What Does a Pandemic Ending Look Like?
BOB GARFIELD From WNYC in New York, this is On the Media, I'm Bob Garfield.
BROOKE GLADSTONE And I'm Brooke Gladstone.
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ARI MELBER When will it end? When will it all be over? We all want to know. We're all wondering. [END CLIP]
BROOKE GLADSTONE I mean, seriously, it's like MSNBC's Ari Melber was speaking for the whole country. Well, most of it.
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NEWS REPORT Breaking news in Texas where Republican Governor Greg Abbott just issued an executive order ending, ending the statewide mask mandate and will now allow all businesses to reopen at 100 percent capacity on March 10th. [END CLIP]
BROOKE GLADSTONE Earlier this week, officials in Texas and Mississippi decided that the pandemic is over, but it's not a majority view.
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NEWS REPORT We've heard from the CDC director, Dr. Wollensky. This is not repeat, not the time to let up in these precautions because there are variants out there, it’s still a very dangerous pandemic. [END CLIP]
BROOKE GLADSTONE According to James Hamblin of the Atlantic, ending precautions, now, it's like entering the last miles of a marathon and taking off your shoes to eat hot dogs. But the question still stands: where is the finish line? What will it take for us to get there? Is there a finish line at all?
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NEWS REPORT That just because you get vaccinated doesn't mean you have the green light to travel? [END CLIP]
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PUBLIC HEALTH OFFICIAL This is really important from a public health perspective. Your behavior doesn't change.
REPORTER But why is that? [END CLIP]
BROOKE GLADSTONE Yeah, why?
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GOV. ANDREW CUOMO Here's what all this means. We're now on track to have enough vaccine supply for every adult in America by the end of May. [END CLIP]
BROOKE GLADSTONE Our leaders keep referring to some kind of luminescence, beckoning us in the dark. Wait, that's not the phrase.
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GOV. ANDREW CUOMO There is light at the end of the tunnel.
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REPORTER Governor Gavin Newsom peppered a press conference with a simple message:.
GOV. GAVIN NEWSOM There is light at the end tunnel, but we're still in the tunnel.
REPORTER He said that again and again.
GOV. GAVIN NEWSOM There's not just light at the end of the tunnel. There's bright light at the end of this time.
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GOV. ANDREW CUOMO The light at the end of the tunnel is in sight, but we can't stop driving now. [END CLIP]
BROOKE GLADSTONE But a lot of us are running out of gas. And according to some experts, that light is set on an infinitely receding horizon. When is this gonna be over? We keep getting mixed messages because there's a lot we don't know, and even more we can't predict. We want definitive answers about how to behave and we can't have them because the nation and its people are diverse geographically, politically, economically and in so many other ways. Still, we wanted to ask the question, how does it end? Rachael Piltch Loeb is a preparedness fellow at the Harvard T.H Chan School of Public Health, and an associate research scientist at the NYU School of Global Public Health.
RACHAEL PILTCH LOEB The reality is there has been such diverse experience that it's pretty hard to imagine a unified end. We know that there are vastly different experiences for our front line, essential workers, people who have been going to work every single day. You know, we live in an incredibly diverse country and that, for better or worse, has led to an incredibly diverse pandemic experience.
BROOKE GLADSTONE You were quoted in an article in The Atlantic by Joe Pinsker, who suggested that even defining the end has to do with what you choose to do. There's a person in his piece who was going to get a tattoo when it was all over. And so when she decides it's safe to get a tattoo, then for her it's all over.
RACHAEL PILTCH LOEB It's an interesting thought that people will mark what they perceive to be the end of the pandemic in different ways. We oftentimes are making decisions around our understanding of the latest data, and data is only as good as the inputs going into it. So, for example, how well is the government able to roll out testing? Who is it that's actually going to get tested? How accurate are the tests? I've seen experts discussing how perhaps when there is on average one hundred deaths a day, which is similar to the number of deaths that would be attributed to the flu per day, that will be a quote unquote reasonably acceptable threshold by which we could say the Covid pandemic is over. And this is kind of the new norm for society. And I think the tolerance that society or community has for continuing to have some of these, I don't want to call them restrictive, but changes to our functional norms.
BROOKE GLADSTONE Why don't you want to call them restrictions? They are! Wearing a mask with your grandparents, there's no way that that could be seen as a neutral thing.
