Living better lives and being smart about Covid

Nearly two years into the pandemic, it is clear that the coronavirus is not going to disappear anytime soon. Surges will happen, variants of concern will pop up and mitigation strategies will need to evolve. 

Yet too many are still paralyzed with doubt and fear over each new uncertainty, as trust in government and other institutions to manage the virus ranges from shaky to non-existent. 

It is past time to ask ourselves, as another COVID winter begins if we have to keep living like this: Anxious over the unknown, worried about large indoor gatherings, tense at every bit of virus news, and frustrated and at times contemptuous of those who have a dramatically different sense of acceptable risk.

Because progress has been made this year. Vaccines that protect against serious illness and death are taking ever greater hold in the United States and are beginning to make their way to the world’s most vulnerable regions; drugs that work against the virus are coming through the pipeline; and, despite a recent uptick in cases, schools and businesses remain open.

Americans should pause a moment and let this progress sink in. The virus will continue to surprise us, and even when scientists manage to predict its worst turns, officials will not necessarily be able to prevent those turns from coming. But what if leaders at all levels made choices so that we don’t have to exhaust ourselves with stress over every curve ball? To help us all live more normally with this virus, rather than let it control us?

That exhaustion has characterized so much of the past two years, as parents, teachers, frontline workers, and small business owners wade through what can feel like an unending morass. Is it safe to celebrate the holidays? Will schools shut down again? When will young children finally be eligible for vaccines? And why are we still having to ask ourselves these questions?

It’s too soon to say how long the current surge will last, or how it might be shaped by the Omicron variant. But even amid that uncertainty, we should push for a more pragmatic path from our decision-makers that will help us protect ourselves and live more normal lives, even as the virus continues to evolve.

Make coronavirus testing as fast, easy, and inexpensive as possible. Ubiquitous testing could help schools stay open and make gatherings of every kind safer. With more than 1,000 people still dying of COVID-19 every day in the United States, it’s past time to make this basic tool as readily available as it is in other countries like South Korea or Britain. 

President Biden’s latest plan — which would require people with private health insurance to submit a claim for reimbursement and people without insurance or private coverage to hunt down free tests at community health centers — does not do nearly enough to achieve that goal. 

Instead, the administration should do what other countries have done, and what the US did so successfully with vaccines: Work directly with companies to get more tests approved and on the market quickly, use advanced purchasing agreements to ensure a steady supply of those tests, and create federal subsidies for clinics and pharmacies to provide them free or very cheap to consumers who want them.

Aim to make the 2021-2022 school year the last dominated by COVID. The Biden administration should have enough testing free and available — and push to have a critical mass of students vaccinated — by September. 

Quarantine and isolation policies will also need an upgrade. The Centers for Disease Control and Prevention still advises people to isolate for 10 days after experiencing symptoms or testing positive, regardless of their vaccination status. Many schools still require anyone who’s been in contact with an infected person to quarantine for several days, at least. 

As breakthrough infections become more common, even among those who have received their boosters, it makes sense to allow workers and students to avoid confinement, or test their way out of it much more quickly.

Masking in schools is uniquely challenging. No one wants to force young children to wear masks for several hours a day indefinitely, but it would also be foolish to abandon the practice completely. A happy medium may be to require masks for students during surges or when new variants of concern are detected and vaccine escape is still being measured. 

The rest of the time, the evidence so far suggests the requirement could be lifted. Nevada has successfully tied its school masking mandates to community transmission rates, and experts say it’s worth trying the same in other states.

Prepare for surges. No scientist or health official has managed to predict, or even explain after the fact, what constellation of forces causes the pandemic to ebb and flow around the globe the way it does. But it’s clear that there will continue to be periods of the substantial uptick in coronavirus cases, and there should be sensible, significantly better policies in place for dealing with them.

Country-specific travel bans are futile: By the time a variant like Omicron is detected in one country, it’s already spread halfway around the globe. Penalizing countries that report new variants — as South Africa did, with Omicron — will only discourage them from sharing that kind of information in the future. Blanket policies — like requiring everyone entering the United States to test negative or possibly quarantine — would be tougher and more expensive to carry out. 

It would also have a better chance of actually working. If federal officials are serious about using border control to slow the spread of dangerous pathogens, they will need to establish clear, enforceable test and quarantine protocols, not to mention adequate quarantine facilities, at ports of entry.

Do away with COVID theater. The coronavirus is airborne, and any money spent on deep cleaning would be better put toward improved building ventilation. But instead of upgrading their HVAC systems, too many schools and businesses are still relying on things that won’t work nearly as well. 

The plastic barriers that have become common in restaurants, nail salons, and offices, for example, can actually impede airflow and exacerbate viral spread. Lawmakers and local officials should make a concerted effort to change that. Not only would improved ventilation help thwart coronavirus, but it would also curb the spread of other airborne pathogens, including the flu and those that cause the common cold.

Keep going on vaccines. Public health powers were once a common feature of American life. When cholera and yellow fever routinely stalked the nation’s major cities, citizens accepted and expected their health departments to issue mandates, quarantine orders, and travel restrictions. It’s crucial for officials to shore up those powers now because scientists say that epidemics and pandemics will become only more common in the years ahead. 

Biden’s vaccine mandates have been bold and effective — and administration officials should stay the course no matter how many legal battles they encounter. Even as we remain vigilant against the coronavirus, we need not remain in a state of paralyzing hyper-vigilance. 

Returning to the sound basics of public health, continuing the progress of medical innovation, and ratcheting back the societal anxiety around the pandemic could make us all a lot healthier.