When does a pandemic begin and end?

In the public discourse, the coming and going of a pandemic has often been compared to a light switch – it comes on quickly and, certainly this time with COVID19, abruptly. As an epidemiologist, an even more apt metaphor comes to mind – a dichotomous process – that the pandemic is either present and posing a certain risk, or not and posing little risk, with no room in between for variability. While this may be a useful comparison for the rapid increase in cases and social challenges characterized by the onset of a pandemic, certainly its exit is a much less discrete – instead more similar to a light on a dimmer – its a continuous, society-wide tapering of perceived risks over the course of several months (at best), represented by a near infinite variety of individual experiences.    

So, as the pandemic in the United States begins to dim, I often think about the changes that are afoot – and wonder what it will be like as we all begin to transition back to a routine that looks more like 2019 than 2020. We know that change is inevitable – but it is rare for there to be a transition that impacts so many of us all at the same time. Undoubtedly, there will be a wide range of reactions to this change – some will be eager to jump back in with both feet, while others will wish to stay on the side of the pool for a while longer. Our reactions may be driven by health-related considerations, or perhaps by a change in perspective brought on by the events of the last 15 months.  

In the midst of this transition, vaccinated epidemiologists are now faced with an interesting dilemma: to mask or not to mask? You must know that the answer to this question is, of course…it depends!

To Mask or Not to Mask

On the one hand, we know that the COVID-19 vaccines are incredibly effective – and the CDC notes that those who are fully vaccinated can resume pre-pandemic activities without a mask (where allowable).

But this hasn’t always been about just protecting ourselves – we know that we’ve been wearing masks to protect ourselves and others. For me, part of protecting others isn’t just about the physical protection, but about psychological protection as well. Unless we adopt Dr. McCullough’s suggestion and start wearing conference-style badges to note our vaccination status, there’s no way for those we interact with to know whether we’re vaccinated. We’ve all had enough second guessing over the course of this pandemic, and I’d prefer not to cause anyone undue anxiety wondering about whether I’m two-weeks past my last dose if we accidentally get too close. So as a Moderna vaccinee, I find myself continuing to wear a mask when out in public – even in spaces where it’s not required. I mask in solidarity with my three sons – who are still too young to be vaccinated – and as a small gesture to those whose paths I might cross in the grocery store.

There’s no right answer here – let’s all just remember to be gentle with ourselves and others. If this territory is challenging for us to navigate, imagine what it must be like for those outside of our field.

Communication

The challenges don’t just end with masking – but questions abound about vaccination, too. A dear friend of mine has been working the COVID-19 response in Detroit, Michigan – with waning cases, her team is transitioning from contact tracing to making calls to increase vaccination coverage. A few members of her team were nervous about making these calls – they were confident about their work with those who had tested positive, or who had been in contact with a positive case, but they didn’t feel like their expertise translated to vaccine promotion. One of her first calls was to a woman who had only received one dose of the Pfizer vaccine – and shortly thereafter had been diagnosed with COVID. She wasn’t sure what to do about getting her second dose, and was thrilled to have been contacted by the health department, saying, “you are exactly the person I need to talk to!” My friend relayed this conversation to her colleagues and reminded them that although they may not know everything that there is to know about the COVID-19 vaccines, that they have a wealth of knowledge to be shared with the community.

Looking forward

Throughout the summer, I encourage you to have these conversations with your family and friends. Whether it be about when or whether to wear a mask, or about vaccination – believe it or not, you do have something to offer that could make a meaningful difference in the slow process to definitively end the pandemic. We may be epidemiologists – and not behavioral scientists or health educators – but we do have a wealth of knowledge to share. We’re comfortable with the fact that there isn’t always one correct answer, and we can use our love of it depends to explain different scenarios that our loved ones might want to consider. And as I always tell my teaching assistants: no one knows everything – it’s always ok to say “I don’t know” – and you can follow-up with more information at a later time.

Featured image by Vera Davidova on Unsplash