RACHAEL PILTCH LOEB Your point is well taken. I also think, though, that in the future they will become guidance for how to reduce the risk you pose to your grandparents.
BROOKE GLADSTONE I get your larger point, but I was also thinking back to the beginning of the pandemic when New York Mayor Bill de Blasio promised health care workers a ticker tape parade when this is all over. That was supposed to feel definitive. I mean, this will be possible at some point.
RACHAEL PILTCH LOEB It will definitely be possible in the not so distant future. We're talking about an outdoor event, where people could still wear masks. But I don't think that there will be a clear moment when we can say we never have to think about covid again.
BROOKE GLADSTONE Well, we're still thinking about the flu.
RACHAEL PILTCH LOEB Yes.
BROOKE GLADSTONE Now, as we speak on Wednesday, the CDC is about to issue new guidelines that reportedly will say that fully vaccinated individuals will be able to gather in small groups with other people who have also been vaccinated. Even for people who have been fully vaccinated, other mitigation measures will still be recommended, including wearing a mask in public and social distancing. I found all of this quite interesting and stipulating that there are many, many factors that are impossible to predict. Would you allow me to try a lightning round?
RACHAEL PILTCH LOEB Sure, we can try.
BROOKE GLADSTONE Here we go! First, when can unvaccinated kids kiss their vaccinated grandparents?
RACHAEL PILTCH LOEB Oh, never.
BROOKE GLADSTONE OK.
RACHAEL PILTCH LOEB It would be very bad – for the grandparents. I would not recommend it.
BROOKE GLADSTONE When can unvaccinated college students flood into sweaty basements and bars?
RACHAEL PILTCH LOEB When should they? When will they? I can see that happening in the fall. I think that there is never a time when that would be a recommendation. They should be getting vaccinated.
BROOKE GLADSTONE Can vaccinated people remove their masks when gathering in small groups with other vaccinated people?
RACHAEL PILTCH LOEB Yes. Having vaccinated people interact with each other, we should feel comfortable with and we should celebrate the opportunity to do that after probably not being able to for so long. The risk that the vaccinated individual is contracting COVID from other vaccinated individuals is incredibly low. So if that vaccinated person goes, has fun with their vaccinated friends and comes home to others who are unvaccinated, it would be pretty unlikely, from what we understand, that that vaccinated person would then spread the virus. But to call it zero is unrealistic.
BROOKE GLADSTONE You would agree that vaccinated people should still be getting tested before traveling or going to a large event – for the sake of other people?
RACHAEL PILTCH LOEB For the purposes of abundance of caution, yes. That is going to continue to evolve as we see how long the immunity lasts, as we figure out whether or not that is still realistic after a few months. What I'm reflecting on, what all of this suggests is just we are flying the plane as it's being built, as we come up with guidelines and recommendations of what's safe both for an individual and for populations.
BROOKE GLADSTONE I understand that getting vaccinated doesn't give me a free pass to do whatever I want, but I find it hard to believe, as some people suggest, that I can't do anything differently, now. I'm inclined to think that's overstating things. Essentially, in order to manipulate the public into being responsible to fellow citizens, it was the same impulse that early in the pandemic had Dr. Fauci claiming that wearing masks was a bad idea. He wanted to make sure people wouldn't hoard them, and that medical people could get them. That doesn't mean I think people are going to not hoard masks – I'm not saying they won't behave irresponsibly – but that kind of social engineering has unintended consequences. And I wonder if you agree with that.
RACHAEL PILTCH LOEB It's hard to know the exact reasons why discussion early on was wearing masks isn't necessary, and then it pivoted to we recommend you should. Perhaps there was this background concern about hoarding, but I also think that our sense of the science evolved and the level of community spread changed.
BROOKE GLADSTONE But in the Far East, they understood that and they had the data to support it. So, in our looking at evolving data, were we ignoring evidence that was on the other side of the world?
RACHAEL PILTCH LOEB So two things. One is, I think that there is already a preexisting culture of wearing masks in many Asian countries.
BROOKE GLADSTONE Because they dealt with SARS type viruses before.
RACHAEL PILTCH LOEB So they dealt with a SARS virus, they've also dealt with flu viruses. They've dealt with many viruses, as have we. Now, culturally and scientifically, the evidence is not, I think, as clear as –
BROOKE GLADSTONE – I'm making it out to be?
