Pandemic Seasons

In our current season -- vaccines, masks, and access to care need to be prioritized

The song Turn! Turn! Turn! has been playing over and over in my mind this week.

I cannot get it out of my head.

Pete Seeger’s handwritten lyrics for Turn! Turn! Turn! They were penned in 1959. The lyrics were pulled directly from the first 8 verses of the 3rd chapter of Ecclesiastes.

The song documents the natural rhythm of life — birth & death, killing & healing, tearing down & building up, weeping & laughing, mourning & dancing, accepting & letting go, loving & hating, silence & speaking up.

As in life, pandemics also have rhythms and seasons — health & illness, surges & declines, fear & understanding, caution & closures, patience & giving up, listening & questioning, mourning & creating a new normal, listening & speaking up.

The current season of the pandemic is one of TRANSITION.

In the distance (probably 6-8 weeks from now), we can see a drop in new cases, hospitalizations, and deaths. And new conversations and policies will focus on how we live in a world where COVID is endemic.¹ We are already beginning to see glimpses of endemic planning/education. For example, we are hearing more and more about how to protect ourselves from exposure to the SARS-CoV-2 virus by wearing an N/KN95 mask. Public health professionals, clinicians, and disease forecasters are expecting that at the end of the Omicron surge there will be a huge influx of short-term natural immunity among the unvaccinated who were diagnosed with COVID and sustained, long-term immunity among the vaccinated. With so much immunity in our communities, we can all begin to imagine a world where COVID is part of our daily lives and not dictating the terms of our daily lives.

BUT…

Endemic COVID is still weeks, possibly months away. The Omicron surge continues. In the past two weeks, the number of incident/new COVID cases has increased by 21%, hospitalizations have increased by 36%, and deaths have increased by 45%.

We are experiencing a COVID surge. A giant wave of cases.

This is a time filled with a lot of illness. And this is a time when steps need to be taken to decrease the spread of the SARS-CoV-2 virus in our communities. This is a season where we need to take steps to protect ourselves and protect those who are vulnerable. This is a time to encourage vaccinations. And educate our communities that there is no shame in being diagnosed with COVID; rather once diagnosed individuals should seek out treatment (especially those who are unvaccinated).

We are experiencing an outbreak of COVID in the middle of a pandemic. During this season, I am strongly advocating for —

1. Masking in all indoor environments.
   (And to the local school board member who is going around town saying that I do not want a mask mandate in schools) this includes schools (preschools, K-12, colleges & universities). From a public health/preventive medicine perspective, everyone should be masking for the next few weeks or until the current surge begins to decline.
   

2. Individuals who are sick need to stay home.
   In the past, I have gone to work with pneumonia (and there was this one time I went to work for 2 days with sepsis). In hindsight, not only did working while sick prolong my illness, but I spread all of my germs with my students and colleagues. When you are sick, stay home. If you cannot stay home because you do not have sick leave or are told to work or be fired, please wear a mask. Obviously, in the long term, I will be advocating for paid sick leave for all workers.

3. Vaccinations.
   Everyone who is able to get vaccinated should. No questions. Stop arguing. Stop making this a political statement. To reach a season of endemic disease, we need immunity in our communities. Vaccines provide a safe route to long-term immunity with little risk. Get vaccinated.
   

4. Creating a culture of confidence in our vaccines.
   The pandemic has forced us to face a lot of fears (individually and as communities). When an unnamed novel coronavirus began to spread two years ago, there was a lot to fear. There were so many unknowns. But two years later, we have highly effective vaccines. In the midst of the Omicron surge, vaccines are preventing severe illness, keeping vaccinated individuals out of the hospitals, and preventing death. We also know that vaccines prevent long-COVID. While I am NOT advocating that we all go out and try to get COVID, we need to be confident in our vaccines.
   
   Vaccines are effective.
   
   Vaccines will provide protection against severe disease and hospitalization if/when you are diagnosed with COVID.
   

5. Accessible and free COVID testing for all, combined with clear instructions for what to do if/when you test positive.
   Providing accessible and affordable testing should allow for the early diagnosis of disease. And if the disease is diagnosed early, individuals can be treated to reduce the likelihood of severe symptoms and hospitalizations. Additionally, clear instructions should be provided for how to care for sick individuals at home, how to protect vulnerable household contacts, and how to report (if necessary) the positive case to other close contacts. I believe when we know what is making us sick, we gain back some control over the situation and can take steps to recover quicker and prevent the spread of disease to others.
   

6. Advocate for public health.

   I recently spoke at a City Council meeting (minute 57 of this video), where I said — “if we have learned anything over the past two years, it is that when our health is disrupted everything else is disrupted.”
   
   We need to create a world where we think about health in all policies.
   
   Public health is local. Public health is about our communities. Public health needs to be well funded and supported. Those of us in public health need to think about how we can learn from this pandemic in order to (re)build healthier and safer communities. This is a moment when public health professionals need to be speaking out — calling for vaccines, masks, and access to care. And we — the public health community — need to be (re)imagining the future where COVID is endemic.

A new pandemic season is on the horizon.

But given the current season of surges and all record-breaking case counts, hospitalizations, and deaths — we need to get vaccinated (and boosted), wear our masks, and stay home when we are sick.

To every season, turn, turn, turn…

And there will be more to come right here as the seasons change, subscribe today.

1. Endemic comes from two Greek words — en which means in, and demic which means people or the populous. Literally, the word means in people or among the peoples/populous.