The pandemic has entered a twilight zone, neither causing major disruption to the nation nor vanishing. Everyone is looking forward to a summer without masks or terrifying case spikes. The government has dropped the requirement that international air travelers test before entering the United States. We have vaccines, antivirals and diagnostic tests in surplus. So far, so good.
But there is still a nagging uncertainty, one that is not trivial. The biggest unknown is whether new variants will evolve. Omicron was an example of how mutation can deliver an unpleasant one-two punch. It could happen again. This possibility is particularly important in planning the formula of new vaccines and boosters. Moderna has announced that clinical trials showed good results for a bivalent booster — a vaccine against both the earlier strains beta and delta, and against omicron — and that will be the company’s lead candidate for a fall booster, pending approval. Pfizer says it is studying multiple platforms and approaches and will have data soon.
On the radar is the question: How long will omicron be around? A serious evolutionary change in the virus could pose a major challenge to everyone’s plans.
More certainty seems at hand for mRNA pediatric shots. Parents of children under 5 years old have been waiting a long time for a regulatory green light, and it arrived none too soon. It is still unsettling that the youngest people previously authorized for vaccination, from 5 years old to 17, have the lowest vaccine uptake; we hope parents of the smallest kids will not be reluctant.
The virus is still spreading. For a couple of weeks, the recorded U.S. seven-day moving average of daily new cases has been hovering around 100,000, and is probably much higher because of underreporting. The current levels are higher than during most of year one. The difference is that now there are diagnostics, vaccines and therapeutics to fight back. Moreover, at this point, far more is known about viral transmission, such as the value of face masks and the importance of improved ventilation and filtration. Also, the population’s level of immunity, both vaccine and natural, is far higher than it was in 2020, even if overall vaccination has not reached optimum levels.
What’s happening appears to be the gradual transition from pandemic emergency to endemic predictability. Still, complacency is dangerous. Wearing face masks in crowded indoor spaces, including on mass transit, is prudent. So are boosters. The bottleneck for at-home diagnostic tests has eased, and while the rapid antigen tests are not foolproof, frequent testing is a valuable tool to be alert to possible infection. Do it all.
Public health must include mental health. At this point and considering the tools for protection, a careful return to normalcy, socializing and travel is welcome and necessary. If the virus threatens anew, then a pivot to more restrictions is always possible. But right now it seems proper to say: Welcome to the twilight zone; things are getting better. And stay safe.