live in a highly vaccinated area of mostly like-minded individuals, I need to start changing lanes. I need to start accurately assessing my own risk and the risk of my family because *we* are not doing great and I don’t think *we* are always following the science when we decide what we are and are not going to do. Thankfully I am not a public health official and I do not have to make decisions that affect others. All I can do is make decisions within the rules and guidelines provided by actual public health officials.
I want to be ready for the off ramp when it does come. I want to be ready for my kids to return to school unmasked when officials decide that is safe. I want to feel comfortable in my own classroom when that happens, and I need to start thinking about it now if I’m going to feel okay about it in the fall (which is the earliest it would ever happen around here, I’m sure). I think a lot of people where I live need to start thinking about these things now, so that when we do start inching towards normalcy, they will be mentally and emotionally prepared for it. Because right now we are not. And there are a lot of complicated, non-science-based reasons for that.
Thank you for reading along as I figure all this stuff out. It’s messy and it’s complicated and it’s important to talk about. I appreciate your input – it’s helpful to understand where other people are at and why.
It was interesting reading other people’s viewpoints for sure! Thanks for starting the discussion.
One thing that will be challenging with the shift will be letting go of the anger at those who didn’t follow the rules the whole time and, similarly, letting to of the identity of being a mask wearer! At my son’s basketball game the other day, I sat next to a father and son who were not masked. I should add that the rules were clear that only one family member is allowed in the gym, but clearly this family didn’t think to follow this rule. The son (preschool age) was also sitting close to me and coughing periodically. If I think about this logically, I know I am okay. I am in a kf94 mask. The dad was probably vaccinated, if not boostered, because players and guests were supposed to upload vaccination information or negative PCR to attend, although I’m not sure how well enforced this has been, given they let the kid in. This family probably already had covid in the last month (based on what I know about where they live, where their kids go to school). So if I’m safe, why am I so upset? Probably because they can’t be bothered to follow the rules and have been contributing to the prolonged crisis. At some point, I am going to need to let go of this anger because I can’t say “it’s okay if people are unmasked” and then get angry when people aren’t masked. I don’t know how to move past this. The divisions are DEEP.
SF is at 81/100,000 death rate.
SF population over age 5yrs is 86% vaccinated.
Every county and state has different situations.
You are raising good questions.
I wish the only people impacted by a decision to not vaccinate and mask would be that person who made those decisions. But that is not the case.
Thank you for talking about this. I’m in SF too and agree that we need to start transitioning to being less fearful of Covid. My husband and I disagree about safety vs social life, though we will both feel a lot more comfortable when our asthmatic 3 year old has been vaccinated. We have to keep reminding ourselves that we were never very concerned about us but about the vulnerable elderly population. My callous thought now is if they don’t get vaccinated that’s their problem. And since we have such a high vaccination rate here, we can definitely start loosening our grip. It’s hard, fear is almost like a habit.
Thank you for writing about this, I think you are brave considering the slightly unhinged comments I see on twitter accusing anyone who wants to talk about getting rid of masks as disgusting and selfish. I am finding this whole discussion really emotionally difficult especially considering my whole family was so incredibly careful this entire pandemic, to our great emotional cost, despite being very low risk for COVID ourselves. It’s such a slap in the face to be called names now for wanting to talk about how things have changed. Im glad your comments seem to be generally pretty civil.
I think so many of us are taking a lot of mental short cuts which is really understandable given how fraught it t feels to be constantly reevaluating risk over multiple years. So we think vaccination = good, therefore we should be giving the little kids there chance to be vaccinated! Without really thinking about what vaccination does at this point in time, which is reducing but not eliminating entirely the risk of severe outcomes and onward transmission. But under 5s risk is already SO low (aside from preemies and newborns, I am not up to speed on their relative risks) that if we think well we should give everyone the chance to have their risk set to that of a boosted adult, they are already there. So what is it we want? Reducing the risk further? Sure that is a good goal, but not something to be waiting on in my opinion. Reducing transmission to other people? This I can understand if you have a very vulnerable person in your house such as some one very immune compromised. But honestly if I was that severely compromised I would not have my child in group care because the list of pathogens they can bring home is so long. Nothing is going to eliminate that. And vaccination will reduce but not eliminate that risk for under 5s if the data is similar to what we have seen in other age groups. So I guess I still don’t think this argument merits keeping kids in masks indefinitely or even until they can be vaccinated.
Similarly, I have people who I love who have chosen not to get vaccinated. I care about them and want them to be well. But not at a continued cost to my children.
I, like you, live in an area with incredibly high vaccination rates and our hospitals were ok during this winter, I am not aware of any procedures being pushed because of hospital capacity although I do know of one that was pushed because the dr was concerned there was going to *be* insufficient capacity. But that didn’t actually happen. I think that’s really important but achievable everywhere in the US with vaccination. But also like you my kids had virtual school far longer than the rest of the country and my son still has to wear a mask outdoors at his preschool (he’s 3). We don’t have a crisis in our hospitals but we don’t have dramatic insufficiency in our mental health providers to deal with the results of this isolation other low level traumas. So why can’t we switch to addressing this actual crisis? Kids are so so anxious now. I have heard stories and I’ve seen it first hand. They need to be able to see their friends and learn to talk properly. I don’t understand why no one cares about this here.
I think easing of some restrictions in SF makes some sense given the high vaccination rates. I am happy to live in a place that is similar, but am surrounded by and work with a large number of people who think vaccination is stupid. And masks. And any covid mitigation strategy whatsoever. Furthermore, the Covid mitigation policy that makes sense in one area may make no sense whatsoever in a place with different baseline behaviors and different rates of vaccination. I’m quite content letting the anti-everything people do what they want around each other, but then they come to where I live and want to force me to live the same way and accept all of their anti-science BS. Maybe that doesn’t happen where you live, but it definitely does where I live.