Now’s not the time to dispense with COVID-19 precautions

Too many Americans seem to believe the COVID-19 pandemic is over — or at least that conditions have improved to such an extent that they can forgo precautions. This is most evident in the knee-jerk response to the court order this week lifting mask mandates in transportation settings, with many transportation agencies and corporations immediately dispensing with their requirements.

This is misguided. In reality, the United States has experienced a concerning rise in cases in recent weeks because of the spread of new omicron subvariants. Failing to take this seriously could put vulnerable Americans at risk.

We fear that Americans don’t have a good sense of the true state of the pandemic. Some of the confusion can be traced back to the Centers for Disease Control and Prevention’s “COVID-19 community level” metric introduced in February. The change was misleading, causing many in green areas to think they are at low risk of contracting the coronavirus, when in reality, the metric mainly indicates that they would have access to a hospital bed if they fell seriously ill.

Meanwhile, cities and states have been changing their definitions of covid hospitalizations, reducing surveillance activities and shifting to less frequent reporting of cases. The lack of a public health infrastructure for reporting at-home test results and shrinking access to testing because of closure of mass testing sites and the end of the federal COVID program for the uninsured also obscure the spread of the virus.

With covid increasing again, there are many reasons we should still take precautions. High rates of transmission increase everyone’s risk of serious illness, which depends not just on how deadly a variant is but also on the chances that individuals encounter it. We saw this during the omicron surge, when more than 150,000 Americans died. While vaccines are highly effective at reducing the risk of serious illness, they are not perfect and the protection they offer against infection wanes over time. Moreover, U.S. vaccination rates still trail those of other high-income countries, and only a minority of Americans eligible for boosters have received them. We cannot rely solely on vaccinations.

We should also be concerned about long COVID, which has too often been minimized or ignored. Research shows COVID can cause long-term damage to organs including the brain, heart and lungs. The condition is also is linked to conditions such as diabetes, blood clots and dysautonomia. It simply isn’t wise to roll the dice and allow ourselves to be reinfected multiple times given the potential health consequences.

Also keep in mind that even mild illness has disproportionate impacts. Many workers do not have paid sick leave, making lost days of work because of COVID more burdensome for low-income Americans. Moreover, suspending all precautions risks exacerbating existing COVID inequities by race and income.

Pundits and even the CDC itself are emphasizing that it’s up to individuals to make their own choices about how to protect themselves depending on their risk tolerance. But this narrative goes against the foundation of public health. When a virus capable of serious illness is so widespread and not everyone has equal access to tools to protect themselves, the best way to keep everyone safe is through collective policies.

This is why overturning the federal mask mandate for public transportation is disastrous. Millions of essential workers, low-income communities and immunocompromised or disabled people rely heavily on buses, trains and subways. They shouldn’t have to make the impossible choice of traveling to work, healthcare appointments or grocery stores and increasing their risk of contracting the virus. Masks help keep these essential spaces accessible to all, and they are far more effective when everyone wears one.

As Philadelphia’s health commissioner explained regarding the city’s decision to reinstate its mask mandate: “By wearing masks consistently, we can continue to go about our daily lives and continue to take part in the life of our city without contributing to increasing transmission of COVID-19,” and that it makes sense to be more careful given the “history of disparities has impacted particularly our Black and brown communities in the city.”

And while effective treatments such as Paxlovid are now available, that doesn’t mean we can throw caution to the wind. Availability does not mean equal access, especially for treatments that require early testing and connection to a health-care provider. Given this, preventive measures remain critical.

Something we keep hearing to justify the lack of precautions is that it isn’t March 2020 anymore. No, it isn’t. We know so much more about the virus and have so many more tools to protect ourselves. But refusing to use them and pretending that the virus is no longer a threat will only prolong the pandemic, contribute further to mass disability and death and increase existing inequities.

Living with COVID should not mean abandoning all responsibility to each other. We have to continue working together to protect one another so that we can keep society safe, open and accessible to everyone.