A Simple Rule of Thumb for Knowing When the Pandemic Is Over
At some point—maybe even soon—the emergency phase of the pandemic will end. But what, exactly, is that magic threshold?
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Some experts were even more conservative. Crystal Watson, a health-security scholar at Johns Hopkins University, suggested a threshold of 0.5 newly diagnosed cases per 100,000 people every day, and a test-positivity rate of less than 1 percent. That would translate to fewer than 2,000 cases a day in the U.S., compared with the current 60,000 or more. We’d also want to log at least one month of normal hospital operations without staff or equipment shortages, she said.
While every proposed threshold remains far below what we’re seeing right now, the researchers I spoke with believe that if vaccine uptake is high enough, those numbers can be reached. Watson suggested a target of 80 percent coverage for populations older than 65, and 70 to 80 percent for everyone else. For the latter, “perhaps 60 percent is more realistic,” she said.
So far, no state has reached those vaccination levels in any population. It is possible, however, that in specific, high-risk subpopulations, targeted efforts could drive vaccination rates to very high levels. Our best example is in long-term-care facilities, which have been linked to 35 percent of total COVID-19 deaths in the U.S. The federal government’s vaccine rollout made residents and staff in these facilities a priority and provided specific funds and operational help to vaccinate these people beginning in December. At the COVID Tracking Project, we’ve seen the share of deaths attributed to long-term-care facilities drop by more than half over the past six weeks, which suggests the vaccines are working.
The large number of Americans who’ve already been infected will also be crucial for reaching transmission-slowing levels of immunity. The CDC estimates that more than 83 million Americans have been infected with COVID-19, far more than the official, confirmed case total of 28 million. Forty-four million Americans have received at least one dose of a vaccine. Even assuming some overlap between the previously infected and the vaccinated, perhaps 100 to 120 million Americans have some level of immunity. That’s roughly one-third of the population.
It could take months for the size of this group to reach a point where the number of COVID-19 deaths a day falls below 100. Until then, we’ll be confronted with a different sort of risk: that, for some, the pandemic feels like it’s over long before it actually is. Just as the country has never taken a unified approach to battling COVID-19, we may very well end up without a unified approach to deciding when it ends. That’s why public-health experts are desperately urging Americans to hold firm even as the pandemic seems to be receding. “We’re lifting mitigation measures too soon,” warned Gounder, the infectious-disease specialist at NYU. “We’re taking our foot off the brake before putting the car into park.” If enough people ignore that message and decide the pandemic is over for them, it may very well put off the moment when we can say that the pandemic is over for everyone.