On April 27, Dr. Anthony Fauci noted that the U.S. is “out of the full-blown explosive pandemic phase” and, in effect, entering endemicity. Earlier that week, the Centers for Disease Control and Prevention presented data from antibody testing showing that as of late February, nearly 60% of the U.S. population had already caught COVID-19. In younger age groups the numbers were even more striking; 75% of children showed evidence of prior infection.
In Hawaii, as in much of the country, there’s a palpable sense of people wanting to work, travel and get together as we did before our collective adventure with this new virus began. Many folks are doing so already. After two years of living under a cloud, it’s difficult not to run toward the sun.
Unfortunately, despite some hopeful signs — worldwide mortality from COVID-19 is at a nadir, and U.S. hospitalizations remain relatively low — none of this means that the pandemic is truly over. As an infectious disease physician, I spend much of my time caring for patients with new COVID-19 infections, which are clearly on the upswing as new subvariants continue to spread.
Our hospital is seeing admissions from COVID-19 rising steadily now, as are others in the state. And long COVID, which we don’t yet understand well, is affecting a remarkable number of people. While it may seem like we are done with this virus, it’s very clearly not done with us yet.
How this pandemic will evolve from this point forward — what the endemic stage will really look like — depends on several factors beyond our individual control: the virus’s evolution; how durable our immune response to vaccination and prior COVID-19 proves to be over time; and the development of better COVID-19 vaccines and treatments.
But that doesn’t mean that we have no control, either as individuals or as a community. In the months to come it’ll be increasingly important to focus on what we can do for ourselves, and for each other. It’s crucial not to let pandemic fatigue take the place of common sense and thoughtfulness.
So, if you haven’t yet been vaccinated for COVID-19, it’s never too late — even if you’ve already caught COVID-19, vaccinations offer real benefit against re-infection. If you are vaccinated, please make sure you’re appropriately boosted. Though mask mandates have largely disappeared, that doesn’t mean that you shouldn’t wear a mask in some situations, especially if you’re older or medically fragile. If you choose to wear a mask, make it a good one — N95s, KN95s and KF94s protect you much better than cloth or surgical masks.
When hosting a graduation party or just spending time with friends, consider the lanai, the backyard or the beach. Get tested for COVID-19 if you start to feel sick, even if it just feels like a cold. Especially with home tests, your first test might be negative — it’s important to re-check a negative result a day or two later. And if you do catch COVID-19, always speak with a physician or nurse promptly, even if you’re not feeling very sick. Our COVID-19 treatments work best within the first week of symptoms before the dangerous, later phase of the infection sets in.
Hawaii has done remarkably well in the pandemic so far. I think a lot of that stems from a deeper sense of community here than exists in most parts of the world. The pandemic and the virus are still with us, evolving steadily. Let’s not be so eager to forget about COVID-19 that we stop taking care of ourselves and caring for each other.
Dr. Tarquin Collis is chief of infectious disease at Kaiser Permanente Hawaii.
