(NEW YORK) — After months of unrelenting surges, COVID-19 infections and hospitalizations are falling rapidly across the United States, a welcome reprieve for many Americans, who are hoping that the decline will herald the beginning of the end of a difficult two years and a return to a much-awaited normalcy.
Although COVID-19 infections remain at levels comparable to prior peaks, with an average of 147,000 new cases still reported each day, politicians across the country, sensing the public pandemic fatigue, are eagerly moving to lift restrictions.
In just the last week, governors in 11 states and Washington, D.C., have announced an end to their statewide masking policies and other mitigation measures. Federal agencies and local jurisdictions are also moving to cut down on publicly available COVID-19 data.
Although health experts agree the COVID-19 decline is encouraging, many are urging caution not to declare victory prematurely out of fear of a potential viral resurgence. Many experts are also expressing concern over declining data availability.
“While we are in a much better place than we were a month ago, we still have to apply caution. Opening too quickly can lead to unnecessary increases in transmission that will only prolong the current surge and potentially accelerate the pace of a new variant,” said Dr. John Brownstein, an epidemiologist at Boston Children’s Hospital and an ABC News contributor.
The Centers for Disease Control and Prevention is also remaining vigilant, advising Americans to keep their masks on, particularly in areas of high or substantial transmission, despite contradictory messaging from state leaders.
“We are looking at all of our guidance based not only on where we are right now in the pandemic, but also on the tools we now have at our disposal, such as vaccines, boosters, tests and treatments and our latest understanding of the disease,” CDC Director Dr. Rochelle Walensky told reporters Wednesday during a White House COVID-19 briefing, adding that the agency could “soon” deliver updated mitigation guidance.
“We want to give people a break from things like mask-wearing, when these metrics are better, and then have the ability to reach for them again should things worsen,” Walensky said.
However, despite encouraging downward trends of new cases, hospitalization totals and deaths rates remain high, she added.
Across the country, about 80 million Americans are still unvaccinated, and more than half of those who are eligible to receive a booster shot have yet to do so, according to federal data.
Some health experts are concerned that the accuracy of COVID-19 case counts is potentially underestimated, given the increasing availability of home tests, which are rarely reported to health authorities.
“In addition to asymptomatic or mild cases, which can go unrecognized by infected people who do not get tested, positive rapid home tests are also not being counted,” Dr. Maureen Miller, professor of epidemiology at Columbia University’s Mailman School of Public Health, told ABC News. “There are also an unknown number of people who chose not to get tested, because they can either not afford to be infected because they don’t get paid if they’re sick or they don’t want to know or believe that they have contracted COVID-19.”
‘This is not the time to let our guard down’
Nearly two years into the pandemic, there is a feeling of exhaustion among Americans over the need to wear masks and other mitigation measures.
“If you really want to get the epidemic behind you, put it in the rearview mirror, just saying you’re done with COVID — you may be done with COVID, but COVID is not done with the United States, nor is COVID done with the world. We’ve got to do what it takes to get it to be done,” Dr. Anthony Fauci, chief medical adviser to the White House, said during an appearance on MSNBC on Tuesday. “We’re not out of the woods yet.”
Health experts believe that though these frustrations are valid, the benefits to keeping these measures in place for a bit longer would be beneficial in preventing another resurgence.
“This is not the time to let our guard down. Pulling back on restrictions has to be incredibly nuanced and based on robust data produced at the local level,” Brownstein said.
The issue of when is the right time to end mitigation measures remains complicated, particularly given the understanding from scientists that this virus will never be fully eradicated.
“Does that mean we have to wear masks for the rest of our lives? No, because we don’t usually design interventions that last forever, particularly ones that are not well tolerated,” said Dr. Jennifer Nuzzo, lead epidemiologist for the Johns Hopkins Coronavirus Resource Center.
It is important to consider feasibility and implementation issues, given how tired people are of the pandemic and the willingness of the public to continue to adhere to certain measures, Nuzzo said, adding that it is important for health officials to determine when is a decent time to relax mandates.
