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723 Epidemiologists on When and How the U.S. Can Totally Return to Regular

Covid-19 cases are falling in the US and masks are no longer required everywhere, but the pandemic is not over yet – and not until younger children can be vaccinated too, epidemiologists said in a new New York Times poll.

The real end to the pandemic – when it becomes safer to return to most activities without precautionary measures – will come once at least 70 percent of Americans of all ages are vaccinated, they said. Teens have only received vaccines this week, and those for children under the age of 12 are not yet approved.

“Children are key to ending the pandemic,” said David Celentano, chair of epidemiology at Johns Hopkins University and one of 723 epidemiologists who participated in the survey this month.

They are optimistic that this will happen, even if it doesn’t happen as quickly as many Americans hope. Five years from now, they expect Covid-19 to be more like the flu, circulating at a lower rate and with a few deaths per year – but no longer a public health crisis requiring lockdowns.

“It feels like there’s a light at the end of the tunnel,” said Gretchen Bandoli, assistant professor of pediatrics at the University of California at San Diego. “We have the tools we need to get there and it feels within reach.”

However, it is still unclear whether the United States can achieve this level of vaccination. And even if domestic cases decline, the global number of Covid-19 is increasing in parts of the world that did not have equal access to vaccines.

Americans are already starting to do things that for the past 14 months they have been advised to avoid. The Biden government said Thursday that fully vaccinated people would no longer have to wear masks in most locations. (The survey was conducted in the last two weeks prior to the mask’s announcement.)

In the poll, about 85 percent of those polled said it is likely that Americans can safely gather for a July 4th barbecue this summer, as President Biden has called for. A slightly higher proportion said it was likely that schools could be fully open in the fall and that families could safely gather indoors during the winter break.

Still, the campaign to vaccinate more Americans cannot wane until the children are protected, they said. Half of respondents said at least 80 percent of Americans, including children, needed to be vaccinated before most activities could be safely performed without precautionary measures. Although children are less likely than adults to develop severe cases of Covid-19, the scientists said their immunity was important as they could host the virus and provide a way to keep circulating or develop new variants.

“Children cannot be left out of the equation as we reopen,” said Corinne McDaniels-Davidson, director of the San Diego State University Institute of Public Health. “The idea that they cannot transmit Covid or that they are immune to disease is widespread among the lay public. We need education here. “

When assessing when to consider the acute phase of the Covid pandemic, they said vaccinations were more relevant than other metrics such as new cases, hospitalizations or deaths (because an effective vaccination campaign would lower those rates, they said).

The land is not there yet. Nationwide, 36 percent of Americans are fully vaccinated, and the rate of vaccination has slowed.

Of the 723 epidemiologists who took part in the survey, 35 percent work for governments. The rest are mostly academics. The questionnaire was distributed to two large professional groups, the Society for Epidemiological Research and the Council of State and Territorial Epidemiologists, as well as some individual scientists.

The decision to reopen states is based on many factors, including decisions made by the governors and the considerations of business owners, and may not be based on the recommendations of respondents. Even before the CDC announcement, around half of the states had lowered mask requirements or lifted capacity limits for hiring for large groups, and more could follow in the coming days. Many health professionals also fear that such a high vaccination threshold – enough to achieve what is known as herd immunity – may not be achieved.

Updated

May 15, 2021, 10:06 a.m. ET

However, survey responses from the group of scientists suggested that a full reopening without high vaccination rates could be linked to a sustained outbreak of the virus in the US and around the world.

“The inability to vaccinate effectively around the world could continue to haunt us,” said Cynthia Morris, an epidemiologist at Oregon Health & Science University.

Americans’ reluctance to accept vaccines is the biggest threat to ending the pandemic, the scientists said. They were also concerned about the emergence of new virus variants or the too rapid return of people’s prepandemic routines. A significant proportion – 22 percent – feared that politicizing public health could hamper the fight against the virus.

“The more people refuse vaccinations, the longer Covid will hang around,” said Ethan S. Walker, an epidemiologist at the University of Montana.

