More than 2 million people in the United States are getting vaccinated against the coronavirus every day, but case counts are once again on the rise as some states begin to lift public health restrictions. Now, Americans are looking toward the warmer months ahead and wondering: What will our second summer in the COVID era be like?
Right now, a little more than one in six people, or 15.8 percent of the population, have been fully immunized. Federal guidance on how to go about life post-vaccination is still emerging, but what we know so far — like that fully vaccinated people can safely gather with other fully vaccinated people inside without masks — is encouraging.
The promise of protection from any of the three shots that have been authorized in the United States offers a much-needed beacon of hope, even as researchers are still collecting important data on these vaccines. A recent study from the Centers for Disease Control and Prevention involving Pfizer and Moderna’s mRNA vaccines concluded that fully vaccinated people were 90 percent less likely to become infected with the coronavirus in “real-world conditions” like the workplace. But there are a couple key questions we just don’t have the answers to yet.
It’s not clear how long the protection given by any existing COVID-19 vaccine lasts, or whether the vaccinated can still transmit the virus to the unvaccinated. Data so far suggests that these vaccines provide meaningful protection against more transmissible variants of the virus, but measures like wearing a mask and keeping a distance from others in public places will remain crucial to stop their spread in the first place.
On Monday, CDC Director Rochelle Walensky warned that the current state of the pandemic in the U.S. — where cases, hospitalizations and deaths are ticking up, and just under 1,000 people are losing their lives to COVID-19 each day — bears an unsettling resemblance to what things looked like in some European nations weeks prior to the spike in cases they’re seeing now.
“We can change this trajectory of the pandemic, but it will take all of us recommitting to following the public health prevention strategies consistently while we work to get the American public vaccinated,” Walensky said.
Easing up on those prevention strategies too soon threatens to undo the significant progress that’s been made in this country over the past several weeks to get this virus under control. That’s why the push to get back to some version of “normal” life should “be a dial and not a switch,” according to Dr. Preeti Malani, chief health officer and a professor of medicine in the infectious diseases division at the University of Michigan.
The safer way to approach socializing in an ongoing pandemic involves a similar risk assessment to the one many people have been exercising since stay-at-home orders were lifted months ago, rather than throwing caution to the wind.
“It’s important to continue to be very vigilant, to wear masks, physically distance, wash your hands and get your vaccine when it’s your turn,” said Dr. Susan Bailey, president of the American Medical Association. “I think we’re much better off than where we were, but we are not out of the woods yet.”
Here’s a closer look at some of the variables that will determine how the pandemic plays out in the U.S. over the next few months, plus some tips you can use when making your own summer plans.
How to go about your social life this summer
When you’re deciding whether to attend a gathering or spend time with friends and family in the coming months, the CDC recommends keeping some key guidelines in mind:
The same rules that applied last summer still apply to this one. It’s much safer to get together with people outside than inside — that goes for dining out at restaurants, too — especially if someone is unvaccinated.
CDC guidance says that fully vaccinated people can safely be unmasked around unvaccinated people from one other household indoors, but only if those people are at a low risk of developing a severe case of COVID-19. That means it’s safer for vaccinated grandparents to spend time with their unvaccinated children or grandchildren than it is for unvaccinated elders to see their vaccinated loved ones.
It’s difficult to accept that some of the hallmarks of pre-pandemic life, like packed bars or concert venues, most likely won’t be safe options anytime soon. But the good news is that plenty of activities that would’ve been risky a year ago, like getting together with people outside your household, are much safer with basic safety measures in place, especially if all parties involved are vaccinated.
“Focus on what you can do and not what you can’t,” Malani said. “We can do a lot of things, but it’s just going to be in smaller groups, and it’s going to be with some precautions.”
She added that the presence of more transmissible variants means there’s “less room for error” when it comes to measures like masking and distancing. It’ll still be important to mask up when going to any local business where you’ll be interacting with people you don’t know personally.
Those types of precautions get increasingly effective as the virus’ spread slows. Dr. Otto Yang, an infectious disease expert at the University of California, Los Angeles, compared the effort to putting out a fire, a task that’s much easier to carry out when that fire is largely contained but popping up in a few noticeable places rather than raging broadly across a large area.
“In my opinion, we should be doubling down when the virus has gotten to the point that it’s almost extinguished or getting closer to being extinguished,” Yang said. “The more pressure you put on it, the more effect you have.”
