By Damian McNamara
Have we reached a long-awaited turning point in the COVID-19 pandemic in the United States? Or do we still have some time before we can return to anything resembling life as we knew it in 2019?
The CDC's relaxation of masking and social distancing guidance for vaccinated Americans is one reason for optimism, according to some, as is the recent milestone of surpassing 50%.
Ali H. Mokdad, PhD, told Medscape Medical News , "My concern now is that people who don't want to get vaccinated look around and say, 'Oh, we're in a really good position. Infections are down, more than 50% of Americans are vaccinated. Why do I need to get vaccinated?'"
Another potential problem is waning immunity, added Mokdad, a professor of health metrics sciences at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. Companies are developing booster doses, and Anthony Fauci, MD, the White House's chief scientific advisor, said they might be needed in the future.
Mokdad said this could increase vaccine hesitancy. "Someone might think, 'Why should I get this vaccine when there's a new one? If I wait two months, I'll get a new one.'"
“We can definitely be optimistic. Things are moving in the right direction,” Dr. John Segreti told Medscape Medical News when asked to comment. “The vaccines appear to work as well as advertised and hold up in real-world situations.”
However, "it's too soon to say it's over," he emphasized.
"There is still moderate to substantial community transmission in almost every part of the U.S. It may take some time before we see transmission rates decline to the point where the pandemic will be declared over," added Segreti, a hospital epidemiologist and medical director of infection control and prevention at Rush University Medical Center in Chicago, Illinois.
The global outlook is another reason for pessimism, he said. “There isn’t enough vaccine for everyone. As long as there is uncontrolled transmission of the coronavirus anywhere in the world, there is a greater chance of selecting for variants and strains that can escape the vaccine.”
"But overall I'm much more optimistic than I was 6 months ago," Segreti added.
Vaccines vs variant
In a study evaluating two COVID-19 vaccines against the B.1.167.2 variant first reported in India, researchers assessed data from Public Health England and reported reassuring news that the vaccines protected against this variant of concern. They studied the efficacy of the Pfizer/BioNTech and AstraZeneca/Oxford vaccines.
"After two doses of either vaccine, there were only modest differences in vaccine effectiveness with the B.1.617.2 variant," the researchers noted. "The absolute differences in vaccine effectiveness were most pronounced with the first dose. This would help maximize vaccine uptake with two doses among vulnerable groups."
The study was published online on May 22 as a preprint on MedRxiv. It has not yet been peer-reviewed.
The positive findings sparked much discussion on Twitter, with some still urging caution about celebrating the end of the pandemic. For example, a tweet from Aris Katzourakis, a paleovirologist and researcher at Oxford University, UK, questioned how the results could be interpreted as good news "unless their background was unreasonably catastrophic."
"It depends on what happens with hospitalizations and deaths, as Andrew Pollard said this morning," responded Charlotte Houldcroft, PhD, a postdoctoral research associate at the University of Cambridge in the UK.
Pollard also told The Guardian : “We can live with the virus; in fact, we’re going to have to live with the virus in one form or another. We just need a little more time to be certain about this.”
Seasonal variation?
Others acknowledge that while cases are declining in the US, it could mean that COVID-19 will become a seasonal illness like the flu. If that is the case, they warn, a lull in COVID-19 cases during warmer weather could foreshadow another surge in the winter.
But, Segreti said, it's too early to say.
"It's reasonable to expect that at some point we'll need reinforcements," he added, but the timeline and frequency remain unknown.
Economic indicators
The US economy was operating at 90% of where it was before the pandemic, according to the 'Back to Normal Index' calculated by CNN Business and Moody's Analytics based on 37 national and seven state measures.
The index improved in 44 states in the week leading up to May 26, which could also reflect an overall improvement in the COVID-19 pandemic.
State and federal unemployment figures, job postings and hiring rates, and personal savings appear to be trending positive. Conversely, box office sales, hotel occupancy, and domestic air travel continue to struggle.