Opinion: COVID isn't going away, so this is how we can live with it and stay safe

With more than 500 Americans still dying every day from COVID-19, the pandemic continues.

And a surge of cases in Asia and Europe — which has foreshadowed outbreaks in the United States — suggests that another wave of infection and death may be coming. The emergence of a new subvariant, BA.2, which is already becoming prevalent, will pose new challenges because existing vaccines appear to provide quickly waning protection against it.

Nevertheless, while the pandemic is far from over many Americans are done with it. Restaurants and malls across the country are now filled with mask-less patrons; most schools have returned to in-person instruction and many are dropping their mask mandates. While the state of Michigan has dropped its mask mandate, the organization I lead, Michigan Medicine, still requires all health care workers to wear masks along with anyone else in spaces where patients might be present for care or related services.

While spread of the rapidly mutating virus may lead federal and state officials to re-impose more stringent safeguards. Philadelphia reinstated its public mask mandate on April 11. But it, to date, is the only major city to do so. For the time being at least Americans will be left on their own to decide how best to protect themselves. 

What to do? 

Two years into the pandemic, the science shows that everyone, including those who are fully vaccinated, is vulnerable. Since the only way to contract the disease is from other people, the safest course is to avoid human contact. That, of course, is not really an option. The challenge then is to calculate your personal risks, your tolerance for risk and then avail yourself of the proven strategies that can limit exposure and the virus’s impact if you do get sick.

These efforts include:

► Assess Personal Risk: Although anyone can contract COVID-19, the data are clear that the elderly and those with pre-existing medical conditions — including cancer, lung problems, heart disease, diabetes and obesity — are at greater risk of becoming gravely ill or dying from the virus. Such individuals must take more aggressive steps to limit their potential exposure. The T.H. Chan School of Public Health offers a nifty tool for assessing a range of other risk factors.

► Get vaccinated: Every study shows that currently available vaccines provide significant and safe protection from the virus. While their effectiveness wanes over time, the CDC reported on March 18 that COVID sufferers who had received 2 or 3 doses of an mRNA COVID-19 vaccine such as those from Pfizer and Moderna were 90% less likely to require a ventilator to die in-hospital than the unvaccinated. 

► Wear a Mask: Although our growing knowledge of COVID and personal behavior has raised questions about the effectiveness of cloth masks, the research shows unequivocally that N95, KN95 provide strong protection. The CDC reported last month that “using a face mask or respirator in indoor public settings was associated with lower odds of acquiring SARS-CoV-2 infection, with protection being highest among those who reported wearing a face mask or respirator all of the time.” They also protect those around you. It is also best to change your masks regularly. More use raises the likelihood that pathogens can attach to them or they can become loose and allow particles to slip through. A good rule of thumb is to replace a mask after five uses. 

► Choose the Outdoors: The virus can be transmitted more easily indoors, so you can limit your exposure by choosing outdoor options wherever possible. Look for restaurants and other facilities that provide unrestricted cross-ventilation — tables that a spaced wide apart in the open air — are preferable to those that provide enclosed spaces outside. Patronize businesses that require proof of vaccination for entry. 

►Practice Social Distancing: Virus particles need to jump from a carrier to infect you. Shorter distances make this journey easier. Where practical try to main a distance of three to six feet from other people — besides, nobody likes it when you get in their face.

► Stay Clean: At the start of the pandemic, health officials advised us to wash our hands frequently and use sanitizer. This remains gold standard advice as it greatly reduces the possibility of transferring the virus into your body through the eyes and nose. As an added benefit, this will help protect you from a range of illnesses in addition to COVID.

Although it is drawn from science, the guidance I’ve offered is really just common sense. Just as there is no magic bullet to stop the pandemic, there are no great secrets to protecting ourselves in the age of COVID. Bottom line: get vaccinated; limit your direct exposure to others through protective gear such as mask and the liberal use of soap and sanitizers, and try to avoid confined spaces where possible.

These simple steps offer the best chance to return to a life that is normal and safe.

Marschall S. Runge, M.D., Ph.D., is executive vice president of medical affairs and dean of the Medical School for the University of Michigan. He serves on the board of directors for Eli Lilly and Company.