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January 6, 2022

A National Strategy for the “New Normal” of Life With COVID

Author Affiliations
  • 1Perelman School of Medicine and The Wharton School, University of Pennsylvania, Philadelphia
  • 2Center for Infectious Disease Research and Policy, University of Minnesota, Minneapolis
  • 3Grossman School of Medicine, New York University, New York, New York
JAMA. 2022;327(3):211-212. doi:10.1001/jama.2021.24282

As the Omicron variant of SARS-CoV-2 demonstrates, COVID-19 is here to stay. In January 2021, President Biden issued the “National Strategy for the COVID-19 Response and Pandemic Preparedness.” As the US moves from crisis to control, this national strategy needs to be updated. Policy makers need to specify the goals and strategies for the “new normal” of life with COVID-19 and communicate them clearly to the public.

SARS-CoV-2 continues to persist, evolve, and surprise. In July 2021, with vaccinations apace and infection rates plummeting, Biden proclaimed that “we’ve gained the upper hand against this virus,” and the Centers for Disease Control and Prevention (CDC) relaxed its guidance for mask wearing and socializing.1 By September 2021, the Delta variant proved these steps to be premature, and by late November, the Omicron variant created concern about a perpetual state of emergency.

In delineating a national strategy, humility is essential. The precise duration of immunity to SARS-CoV-2 from vaccination or prior infection is unknown. Also unknown is whether SARS-CoV-2 will become a seasonal infection; whether antiviral therapies will prevent long COVID; or whether even more transmissible, immune-evading, or virulent variants will arise after Omicron.

Another part of this humility is recognizing that predictions are necessary but educated guesses, not mathematical certainty. The virus, host response, and data will evolve. Biomedical and public health tools will expand, along with better understanding of their limitations. The incidence of SARS-CoV-2, vaccination rates, hospital capacity, tolerance for risk, and willingness to implement different interventions will vary geographically, and national recommendations will need to be adapted locally.

It is imperative for public health, economic, and social functioning that US leaders establish and communicate specific goals for COVID-19 management, benchmarks for the imposition or relaxation of public health restrictions, investments and reforms needed to prepare for future SARS-CoV-2 variants and other novel viruses, and clear strategies to accomplish all of this.

Redefining the Appropriate National Risk Level

The goal for the “new normal” with COVID-19 does not include eradication or elimination, eg, the “zero COVID” strategy.2 Neither COVID-19 vaccination nor infection appear to confer lifelong immunity. Current vaccines do not offer sterilizing immunity against SARS-CoV-2 infection. Infectious diseases cannot be eradicated when there is limited long-term immunity following infection or vaccination or nonhuman reservoirs of infection. The majority of SARS-CoV-2 infections are asymptomatic or mildly symptomatic, and the SARS-CoV-2 incubation period is short, preventing the use of targeted strategies like “ring vaccination.” Even “fully” vaccinated individuals are at risk for breakthrough SARS-CoV-2 infection. Consequently, a “new normal with COVID” in January 2022 is not living without COVID-19.

The “new normal” requires recognizing that SARS-CoV-2 is but one of several circulating respiratory viruses that include influenza, respiratory syncytial virus (RSV), and more. COVID-19 must now be considered among the risks posed by all respiratory viral illnesses combined. Many of the measures to reduce transmission of SARS-CoV-2 (eg, ventilation) will also reduce transmission of other respiratory viruses. Thus, policy makers should retire previous public health categorizations, including deaths from pneumonia and influenza or pneumonia, influenza, and COVID-19, and focus on a new category: the aggregate risk of all respiratory virus infections.

What should be the peak risk level for cumulative viral respiratory illnesses for a “normal” week? Even though seasonal influenza, RSV, and other respiratory viruses circulating before SARS-CoV-2 were harmful, the US has not considered them a sufficient threat to impose emergency measures in over a century. People have lived normally with the threats of these viruses, even though more could have been done to reduce their risks.

The appropriate risk threshold should reflect peak weekly deaths, hospitalizations, and community prevalence of viral respiratory illnesses during high-severity years, such as 2017-2018.3 That year had approximately 41 million symptomatic cases of influenza, 710 000 hospitalizations and 52 000 deaths.4 In addition, the CDC estimates that each year RSV leads to more than 235 000 hospitalizations and 15 000 deaths in the US.3 This would translate into a risk threshold of approximately 35 000 hospitalizations and 3000 deaths (<1 death/100 000 population) in the worst week.

Today, the US is far from these thresholds. For the week of December 13, 2021, the CDC reported the US experienced more than 900 000 COVID-19 cases, more than 50 000 new hospitalizations for COVID-19, and more than 7000 deaths.5,6 The tolerance for disease, hospitalization, and death varies widely among individuals and communities. What constitutes appropriate thresholds for hospitalizations and death, at what cost, and with what trade-offs remains undetermined.

