‘People really are ready to be done’ with COVID
Experts say fatigue a factor to omicron spread in Conn.
Anthony Fauci said recently that most people can expect to be infected with the coronavirus eventually.
“I think, in many respects, omicron, with its extraordinary, unprecedented degree of efficiency of transmissibility, will, ultimately, find just about everybody,” the chief medical adviser to the president told the Center for Strategic & International Studies.
That pervasive belief — that despite two years of efforts to “flatten the curve,” the virus is ultimately inescapable — has led, according to experts, to a reduction in mask wearing, a stagnation in vaccination and booster rates, and a general
complacency, despite nearrecord COVID hospitalizations.
“I think many people have given up. Not all, but many have,” said Art Caplan, a Connecticut resident and founder of the New York University Langone’s division of bioethics. “They’re completely exhausted, they’re tired of it.”
People have “heard or don’t believe” that the virus can be contained, Caplan said, and a part of that problem is messaging.
“We messaged so hard that vaccination was about spread,” he said. But the vaccines, while effective in preventing severe disease and death, particularly if a patient is boosted, have not put much of a dent in COVID transmission, particularly since omicron began circulating.”
“Its purpose is to turn a deadly disease into a common cold,” Hartford HealthCare’s Ulysses Wu said.
So people have started to feel that if “the vaccine doesn’t prevent me from getting it, then it’s pointless,” Caplan said.
There are good reasons to lighten up a bit, according to Caplan. There is some evidence, both scientific and anecdotal, that the omicron variant is resulting in shorter hospital stays and less mortality.
There’s a belief, he said, that, “If I get it, it’s mild,” and vaccination has acted as a buffer for many patients formerly considered vulnerable.
“The vulnerable group has shrunk,” Caplan said.
For example, a slightly overweight, pre-diabetic person with a history of asthma is “absolutely” at lower risk now than they were in spring 2020, particularly if they are boosted, according to Scott Roberts, associate director for infection prevention at Yale New Haven Hospital.
While that patient, “Like many other people, can have some risk factors for severe disease,” the fact that they are boosted means your risk of being hospitalized, or dying of COVID, is exceedingly low,” he said.
Wu said the issue is one of personal choice versus “societal consequence.”
“I don’t know if people have given up per se, but I will say that people are getting into their minds deciding what they want to do and what they don’t want to do, and that all revolves around personal choice,” he said.
Personal choices in the midst of a pandemic, however, affect other people. Wu said the choice to not wear a seat belt affects yourself. The choice to not
wear a mask affects everyone around you.
“The problem with COVID is that, even with personal choice, there is a societal consequence,” he said. “And we do have to remember that it’s not the same as just not wearing your seat belt, or not washing your own hands before you eat.”
But Caplan said the implications of those personal choices are often hidden from view.
“The overwhelmed hospital is not something that people see, it’s not something the media does a good job personalizing,” he said. “It’s not commanding sympathy or empathy.”
Letting the ‘firehouses burn down’
“It’s as if we were willing to let the firehouses burn down because we don’t really want to deal with the problem of fires anymore,” said Dr Eric Schneider, senior vice president for policy and research at the Commonwealth Fund. “It’s really startling.”
Schneider attributes the problem to fatigue: “I do get the sense that people have basically decided they just can’t cope anymore. They’re just going to do whatever they used to do normally.”
“It’s been two years. I feel it, too. People really are ready to be done with this,” he said.
Schneider, like many, has noticed crowded restaurants filled with maskless patrons and lagging booster rates, all while there are nearly more COVID-positive patients in hospitals than ever before.
“People are gathering in restaurants without masks on,” he said. “And it’s unfortunate, because this is actually the exact moment when masking, distancing, booster shots really can make a huge difference, as omicron is spreading.”
There is a cognitive dissonance, Schneider agreed, a sort of disconnect between what is happening in emergency rooms and what is happening in restaurants, bars, schools and stores. They’re all overcrowded.
“If people could see what’s going on in emergency rooms and in hospitals, just the tremendous devastation and burnout that’s happening for health care workers, because this isn’t just about COVID,” he said. “This is about every emergency someone might have, and not even emergencies, urgent need for health care for other conditions.”
There have been 837,274 COVID-related deaths in the United States, an average of about 1,600 every day. On Thursday, the state reported there had been 9,442 total COVID deaths in Connecticut since the start
of the pandemic.
“It’s hard to imagine that we would have gotten to the point where we kind of shrug our shoulders at that much death,” Schneider said.
Yale New Haven Health director of infection prevention Rick Martinello noted that only one virus, smallpox, has been effectively eradicated in all of human history.
“We always lose,” he said. “At best, we reach a detente with the virus.”
That detente, as Martinel- lo called it, will be more clear “in time.” It’s likely the coronavirus will never disappear, but will cease to be as much of a concern.
“We know that other viruses we’ve achieved that status with, some of them aren’t significant pathogens anymore, but they still circulate routinely,” he said.
Though Martinello agreed there’s no talk of “flattening the curve” anymore, he said while it was a valuable and accurate goal, it was not paired with the reality of past pandemics.
“It wasn’t paired with, that pandemics usually last two to three years,” he said.
The message should have been short, medium and long term, Martinello said.
“‘This is what we need to do today and tomorrow. This is what we want to achieve in the short term, but we know this is going to be a long-term problem.’ That was not part of those original communications,” he said.
Dr. Jim O’Dea, vice presi- dent for Hartford Health Care’s Behavioral Health Network, said the choice to not wear a mask or socially distance is to some degree an effort to preserve some mental health stability in the midst of an extended pandemic.
“This has been a devastating time in this country and the length of this pandemic, and all of the disruption it has put into our personal lives, has been devastating,” he said.
The social isolation, in particular, “has been very difficult,” O’Dea said.
“I think actually, we will see, for several years, a mental health pandemic after this pandemic, because we’re illuminating issues that are stress and turmoil. It’s resulted in sleep disturbance and appetite disturbance and levels of depression,” he said.
Going out to crowded bars, even while emergency rooms are full of COVID patients, might be a way to manage that sense of isolation, to fight that depression.
“I think we have to really focus on combating social isolation, but in new and different ways,” O’Dea said.