Have Hope
My shoulders fall away from my ears every time I talk with my friend Monica Gandhi, MD, MPH, Professor of Medicine at UCSF and infectious diseases and public health expert.
HOPE. It does a body good!
Monica and I had a lively conversation this week about emerging data, vaccine optimism, and replacing fear with facts as we face reentry. I’d be THRILLED if you watched our interview.
Why do we have hope?? Because scientific evidence and real-world data support it. And when hope is rooted in facts, doctors should dispense it.
Another resource: this great interview with three experts from Harvard, UCSF (Monica), and UCLA on what you can and cannot do after vaccination.
The upshot:
Follow the facts. (For a full update, see my newsletter from Monday.) And on Tuesday, the New England Journal of Medicine published incredibly hopeful real-world data demonstrating that the risk of getting COVID-19 after vaccination is 0.05%. When we understand the unfolding scientific evidence and get comfortable with relative risk, making decisions (and letting go of fear) is a heck of a lot easier.
Prune your media intake. The media continues to under-report all the optimistic news and put a negative spin on positive news. We have every reason to be optimistic with three incredible vaccines slashing the case rates, hospitalizations, and deaths. But for some strange (and fascinating) reasons, the media and many public health experts are dragging their heels reporting to the public the very good news about what lies ahead. So decide who you trust, limit your incoming news emails, and take long breaks from your TV and phone.
Socialize safely. Our mental health hinges on it. We are not only wired for survival; we are wired for connection. The vaccines essentially take death and severe disease off the table. So once you are vaccinated, it's time to socialize, hug, and convene with loved ones. Vaccinated people can be together without fear—whether it's two, five, or one hundred vaccinated people. (The CDC needs to amend their recommendation; it doesn't make any sense to limit the number of other vaccinated people you can be with once you’ve been vaccinated.)
Vaccinated people can mix with unvaccinated people, too, as long as people understand the risks. For example, unvaccinated people are at extremely low (if not zero) risk of catching the virus from a vaccinated person, but unvaccinated folks can still get COVID from other unvaccinated people who are not in the same household. And as case rates and community transmission drop further, you might feel comfortable, for example, letting your unvaccinated kids play with other unvaccinated kids given the reduced risk of kids getting very sick from COVID-19. Of course it all depends on the child, their health, and our parental risk tolerance which—again—should always be checked against the facts. It’s starting to sound like common sense, right? We need to resume employing it!
Do your best to take the fear out of the driver's seat. After a year under siege, it's normal for our bodies and minds to be in survival mode. We’ve been bracing against a headwind for so long. But it's time to start pivoting towards normalcy—particularly if you've been vaccinated or if you are surrounded by mostly vaccinated people and low risk yourself. Of course people who have not been vaccinated still need to mask and distance from others. But when we’re afraid, we tend to overestimate risk, and can make ourselves sick. I am witnessing first-hand the physical manifestations of stacked trauma in my office every day. From high blood pressure to heartburn, depression and flaring diabetes, our stress—and how we manage it—matter more than ever. I recommend trying your best to identify your worries, replace fear with facts, and do your best to “unstick” yourself from survival mode if able. And if not, ask for some help. (See my posts for...well...the last year for ideas….And in case you missed it, I recently wrote an Op-Ed in the Washington Post about fear of reentry here.)
Consider your future. The data is clear. The vaccines not only take death and severe disease off the table and turn COVID-19 into its wimpy cousin, the common cold, vaccinated people also do not transmit enough virus to sicken other people. The natural question, then, is when do we no longer need to wear masks? As Monica and I discussed, arguably the only reason to wear a mask after you have been vaccinated is for politeness—ie. solidarity with fellow Americans who have not been vaccinated. But once everyone who wants a vaccine has been able to get one and once community spread has fallen even further, we’ll be able to unmask. At that point, and hopefully before, we’ll begin the process of recovery.
Keep it real. Optimism is not to be confused with indifference towards the enormous economic, physical, and mental health of the pandemic. We have lost over 545,000 American lives. We continue to see death and destruction all around us. Disadvantaged populations are suffering disproportionately and in unmeasurable ways. Too many people don’t have the luxury of mitigating risk. The variants are circulating, are in part responsible for 32 states having a higher seven-day average number of cases this week over last, and will cause more infections when (mostly unvaccinated) people let down their guard or can’t avoid exposure. A small percentage of vaccinated people will get COVID-19, and we should not be surprised when this happens.
But regardless of who you are, where you live, or what your politics are, vaccination will pave the way toward normalcy. We just have to be ready.
I will see you later this week. Until then, be well.
P.S. Join me on Monday at 8 pm ET (5 pm PT) on Instagram live with my friend Professor Emily Oster, PhD, to talk about kids and COVID-19, managing risk, and making smart decisions as the pandemic evolves.