Covid-19 Policy
The Covid situation looks a lot better today than it was a year ago. But that doesn’t mean everything is fine – especially for people like me who are still “High Risk.”
The CDC is again telling high risk people what steps they can take to protect themselves from Covid-19. But four years and thousands of "takes" into the pandemic, most of us still don't feel like we know what protecting ourselves actually means. And what few tools we do have are stigmatized, broken, or being taken away. Even under the best circumstances, High Risk people like me can’t completely protect ourselves from Covid-19. The best we can do is reduce our risk a little and hope that current promising trends continue.
"High Risk" includes people like me, who because of chronic respiratory problems and other physical disabilities, would probably have a much rougher time with Covid — even when fully vaccinated and boosted. Many of us are asking, "Where are we with Covid? And what more, if anything, we and our fellow citizens possibly ask others to do to keep our risks as low as possible?"
And it’s worth remembering that the pandemic is still happening. Current positive trends aren’t guaranteed to last. Long Covid will probably continue to generate all kinds of personal and societal ripple effects well into the future. Plus, our sense of what’s an acceptable or low level of Covid risk and impact may still be badly out of balance. Infection, hospitalization, and death rates are nowhere near what they were this time last year. But significant numbers of people are still dying from Covid in the U.S. every day.
According to the January 26, 2023 New York Times, Coronavirus in the U.S page, "The average number of deaths announced each day has remained at or above 500 for most of January,” a figure that is “about double the number of daily deaths typically seen in a bad flu season."
Can anything more be done now to protect High Risk elderly, disabled, and chronically ill people from Covid-19 — or from other dangerous, infectious illnesses?
Unfortunately, people’s answers to this question seem to depend on politics, their own health conditions, and whether they are:
- A. Relieved to be “back to normal.”
- B. Cautiously optimistic that Covid will continue to dwindle from now on.
- C. Afraid of deadlier and more contagious variants to come.
- D. Crushed by feelings of abandonment and impending doom.
There are miles of complex territory between "The pandemic is over" and "The government is covering up a continuing calamity" – between "Disabled and chronically ill people are irrationally afraid," and "Current Covid policies are eugenics in action."
Regardless of where any of us stands, our questions are still valid. How worried should we be? And what more can public health officials, policymakers, and all of us do to keep pushing back against Covid-19 and other infectious diseases? There are probably dozens of steps we could and perhaps should be taking. Here are four fairly modest steps that would be useful for High Risk people right now.
1. Give us a more useful Covid map to measure our personal risk.
Go back to making community infection rates the main measures shared with the public. The CDC’s "Community Risk Level" maps now may be okay for hospital and local government planning purposes. But they are misleading for individuals who want to assess their personal risk.
The problem is that “Community Risk Level” ratings are heavily influenced by hospitalizations and death rates, but don’t clearly show infection rates. These maps provide some useful information for public health planners. They report how the healthcare system in each county and state is doing, but not how much Covid is spreading.
A better resource can be found at the “COVID Act Now” US COVID Tracker site. It too prominently displays the CDC’s "Community Risk Level" map. But it’s also fairly easy to find state and county level infection rates and other useful measures individuals can use to assess their personal risk. And there are Infection and death rates maps at CNN that offer a more immediate, graphic picture of Covid intensity by state and county.
The CDC could do a much better job of offering Covid maps designed to be risk assessment tools for individuals, and not just public health planners. This would give High Risk people a lot more confidence about what it really means to us when a map tells us our local Covid risk is “Low,” “Medium,” or “High.”
2. Give us a risk level that we can reasonably treat as safe.
It would be a lot easier for High Risk people to decide when we can relax about Covid if we had some idea of what infection rates to look for. Most of us, though certainly not all, are already getting together with family and close friends now. We may wear masks indoors, ask others to do the same, test ourselves, and ask others to test before we see them. Most of us aren’t anything close to “locked down.” But how do we know when it’s realistically safe to wait in a doctor’s office, eat in a restaurant, or work in a crowded office, without wearing a mask or taking other precautions?
Each of us must decide our own definition of “safe.” But it might help to have a conservative but reasonable local infection rate below which most people, including most medically vulnerable people, should be able to forgo most precautions in most situations. For instance, should we feel comfortable with a daily rate of 10 or fewer cases per 100,000? Is 20 or fewer good enough? Or, should very high risk people wait for rates more like 5 per 100,000 or lower?
We all have the option of setting our own arbitrary thresholds. "Above this weekly infection rate I'll wear a mask indoors — below it I won't." But it would be nice to have at least some medical and scientific advice, geared specifically to High Risk people, about when we can actually take it easy. It would also help to have some kind of credible backup with schools and employers, when our ideas of what is and isn’t safe clash. Just continuing to advise that we “talk to our doctors” isn't enough. Lots of our doctors don't know what to tell us. They need better guidance too.
If it's going to be mainly up to us to assess our own risks, we need better tools to measure them by.
3. Help us compare relative risks.
One of the Covid skeptics’ favorite arguments throughout the pandemic was the idea that the virus wasn't much worse than seasonal flu or other health risks we are all used to. They were wrong. Covid was and still is more widespread and dangerous than the flu and many other causes of serious illness and death. But it's been hard to find easy-to-read data demonstrating that.
It would help to create and circulate an accurate and easily readable chart comparing illness, hospitalization, and death rates for Covid – alongside seasonal flu and other infectious diseases. It might also help to have ready access to charts showing the top 5 leading causes of hospitalization or death in a given period.
Whether or not the pandemic is over, now or two years from now, people with less tolerance for infectious diseases could use frequently updated risk levels and comparisons between different illnesses and other causes of death. If we are supposed to have a level-headed sense of proportion about Covid or any other disease, give us that data we need to actually “put things in perspective.”
These aren’t the only changes we need, or the most important. There are more complex, long-term, and effective improvements to work on – like updated vaccines and more effective building ventilation and air filtration.
But if high risk people – and everyone else for that matter – are mainly going to be left on our own to protect ourselves, then we should at least have better tools to do so.
