For many, belated realization that COVID will be ‘a long war’ sparks anger and denial – .

For many, belated realization that COVID will be ‘a long war’ sparks anger and denial – .

In May, when the CDC said fully vaccinated people can ditch masks and social distancing, it seemed to signal a return to normalcy. But epidemiologists warned at the time that the move was probably not permanent and should not be interpreted as the end of COVID-19 as a daily concern. Colder weather or a right hook in the evolution of the virus could bring back the restrictions right away.

Yet Americans seem shocked by the recent turn of events. Last week, the Centers for Disease Control and Prevention advised everyone – even those who have received COVID-19 injections – to revert to indoor masking, a move prompted by new data showing that the hyper-contagious delta variant colonizes the nose and throat of some vaccinated as well as unvaccinated people, which means that they can just as easily spread this new version of the virus, while being protected against the worst manifestations of the disease .

The prospect of facing a protracted epidemic phase – and once again adjusting to an ever-changing list of restrictions – has brought another hallmark of the pandemic back to America: anger.

This time around, it’s not just the predominantly Republican anti-masking chorus that rears its provocative head (although the fights for school mask mandates have returned with a vengeance). From coast to coast and across the political spectrum, contempt for the unvaccinated is increasing. “It’s the unvaccinated people who let us down,” Alabama Gov. Kay Ivey, a Republican, said on July 22 as his state with one of the lowest vaccination rates in the country , was shaken by a 530% increase in COVID-19. hospitalizations in just three weeks.

Among those vaccinated, there is the feeling that the freedoms they have gained by being vaccinated – traveling, eating out, concerts, sports, school, seeing friends – are now threatened by those who still resist.

While this new flavor of outrage may sound like righteous outrage, mental health professionals say what’s behind it is fear.

“It’s scary to admit that someone else has power over you and you’re at their mercy and scared of them, but showing that it’s not a very American ideal,” said David Rosmarin, associate professor of psychiatry at Harvard Medical. School and clinician at McLean Hospital. “Instead of expressing that fear, it’s much more comfortable to blame someone else. “

Anger is what people in his profession call a “secondary emotion”. It is a feeling that arises in response to a more primitive emotion, such as fear and anxiety that some aspect of your life is threatened. “The reality is that there are millions of people who are miseducated about something, they make a big mistake that will have huge consequences that could affect you and your family, and that scares you,” Rosmarin said. “But nobody says that. “

Part of the problem is cultural. “In America you are expected to be a god,” he said. Showing one’s vulnerability is akin to blasphemy. Just look at the backlash Olympic gymnast Simone Biles faced last week in response to her withdrawal from the team event in Tokyo, citing her sanity. He would like to see leaders at the state level and at the national level do a better job of modeling this kind of behavior rather than leaping into blame and shame.

READ MORE: What Delta Has Changed In The COVID Pandemic – And What It Hasn’t Changed

For those who have made a living studying pandemics, they see another lesson in the current wave of outrage – the danger of setting unrealistic expectations. “One of the big mistakes of the US response to COVID, among many others, was initially failing to make it clear that this was going to be a long war,” said historian John Barry, who wrote the definitive account of the Spanish flu of 1918. pandemic, “The great flu”.

For much of the pandemic’s first year, many senior public health officials touted the idea that our way out of the pandemic was to achieve herd immunity – a phenomenon whereby a pathogen stops self-healing. spread because so many people are protected from it, either through previous exposure or by vaccination. Between natural infections and vaccines, if we could reach 60% or 70% of the population with some immune memory to SARS-CoV-2, the thought is gone, we could build a wall of protection around the still vulnerable, enough to completely buffer the transmission of the virus.

But even before delta emerged, some scientists doubted it would work. If other endemic coronaviruses were any clue, immunity to natural infections waned within a few years. Vaccines blocked transmission, but not entirely. New variations could erode the protections afforded by both. Now delta appears to be doing just that.

A more likely scenario for getting out of the pandemic phase of COVID-19, many scientists told STAT earlier this year, was that over time, possibly over a period of years, our immune system would learn enough about it. SARS-CoV-2 to avoid the deadliest. symptoms of infection. In this way, the pandemic pathogen would become endemic – circulating among us and causing smaller seasonal outbreaks of milder disease.

Past pandemics have all ended this way. But these, all caused by influenza viruses, followed a familiar pattern. They had struck hard and fast, accumulating a massive number of corpses – many of them children – in a matter of weeks. Then suddenly, the wave would pass. Reaching an immunological truce usually took about a year and a half to two years.

SARS-CoV-2 is not a pandemic influenza. It is not as uniformly fatal. He spares the children the worst of the disease. And flare-ups can last for weeks or even months, only diminishing when humans change their behavior, rather than the virus turning off on its own. “Past pandemics just aren’t a precedent for this one,” Barry said.

Epidemiology researchers like Jennie Lavine of Emory University have turned to models to try to predict when SARS-CoV-2 could transition from a pandemic pathogen to endemic. In an article published in Science, Lavine and his co-authors predicted that this transition could take anywhere from a few years to a few decades, depending on how quickly the pathogen spreads and the extent of adoption of the pathogen. vaccines.

This is not the time frame that most people have thought. As a result, people are now not only angry, but in denial, after everything we’ve been through – the lockdowns, the staggering death toll, the historic race to build a COVID vaccine – after all of this, SARS – CoV-2 is still with us, a threat that must still be navigated.

READ MORE: How the COVID pandemic ends: Scientists look to the past to see the future

Which is why this time around, epidemiologists like Lavine fear that it will be even more difficult to get people to don masks, especially those who thought the pandemic was over for them by the time they received their. vaccines.

“There is a way the rhetoric around collective immunity has been a disservice, and I think we are probably seeing it making this moment worse as people start to face tangibly in their communities that this is wrong. not go away, ”Lavine said.

The good news, she said, is that nothing in the recent history of the coronavirus suggests that it will not end up becoming a mild endemic virus, joining the family of common cold-causing insects. That could change if new variants were to treat young children with much more serious illnesses, or completely blind the immune systems of people who had been vaccinated or previously infected. “Fortunately, at this point, those two things hold together,” Lavine said.

“So the light at the end of the tunnel for me is that the long term situation still doesn’t look so bad, it’s just that it’s not that kind of” hitting that magical threshold of immunization coverage and it’s all over. “. It’s a slower progression with a less crisp ending, ”she said. “It doesn’t mean that there is no end. It’s just harder to see it for sure, and disappointing when it hasn’t happened as we perhaps have been led to believe.

This article is reprinted with permission from STAT. It was first published on August 2, 2021. Find the original story here.


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