Scott Bartell, an epidemiologist at the University of California at Irvine, said, “I hope that one day Covid-19 will look more like measles, which will be largely cleared but not eradicated, with sporadic outbreaks and clusters, mostly among those who do are not immunized. “

Even if the spread of Covid-19 decreases to the point that most activities can resume, there are some aspects of pandemic life that epidemiologists say will last much longer.

In particular, they say masks are a norm that should continue, even if that view conflicts with the new CDC guidelines. More than 80 percent of them say people should keep wearing masks after being with strangers inside and outside in crowds for at least another year.

They want to see the continuation of what they think are the rare silver linings from last year. They hoped that people would have to travel to work less often. They wanted expanded grocery delivery and takeaway restaurants, as well as telemedicine visits for routine medical appointments. Many buildings have improved their ventilation, improvements that pay off in other respiratory diseases.

They also hoped people would maintain habits that generally make them healthier: avoiding things like going to work when sick, shaking hands, and even blowing out birthday candles.

“I can’t believe we used to celebrate birthdays by eating a cake that someone was blowing everywhere,” said Brian Labus, an epidemiologist at the University of Nevada in Las Vegas.

In the past year, epidemiologists suddenly found themselves in the spotlight. One of her challenges has been to tell the public a complicated truth of her profession – that there are seldom clear right or wrong answers about risks and benefits.

“As epidemiologists, we are constantly faced with uncertainty and we are pretty familiar with that,” said Kevin Martinez-Folgar, Ph.D. Student at Drexel University. “We need to create better ways to get this uncertainty across to the public in order to avoid all of the misinformation problems we have right now.”

Most importantly, they wish they had been able to better communicate the fact that science was moving and that health advice, by definition, would change as scientists learn new things.

When asked what public health practitioners should have done differently during the pandemic, David Abramson of NYU’s School of Global Public Health said he wished They would have “reinforced how much science changes every day, and with it the recommendations for protective measures”.

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A whole bunch of Epidemiologists Anticipated Masks-Sporting in Public for at Least a 12 months

When federal health officials said Thursday that fully vaccinated Americans would no longer have to wear masks in most locations, it came as a surprise to many in the public health sector. It was also in stark contrast to the views of a large majority of epidemiologists surveyed by the New York Times over the past two weeks.

In the informal poll, 80 percent said Americans were required to wear masks in indoor public spaces for at least another year. Only 5 percent said that people will no longer have to wear masks indoors by summer.

In large outdoor crowds, such as at a concert or protest, 88 percent of epidemiologists said it was necessary even for fully vaccinated people to wear masks.

“Unless vaccination rates rise to 80 or 90 percent in the next few months, we should wear masks in large indoor public spaces,” said Vivian Towe, program director at the Institute for Patient-Centered Results.

Responses came from 723 epidemiologists submitted between April 28 and May 10 before the Centers’ new guidelines for Disease Control and Prevention. The survey asked epidemiologists if they were in different sized groups outdoors and indoors with people whose vaccination status was unknown. The situations were in line with the new guidelines governing behavior in public places regardless of their size, where it is impossible to know the vaccination status of others.

Federal health officials have already said vaccinated people can be inside with other vaccinated people, and epidemiologists have largely agreed. However, the CDC’s new guidelines state that masks are no longer required for fully vaccinated individuals, regardless of the size of the congregation and whether they are indoors or outdoors, except in certain situations, such as in a doctor’s office or on public transit.

Epidemiologists are broadly very cautious about Covid-19 as they are trained to understand risks and prevent the spread of infectious diseases. Nearly three-quarters identified themselves as risk averse, and unlike many Americans, they’ve likely been able to work from home over the past year. But they are also trained as many of the academics at the CDC who developed the new policy, and about a third of those surveyed work in government, mostly at the state level.

They admitted that many Americans no longer want to wear masks – and that many have already stopped.

Wearing masks “will be a necessity, which is a very different question from the duration,” said Sophia K., epidemiologist at the Great Lakes Inter-Tribal Council. “I assume that most people will refuse to wear masks in public by the end of 2021, regardless of whether there is still a pandemic or not.”

Many epidemiologists echoed the CDC by saying that people who were fully vaccinated could congregate without taking precautions. However, the CDC went even further than the epidemiologists by giving vaccinated individuals OK to end masking in groups with an unknown number of unvaccinated individuals.