RACHAEL PILTCH LOEB Exactly. Or wasn't necessarily as transparent or wasn't being looked at. I think that there is not one explanation. We all kind of looked at what was going on in terms of lockdowns in Asia at various points when the pandemic first existed and thought it was draconian or pooh-poohed it, and now look at who's emerged from this pandemic faster than the United States. There's a lot to unpack. If we were to compare the response of governments across the world and we could probably spend hours picking that apart.
BROOKE GLADSTONE Just talking about the racial aspect of this would take hours or months.
RACHAEL PILTCH LOEB Absolutely. But I think to your point of what you're calling the social engineering, and I would call ineffective communication, there needs to be more nuance and transparency. Here is what we know. And here's what we don't know. Here's what we're trying to find out, because the reality is getting a vaccine does make a difference in what you can do. And I think that some of that's getting lost.
BROOKE GLADSTONE This past week, Texas Governor Greg Abbott lifted the mask mandate in his state. He said that all the businesses could reopen at 100 percent capacity. It seems that he wants the pandemic to be over. Policy makers don't get to decide when this thing ends. How can people continue to navigate the difference between what's permitted and what's advisable?
RACHAEL PILTCH LOEB I think that people should continue to ask themselves questions that they hopefully have been asking throughout the pandemic, which is do I accept the risk of getting the virus? Do I accept the possibility that I could be passing the virus on to somebody else? You know, what's my comfort level if my parent, grandparent, child, loved one were to get covid because of my actions? And the reality is that cases are still moderately going up, at least as of midweek this week in Texas, in Florida. And we are talking about case counts that are still higher than parts of 2020.
BROOKE GLADSTONE How do you anticipate the different pandemic endings playing out on the global stage? If the virus is out of control in other parts in the world, eventually those mutations will reach here and then we don't know whether our vaccine protocols will work.
RACHAEL PILTCH LOEB I agree with you that the United States will continue to potentially feel the impact of the pandemic when it is not under control in the rest of the world. How much that impact is going to be, I'm not quite sure. But it's going to depend on what are those variants? How infectious are they? Do they avoid the current vaccines? Can we make booster's for them? And again, this is a very Western centric view, just thinking through what would be the impact here in the United States. But we are one world. It does matter that the pandemic is ongoing in other places.
BROOKE GLADSTONE So what do you think we've learned about how we ought to communicate the risks of covid in the future? What should we emphasize?
RACHAEL PILTCH LOEB There is not going to be the tolerance for lockdowns or restrictions to use that word that we had over the past year. Because this emergency phase where we're seeing the impacts of the virus day in and day out will come to some sort of an end. What the conversation should pivot to is what are our societal or community priorities? So, is it that we want kids back in school and we want that school to be in person learning because that's better for their educational development? You can go down the list of what do we want to achieve when we shift the conversation to identifying the priorities within a community or for society at large. There can be a more open conversation that there may still be tradeoffs. Getting everyone together in group settings does pose some form of risk. Perhaps we accept that risk because the risk to not doing it is worse. So the risk to keeping kids out of school for 2 years is worse than the possible spread of covid in a classroom. And that's where we need community input. We need a variety of different communities to identify what matters.
BROOKE GLADSTONE When does the pandemic end for you, Rachel?
RACHAEL PILTCH LOEB [SIGHS] The pandemic will end for me when I feel comfortable going to an indoor event without any qualms.
BROOKE GLADSTONE Masks or maskless?
RACHAEL PILTCH LOEB Maskless.
BROOKE GLADSTONE Do you envision that event?
RACHAEL PILTCH LOEB Yeah, I think it's a wedding or a large indoor celebration where I am not thinking about my risk of covid. If I were to think about any of those events, there is always this anxiety that I have of am I putting myself, my family, my loved ones, at risk by doing this, and is it really worth it to me? An end to this pit in my stomach, the pandemic pit.
BROOKE GLADSTONE Rachel, thank you so much.
RACHAEL PILTCH LOEB Thank you for your time.
BROOKE GLADSTONE Rachael Piltch Loeb is a preparedness fellow at the Harvard T.H. Chan School of Public Health and an associate research scientist at the NYU School of Public Health.
BOB GARFIELD Coming up, more confusion, disgust and dispel. Does it matter which vaccine you get?
BROOKE GLADSTONE This is On the Media.
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