Miller told ABC News she feels strongly the time to lift restrictions is not now.
“Removing mask requirements is a huge mistake,” Miller said. “I understand the urge to not want to wear masks anymore. I hate wearing a mask. I do it anyway. Although cases are decreasing, every state in the United States has elevated levels COVID-19 spread. Not one state is on track for containment. That means there has to be preventive mechanisms in place to slow the spread, and the subsequent hospitalizations and deaths.”
Health experts are particularly concerned about individuals who are residually at risk, those who are immunocompromised and children under 5, particularly because about one-third of Americans are not fully vaccinated.
“The most frightening aspect of removing masking requirements … is the expectation that only the unvaccinated should continue to mask. The unvaccinated are the least likely to wear masks when requirements are in place,” Miller added. “Removing masking requirements ensures that infectious people will encounter susceptible people in greater numbers — with no protections in place to prevent infection. I would expect to see the number of cases rise.”
A drop in data availability
The pullback in the reporting of COVID-19 data by both the federal and state governments is also of great concern to epidemiologists, who have been using the data to help track the course of the pandemic and guide mitigation decision-making.
Since the beginning of the delta surge, dozens of states have ended daily virus data reports. In addition, last month, the Department of Health and Human Services ended the requirement for hospitals to report several key COVID-19 metrics, including a daily total of the number of COVID-19 deaths, the number of emergency department overflow and ventilated patients and information on critical staffing shortages.
“There’s no reason that we should be turning off data streams. Not only does it hamper our current response, but it will leave us more vulnerable to any future waves,” Dr. David Dowdy, an infectious disease epidemiologist at Johns Hopkins Bloomberg School of Public Health, told ABC News.
The curtailment of COVID-19 data stems from “political decisions to downplay the pandemic and the availability of rapid home tests with no requirement to report data to health authorities,” Miller said, adding that available data for hospitalization and deaths still “provide the most compelling evidence that COVID-19 continues to wreak havoc around the country.”
Nuzzo stressed that the most effective and efficient way to track the virus is by having a deliberate, active surveillance plan and consistently monitoring and testing certain subsets of the population across the country in order to determine the frequency with which people are getting infected, as well as who is getting infected.
Analyses of wastewaters, sequencing and data pertaining to infections, hospitalizations and deaths are all critical strategies in understanding the epidemiology of COVID-19, and whether or not it is changing. Each source of data is important, Nuzzo said, because they all “tell you something slightly different, so you kind of need them all in order to add it all up to help you triangulate your way to the truth.”
Not the last one
When exactly the nation will transition from a pandemic to an endemic phase is still up for debate. According to scientists, although the virus will never be fully eradicated, eventually, people will have gained enough immune protection from vaccines or from natural infection that there will be less transmission with milder infections and fewer hospitalizations and deaths, potentially, exhibiting similarities to the flu.
However, for now, many health experts stress that it is critical that Americans remain vigilant, because, as demonstrated by the rapid emergence and spread of the delta and omicron variants, there could still be highly transmissible mutations of the virus, leading to another significant surge.
“Though many might declare victory on the pandemic, we are clearly very far from where we want to be right now, especially with billions of people yet to be vaccinated and the threat of a new variant looming,” Brownstein said.
Nuzzo added that Americans have to be open to the possibility of having to reverse course, and reimplement restrictions.
“Now, some people would argue that means we should never lift the recommendations because people won’t want to go back,” Nuzzo said, likening the use of constant restrictions to a building with no fire that has a fire alarm going off all day. People will ignore the alarm, she stressed, thus, there is some value in giving people a break and then bringing back masks and other measures, if necessary.
Ultimately, she said, COVID-19 will not be the last pandemic the globe will face.
“We need to build and maintain your social habits, so that we can continue to get people to act,” Nuzzo said. “People are weary, and will they be ready to go through something again? Or will they just say, ‘Forget it. I’m done’? I think that we need to kind of replenish the trust.”
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