Covid-19 cases are falling in the US and masks are no longer required everywhere, but the pandemic is not over – and only when younger children can be vaccinated, 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 that requires 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 US 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 respondents 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 for the winter vacation.
Still, the campaign to vaccinate more Americans cannot wane until the children are protected, they said. Half of those surveyed said that at least 80 percent of Americans, including children, needed to be vaccinated before most activities could be safely performed without precaution. Although children are less likely than adults to develop severe cases of Covid-19, the scientists said their immunity was important as they could be hosts for 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. "
In assessing when to consider 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 the business owners, and may not be based on the recommendations of respondents. Even before the C.D.C. Announcement that around half of the states had already lowered mask requirements or lifted capacity limits for settings 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.
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 a too rapid return to 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 eliminated but not eradicated, with sporadic outbreaks and clusters, especially among those who 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.
Specifically, they say masks are a norm that should continue, even if that view changes with the new C.D.C. Orientation aid. 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 make them healthier in general: 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 their challenges has been to convey to the public a complicated truth of their profession – that there are seldom clear right or wrong answers when it comes to 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 said they wished they had better communicated the fact that science was advancing, 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 the N.Y.U. 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".