WRITE YOUR OWN ENDING — I dream of the day I can burn all of my masks. It will be a day when I don't have to check, "wallet, keys and oh yeah mask," before I leave the house. A day when I can put on big dangly earrings without struggling to pull the loops over my ears. A day when I finally know what my writing students at the University of Texas at El Paso actually look like. A day when I can see my kids' faces in their class pictures. To me, that will be the day that signals the end of the pandemic, the moment when the crisis has passed and Covid-19 no longer figures into our daily cost-benefit analysis. It will be the moment when I can start saying "post-pandemic." It's also a day that seems ever elusive. Nearly 60 percent of the U.S. population has been fully vaccinated, but 46,000 people are being hospitalized and 1,200 people are still dying every single day, according to the New York Times . Even those who personally feel the pandemic is over — or was never that much of a threat — still have to contend with the minor inconveniences and major disruptions of Covid. They still have to wear masks in planes and other public spaces and quarantine after getting a positive test. Back in February, I asked a group of Nightly experts how we would know if the pandemic was over. They gave me specific answers: case numbers, vaccination rates, positive test ratios. No one predicted a #CovidZero scenario, but it seemed like we would soon hit a threshold and declare victory. We thought, back then, that we would all be back in the office by now. That was before the Delta variant, evidence of waning vaccine immunity and growing concerns over Covid in kids. So I reached out to the same group of experts this week to re-ask my question about the pandemic's end. Nine months later, they were far less sure about what it would look like and how we would get there. "I don't know what equilibrium will be," said Jeffrey Shaman, a professor of environmental health sciences at Columbia University, who correctly predicted a period of premature exuberance last time around. "I would prefer you would not quote me on a number." The critical numbers to watch, Shaman said, are hospitalizations and infection fatality ratios — the proportion of people who die after being infected. Right now the vaccinated are far better protected than the unvaccinated: a Texas study showed that unvaccinated people made up 85 percent of the state's total Covid deaths from mid-January to October this year. "Covid-19 is a different threat than it was before vaccines," said Abraar Karan, an infectious disease doctor at Stanford University. But, he said, the biggest open question is whether the Covid vaccine's efficacy will wane over time and whether a booster is the last shot in a three-shot series or an annual necessity. A variant that renders the vaccine less effective could emerge, too. Overall, Karan said he's looking to see daily deaths fall below 200 a day — a marker we hit briefly during the summer — and stay there. Worthy goals, according to Saskia Popescu, an epidemiologist with George Mason University and the University of Arizona, would be: 5 new cases per 100,000 people over seven days; transmission rates below 0.9; vaccination rates above 75 percent; and a percentage of hospital patients with Covid of between 1 and 10 percent. In the U.S., only Puerto Rico is close to all those numbers, according to Covid Act Now. Nearly two years after the first detected cases in China, we are still early in the trajectory of a novel virus, Popescu said. At some point in the future — after vaccination rates are high globally and after community transmission levels are low — the challenge will shift to monitoring and addressing small regional outbreaks. But not yet. Declaring the end of the pandemic is more a question of values and politics than of science, Arthur Caplan, a bioethics professor at NYU's Grossman School of Medicine, said when I reached him, repeating what he told me in February. Maybe a better vaccine will come along or deaths will fall dramatically. Therapeutics to better treat Covid are already on the way. But ultimately we — individuals, parents, states, school boards, businesses — will have to keep deciding how much Covid we are willing to tolerate in exchange for living without masks and testing and quarantine requirements, Caplan said. It's what we have done all along. Before the pandemic, immunocompromised people were told to mask up during flu season, Caplan points out. Post-pandemic, whenever that is, even if Covid becomes less deadly and virus levels fall, some people may decide that a trip to the movie theater isn't worth the risk or hassle of getting Covid, but a family visit is. Shaman had another non-numerical post-pandemic marker in mind, one I think about a lot too: "When you guys don't have to write about it that often," he said, "that will be the benchmark."
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