Updated

May 14, 2021, 11:24 a.m. ET

“Either you trust the vaccine or you don’t,” said Kristin Harrington, Ph.D. Student at Emory. “And if we trust the vaccine, it means that there is no limit to the number of people who can get vaccinated.”

Others recognized that political decisions are based on many goals, such as stimulating the economy and encouraging people to get vaccinated.

Most said, however, that wearing masks was still necessary for the time being as the number of Americans vaccinated has not yet reached a level that scientists believe is necessary to significantly slow the spread of the virus. By then, there are too many chances that vaccines that aren’t 100 percent effective will fail, they said.

“Crowded indoor and outdoor conditions require a mask until the community in Covid is much lower,” said Luther-King Fasehun, a doctor and doctor of epidemiology. Student at Temple University.

Sally Picciotto, an epidemiologist at the University of California at Berkeley, said the decision to stop wearing masks indoors was dependent on more people rolling up their sleeves to get the shot.

Respondents also said masks are important in protecting people at high risk and those who cannot be vaccinated, such as children or people with underlying health conditions, while the virus is still spreading.

“Until community transmission is lower, wearing masks will protect the entire community and the rest of the people in the room,” said Julia Raifman, an assistant including children, immunocompromised individuals, and Black and Latino communities affected by Covid- 19 more badly hit were professor of public health at Boston University.

A quarter of epidemiologists in the survey said that people would need to continue wearing masks indefinitely in certain settings, and some said they wanted to continue wearing them in places like airplanes or concert halls, or during the winter virus season.

“Heck, I can now wear a mask for any flu season,” said Allison Stewart, the senior epidemiologist for Williamson County and the Cities Health District in Texas. “Sure, it was nice not to have been sick for over a year.”

Alana Cilwick, epidemiologist for the Colorado Department of Public Health, said, “I plan to wear a mask indoors for the foreseeable future as the vaccine delay is great, especially in higher risk environments like the gym or on an airplane. ”

Only a fifth of epidemiologists said it was safe for fully vaccinated people to socialize indoors without masks in a group of unlimited size. A majority said that indoor gatherings should be limited to five or fewer households.

Even outside, where the coronavirus is spreading much less often, almost all epidemiologists said it was necessary to keep wearing masks en masse when people are around others whose vaccination status they do not know.

“Masks are the second most important vaccine prevention strategy,” said Professor Raifman.

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How U.S. Epidemiologists Are Returning (Fastidiously!) to On a regular basis Life

Other said masks were required in outdoor situations where the distance could not be maintained, e.g. B. when picnicking or hiking. A quarter said masks were always necessary back then.

“Remember to always ensure two out of three: masks, outdoor distancing, especially for those who have not been vaccinated,” said Eyal Oren, an epidemiologist at San Diego State University.

During outdoor activities with large crowds where it is difficult to keep your distance, such as at a concert or protest, the epidemiologists almost all agreed that masks are still necessary regardless of vaccination status. Some suggested that we continue to avoid such events if possible. “There will almost certainly be vaccinated and unvaccinated people who mingle in an event like this,” said Steve Ostroff, an epidemiologist with a private practice.

The endless decisions about how to behave in the pandemic remain complicated. However, the risk calculations are starting to change. When it comes to pandemic decisions for people who have been vaccinated, it may ultimately be less about protecting society as a whole than about one’s own willingness to take risks.

“I think when all high-risk groups are vaccinated it is time to draw attention to the fact that everyone can decide for themselves what risks they are comfortable with,” said Anders Huitfeldt, epidemiologist at the University of Southern Denmark.

Some epidemiologists say this shift can happen once people are vaccinated: “Vaccination should open the floodgates to anything you could do before,” said Zachary Binney, an epidemiologist at Emory.

However, many said coronavirus precautions are important to protecting people at high risk and slowing the spread of the virus, even for people who have been vaccinated: “While I like to take personal risks, I wouldn’t tolerate risks that harm others said Kevin Andresen, who heads the Colorado Department of Public Health’s Covid Response Team. “Covid precautions protect everyone, not just me.”