That doesn’t mean people in the U.S. should stay in their homes and avoid much-needed time in the sun with their loved ones. But it does mean that they should make their own risk assessment when deciding how to socialize safely, both for their own well being and that of their neighbors. Staying local and avoiding any kind of unnecessary long-distance travel — per CDC recommendation — is another important choice that can reduce the opportunities variants have to spread from one community to another.
Dr. Leana Wen, an emergency physician and former health commissioner for the city of Baltimore, told the PBS Newshour she hopes that the CDC will be proactive about updating its guidance for fully vaccinated people. Wen noted that detailed recommendations are important to help people get an idea of which activities are safe.
“If we can say to people, for example, ‘Please hold off on traveling until you’re fully vaccinated and then — two weeks after you receive [your second dose] of Pfizer or Moderna or two weeks after you receive your single dose of Johnson & Johnson — you can travel at that time… I think that’s something that’s a lot more understandable.”
It’s also worth noting that local data on case counts, hospitalizations and deaths isn’t all that useful when it comes to determining which activities are safe. That information is less of a “weather report” and more of a snapshot of the past, Bailey noted. Plus, she emphasized, all it takes is one contagious person at a specific gathering or venue to potentially infect any vulnerable people around them.
That’s why, as Yang put it, these next few months will largely be about keeping common sense in mind. If we build pandemic precautions into our social lives, keep other people’s safety in mind and get vaccinated when we can, we’ll be in much better shape than we were last summer.
How do variants play into all of this?
Vaccines are one of the most crucial tools we have to stop the proliferation of variants of the coronavirus that are more easily transmitted from person to person, which could fuel another surge if left unmitigated.
The virus is still spreading widely in many countries, including the U.S. More hosts means more opportunities for the virus to mutate and for new variants, or versions of the coronavirus with a series of tweaks in their genome that cause them to act differently than their predecessors, to start circulating.
RNA viruses like SARS-CoV-2, the official name for the coronavirus, are actually less prone to random mutation compared to other viruses, but COVID is still relatively new, so its mutation rate isn’t unusual.
“[Mutation is] completely to be expected because the virus has just jumped into humans and it is going to be going through a period where it is optimizing itself to survive in humans because it was previously from another animal host,” Yang said.
A comforting rule of virology is that viruses are generally unlikely to become more lethal as they mutate over time. If a virus kills its host, it kills off its only home, Yang said. A fatal infection can also reduce the chances of an infected host passing the virus on to another person.
Researchers across the globe are surveilling positive tests for concerning new variants, and conducting research to determine what exactly makes them different. In many cases, these variants are suspected to be more transmissible.
But it takes time to do that research. Yang noted that much of what we know about variants like B.1.1.7., a more contagious variant that was first detected in Britain, is based on how they behave in a lab setting.
“The virus may be more easy to spread from cell to cell in the laboratory, or it may be more resistant to antibodies in the laboratory,” Yang said. “That does not necessarily translate to what happens in people.”
Evidence does, however, suggest that several of the variants that have been identified are indeed more contagious, underscoring the need to maintain precautions that decrease the likelihood of their spread.
Another concern is that the coronavirus could mutate to more efficiently circumvent temporary immunity granted either by natural infection or vaccination. Reinfection and mild illness in vaccinated people is an expected possibility, but it would be alarming to see that in large numbers, or to see severe cases in those people.
“If we start to see more and more people develop COVID after they’ve already had it or after they’ve been vaccinated, that’s when all the red alert warnings need to go off,” Bailey said.
But the data so far suggest that the COVID-19 vaccines that have been authorized in the U.S. do offer some protection against different variants. Yang explained that the virus could mutate to resist antibodies generated in people who have contracted COVID-19 before or who’ve been vaccinated. If that happened, he believes that booster vaccines would likely be able to bolster people’s antibody response.
Antibodies, though, are just one facet of the immune response generated by vaccination. T cells, Yang said, also play a key role in protecting against the virus. He added that these cells would not be affected by the mutations researchers have seen in variants so far.
“T cells survey the body and they actually kill cells in the body that are infected with viruses,” he said. “They do that to clear those cells out before they can produce virus. That part of the immune response is probably what accounts for a lot of the effect of the vaccines in terms of preventing serious illness and death.”
The main takeaway from the vaccines versus variants debate: Vaccines are a significant game changer in this pandemic, but they’re not the only tool we have to stop the coronavirus from spreading. The same measures we’ve taken for over a year now — mask wearing, social distancing, avoiding large crowds and poorly ventilated indoor spaces — will continue to be important even as more people are vaccinated.