We have to accept some risk of Covid-19

There’s a growing consensus among health experts: Covid-19 may never go away. We’ll likely always have some coronavirus out there, infecting people and, hopefully only in rare cases, getting them seriously ill. The realistic goal is to defang the virus — make it less deadly — not eliminate it entirely.

This is not a surrender to the virus. For a long time, we’ve lived with the seasonal flu, a family of viruses that kills up to tens of thousands of Americans each year. While we can and should take steps to mitigate the risks of the flu (including getting vaccinated for it every year), we’ve never been willing to shut down society or close in-person schooling to fully eradicate it. Americans have accepted some level of risk to continue living normally.

The same will likely be true with Covid-19. The highly transmissible delta variant appears to have cemented this possibility, showing the coronavirus will continue to spread even in states and countries with higher vaccination rates.

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If you go back to the earlier days of the pandemic, the original hope with vaccines was more modest. Previously, the Food and Drug Administration set the standard for an acceptable Covid-19 vaccine at 50 percent efficacy. The expectation was that the vaccine wouldn’t stop all cases of Covid-19, but would at least reduce the severity of the disease. As Baylor College’s Peter Hotez put it at the time, “Even if it’s not the best vaccine, it still could prevent me from going to the hospital or worse.”

Yet somewhere along the way — perhaps with the news the vaccines were far more effective than expected — that message has been lost. And now anything short of perfection is perceived as a failure.

Consider the recent study, published by the Centers for Disease Control and Prevention, on the outbreak in Provincetown, Massachusetts. The initial headlines about the study focused on the fact that three-fourths of cases tracked in the study were among vaccinated people, showing the virus spread in a very vaccinated community. The implication, propped up by the CDC’s new guidance that vaccinated people should wear masks indoors in public, was that the delta variant can spread at a high level among even the people who got their shots.

But if you dig into the details of the outbreak, they revealed some very good news for vaccinated people. Among the more than 1,000 cases so far linked to Provincetown, there have only been seven reported hospitalizations (some unvaccinated) and no deaths.

If this was 2020, given overall hospitalization and death rates, the outbreak would have likely produced roughly 100 hospitalizations and 10 deaths.

The Provincetown outbreak, then, showed that the vaccines had worked to defang the coronavirus — to make it more like the flu.

“We should cheer,” Amesh Adalja at the Johns Hopkins Center for Health Security told me. “The Provincetown outbreak, contrary to what the press reported, was evidence not of the vaccines’ failure but of their smashing success.”

In short: Pay attention to hospitalizations and deaths, not just cases.

There are concerns about “long Covid” — lingering effects in those infected, like overwhelming fatigue. Still, experts say serious long-term symptoms after a Covid-19 infection seem to be fairly rare (though this issue is still being studied). And, at any rate, these kinds of long-term symptoms aren’t unique to the coronavirus; they happen, for one, with seasonal flu.

While we still have to get more people vaccinated, at a certain point we’ll have to acknowledge we’ve done what we can. It might not be ideal, but we can learn to live with a vaccine-weakened version of Covid-19 — hopefully not too unlike how we’ve long dealt with the flu.