This peak week risk threshold serves at least 2 fundamental functions. This risk threshold triggers policy recommendations for emergency implementation of mitigation and other measures. In addition, health systems could rely on this threshold for planning on the bed and workforce capacity they need normally, and when to institute surge measures.

Rebuilding Public Health

To cope with pandemic, and eventually, endemic SARS-CoV-2 and to respond to future public health threats requires deploying real-time information systems, a public health implementation workforce, flexible health systems, trust in government and public health institutions, and belief in the value of collective action for public good.7,8

First, the US needs a comprehensive, digital, real-time, integrated data infrastructure for public health. As Omicron has reemphasized, the US is operating with imprecise estimates of disease spread, limited genomic surveillance, projections based on select reporting sites, and data from other countries that may not be generalizable. These shortcomings are threatening lives and societal function.

The US must establish a modern data infrastructure that includes real-time electronic collection of comprehensive information on respiratory viral infections, hospitalizations, deaths, disease-specific outcomes, and immunizations merged with sociodemographic and other relevant variables. The public health data infrastructure should integrate data from local, state, and national public health units, health care systems, public and commercial laboratories, and academic and research institutions. Using modern technology and analytics, it is also essential to merge nontraditional environmental (air, wastewater) surveillance data, including genomic data, with traditional clinical and epidemiological data to track outbreaks and target containment.

Second, the US needs a permanent public health implementation workforce that has the flexibility and surge capacity to manage persistent problems while simultaneously responding to emergencies. Data collection, analysis, and technical support are necessary, but it takes people to respond to crises. This implementation workforce should include a public health agency–based community health worker system and expanded school nurse system.

A system of community public health workers could augment the health care system by testing and vaccinating for SARS-CoV-2 and other respiratory infections; ensuring adherence to ongoing treatment for tuberculosis, HIV, diabetes, and other chronic conditions; providing health screening and support to pregnant individuals and new parents and their newborns; and delivering various other public health services to vulnerable or homebound populations.

School nurses need to be empowered to address the large unmet public health needs of children and adolescents. As polio vaccination campaigns showed, school health programs are an efficient and effective way to care for children, including preventing and treating mild asthma exacerbations (often caused by viral respiratory infections), ensuring vaccination as a condition for attendance, and addressing adolescents’ mental and sexual health needs. School clinics must be adequately staffed and funded as an essential component of the nation’s public health infrastructure.

Third, because respiratory infections ebb and flow, institutionalizing telemedicine waivers, licensure to practice and enable billing across state lines, and other measures that allow the flow of medical services to severely affected regions should be a priority.

Fourth, it is essential to rebuild trust in public health institutions and a belief in collective action in service of public health.7 Communities with higher levels of trust and reciprocity, such as Denmark, have experienced lower rates of hospitalization and death from COVID-19.7 Improving public health data systems and delivering a diverse public health workforce that can respond in real time in communities will be important steps toward building that trust more widely.


After previous infectious disease threats, the US quickly forgot and failed to institute necessary reforms. That pattern must change with the COVID-19 pandemic. Without a strategic plan for the “new normal” with endemic COVID-19, more people in the US will unnecessarily experience morbidity and mortality, health inequities will widen, and trillions will be lost from the US economy. This time, the nation must learn and prepare effectively for the future.

The resources necessary to build and sustain an effective public health infrastructure will be substantial. Policy makers should weigh not only the costs but also the benefits, including fewer deaths and lost productivity from COVID-19 and all viral respiratory illnesses. Indeed, after more than 800 000 deaths from COVID-19, and a projected loss of $8 trillion in gross domestic product through 2030,8 these interventions will be immensely valuable.

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Article Information

Corresponding Author: Ezekiel J. Emanuel, MD, PhD, Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Blockley Hall, Philadelphia, PA 19104 (zemanuel@upenn.edu).

Published Online: January 6, 2022. doi:10.1001/jama.2021.24282

Conflict of Interest Disclosures: Dr Emanuel reported personal fees, nonfinancial support, or both from companies, organizations, and professional health care meetings and being a venture partner at Oak HC/FT; a partner at Embedded Healthcare LLC, ReCovery Partners LLC, and COVID-19 Recovery Consulting; and an unpaid board member of Village MD and Oncology Analytics. Dr Emanuel owns no stock in pharmaceutical, medical device companies, or health insurers. No other disclosures were reported.

Additional Information: Drs Emanuel, Osterholm, and Gounder were members of the Biden-Harris Transition COVID-19 Advisory Board from November 2020 to January 2021.

