Is It Always Going to Be Like This Now?

I was on the phone with a friend last week, someone who has been fairly cautious about COVID, and we got onto how she was feeling about Omicron, and the current situation in general. “Honestly, I’m a little lost. It felt like we were just getting comfortable planning things again. And now … should we stop?” I heard a version of this over and over again last week. “We were just going to do the holidays normally again.” “I was just getting comfortable with the idea of a playdate.” “I was going to plan a trip to Disney, finally.” And the questions end in the same way: and now what? Of course, much of this was brought on by the Omicron discussion. There is a lot that is still unknown, although we’ve learned much more in the past couple of weeks. I’d point you again to Katelyn Jetelina for details. On the negative side, the variant appears to be more transmissible, and vaccines provide less robust protection against infection. On the positive side, vaccines — especially with a booster — do continue to provide a good degree of protection. And (even without a booster) vaccines appear to continue to provide strong protection against severe illness and death. The other good news is that some early data is suggesting that Omicron may generate overall more mild illness. There is surely more to come here over the next few weeks. From a public health standpoint, the advice in light of Omicron hasn’t changed. Get all eligible people vaccinated. Get a booster if you’re over 18. Stay home if you’re sick. Rapid test if you can when gathering. Wear a mask in crowded indoor spaces if transmission is high and on public transit. Having said all this: most of the questions I hear are not really about the medical details of Omicron. The angst is broader. The variant renewed feelings of fear, of anxiety. Will we ever just be able to have a f*ing playdate or plan a vacation? Not everyone feels this, but I hear from a lot of readers who do. And, if we’re being honest, it’s a way I feel too. I’m struggling with the issue of future planning. I am a planner; always have been. Omicron was a bit of a spiral because I really want to be able to think about what we’ll be doing in February or May, and the specter of returning to a place of uncertainty is upsetting. It’s made more so by the Groundhog Day feeling of Is it just always going to be like this? In a way, the answer to this is yes, because COVID isn’t going away. There will be evolutions, other variants, changes in the disease environment. In another way, though, we can better adapt, to make our decisions more consistent and our emotional reactions less intense. In that spirit, I have two reflections. Maybe they resonate and maybe they don’t. But if they do, I hope they help. Can I do more stuff now? At the moment, nothing about Omicron suggests that you should act differently, assuming all eligible household members are vaccinated, etc. There is a risk of COVID breakthrough infections even with Delta; and it seems likely that vaccines will remain highly protective against serious illness even with Omicron. What has happened, though, is that the renewed discussion has reminded people of COVID. It has made it salient again, just as some people were starting to move on. The mistake we’re making isn’t the decision to move toward normalcy, which we must do and which we can do safely with reasonable precautions. The mistake is to base that movement decision on just ignoring COVID. If we’re thinking, “It’s fine to do playdates now, because COVID is essentially over,” then any reminder that it’s not over can cause us to lurch to a different decision. Instead, we need to think about these decisions with a realistic stance on the existence of non-zero COVID risks. And the recognition they will likely exist essentially forever. Back in May 2020 I wrote about COVID decision-making in a five-step process (read it here), and, while much has changed, some hasn’t. The first step in that process was to frame the question, and I continue to think that is a crucial step. You cannot ask the question “Should I allow my toddler to have a playdate this weekend or not?” since “or not” is an impossible option to evaluate. You need to put something in place of or not — an actual, concrete alternative. Next weekend? In a month? When they’re vaccinated? Never? If you go through a decision process, you may well decide that allowing a playdate now is preferable to waiting until some uncertain vaccine date in the future. There are benefits to socialization for kids (and adults!), and the risks to small children, even unvaccinated ones, are extremely low. But you make that decision not based on “COVID is over!” but on a realistic view that COVID is in the range of risks you are comfortable taking. The benefit, then, is that when you’re reminded that COVID isn’t over, it’s not so surprising. Your choices could very well still be the right ones. Planning for the future Can I plan a trip to Disney in February? Can we still plan for our visit over Christmas? Uncertainty can be paralyzing. You want to do it, but … what if? When the virus is more salient, the uncertainty is more salient. Sometimes it feels like looking six months out into some kind of fog. Can I really put plans into the fog? Yes. You can. The future is always a little foggy. That Christmas trip you planned to the Bahamas? Even before COVID, all kinds of stuff could get in the way. Your toddler could get norovirus. You could miss your flight. Your flight could be canceled. It could rain the whole time. The resort could shut down unexpectedly due to bankruptcy (this happened to me once). COVID — and the possible policy reactions to COVID — adds another dimension to this uncertainty, but it was there in a substantial way before too. When we plan, even into the fog, we get the value of what economists sometimes call anticipatory utility. (This is even the topic of some of my research, albeit in a very different context.) We can enjoy thinking about the trip, and this can happen even if it has some uncertainty around it. Before COVID, you enjoyed thinking about your trip even though there was always the possibility of a canceled flight or last-minute work emergency. You can do the same now. Summing up There is a complicated subtlety to this advice and this phase. Learning to live with endemic COVID — which, yes, is what we are going to need to do — is going to mean accepting the existence of COVID and taking precautions. But it will also mean acknowledging that it isn’t the only risk or even probably the most significant risk we face most of the time. We need to arrive at a point where we take a rapid test when we need to, but COVID doesn’t live rent-free in our heads all the time. Is it always going to be like this? In a sense, yes. But we can learn to adapt.

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