Remarks by President Biden celebrating Independence Day and independence from COVID-19. July 4, 2021. https://bit.ly/3mJaGnQ
Gounder  C.  The progress of the Polio Eradication Initiative: what prospects for eradicating measles?   Health Policy Plan. 1998;13(3):212-233. PubMedGoogle ScholarCrossref
CDC Health Action Network. Increased interseasonal respiratory syncytial virus (RSV) activity in parts of the southern United States. June 10, 2021. Accessed November 8, 2021. https://emergency.cdc.gov/han/2021/han00443.asp
National Center for Immunization and Respiratory Diseases. Estimated flu-related illnesses, medical visits, hospitalizations, and deaths in the United States—2017-2018 flu season. September 30, 2021. Accessed November 8, 2021. https://www.cdc.gov/flu/about/burden/2017-2018.htm
COVID Data Tracker Weekly Review. Reported cases. November 5, 2021. Accessed December 30, 2021. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
JHU Coronavirus Resource Center. Weekly hospitalization trends. Updated November 8, 2021. https://coronavirus.jhu.edu/data/hospitalization-7-day-trend/inpatient-capacity
Makridis  CA, Wu  C.  How social capital helps communities weather the COVID-19 pandemic.   PLoS One. 2021;16(1):e0245135. PubMedGoogle Scholar
Swagel  P. Letter to Senate Majority Leader Schumer: comparison of CBO’s May 2020 interim projections of gross domestic product and its January 2020 baseline projection. May 2020. Accessed November 8, 2021. https://www.cbo.gov/system/files/2020-06/56376-GDP.pdf
13 Comments for this article
Primary Care at the Center of the New Normal
Howard Haft, MD, MMM | Maryland Department of Health
The authors provide a credible description of the future of our relationship with Covid-19 and a nearly complete list of the actions that are needed to cope with the new reality and be prepared for future threats. However the largest part of the healthcare delivery system was notably absent on this list, the primary care workforce. Primary care, when well resourced and integrated with public health, provides the ability to implement public health strategies broadly across states and jurisdictions. Widely deployed, capable of immunizing populations, testing for both surveillance and treatment, and highly trusted communicators of mitigation strategies, this workforce has the capability of filling in many of the gaps in the current public health system.

For example, the broadly implemented Maryland Primary Care Program has demonstrated how bringing public health tools and resources to primary care can amplify and support public health response to a pandemic, amplifying the coordinated statewide response to testing, vaccination and therapeutics.

As we contemplate the future of the overall healthcare delivery system in the USA , integrating primary care with public health should be a key initiative, with primary care serving as a public good.
Judy Malmgren, PhD Epidemiology | University of Washington
I have been thinking along these same lines for months. So glad someone else wrote the piece! We need to reestablish the public health traineeship program in Schools of Public Health that paid part of my tuition to become an epidemiologist. We need replacements for me and my cohort as we retire, but with an increase in numbers. Systems and infrastructure that function on a large scale need to be built that can handle millions of cases. Already the reporting scales used by health departments are inadequate. Build the infrastructure -  we need it desperately.
A National Strategy for a Disunited Nation?
Steven Livesey, History of Science | University of Oklahoma
In their paper, the authors urge the creation of a new national strategy to look beyond the current Covid-19 crisis and to bring Covid responses into a larger, more robust public health system. They assert, “To cope with pandemic, and eventually endemic SARS-CoV-2, and to respond to future public health threats requires deploying real-time information systems, a public health implementation workforce, flexible health systems, trust in government and public health institutions, and belief in the value of collective action for public good.”

These are laudable goals and certainly recognitions of necessary components. But nowhere in their essay do
the authors tell us how we are to achieve trust in government and belief in the value of collective action for public good. On the anniversary of the January 6 insurrection, we seem to be very far from this collective purpose, and no one seems to have a feasible plan to rebuild the trust that has been eroding for at least the past 2 generations. We cannot convince sizable populations to adopt basic public health strategies like wearing masks in close interior spaces, and state governments across the country are actively opposing mitigation strategies that the authors suggest.

Until the authors augment their paper by explaining how to heal the disunity so prevalent in modern America, I see little in the recommendations here that will be implemented successfully.
Endorsement and Integration with Mental Health Care
John P. Glazer, MD | Child and Adolescent Psychiatry
All Americans, and the medical provider community who serve our citizens, owe Dr. Emanuel and his colleagues a debt of gratitude. It is not comfortable to speak out so directly but absolutely necessary in the health crisis we all face.

I urge all Americans to take the authors’ specific recommendations with the utmost seriousness and the Biden administration to immediately open communication channels with these distinguished physician members of the former Biden transition team; and urge that the burden COVID, flu, and other respiratory viruses pose for Americans with limited resources, and those dealing with depression, anxiety, and suicidal
feelings, particularly children and teens, be directly addressed, with desperately needed treatment resources directed to them.
COVID Data Analysis
David Loiterman, MD | Past Board Chair and President, Chicago Medical Society ( Ret )
Thank you for publishing Dr Emanuel and colleague’s perspective on proposed forward-looking strategies for dealing with COVID, RSV, and other endemic respiratory pathogens.

The two newly released antiviral anti-replicative medications as well as other creative antiviral medications in the regulatory pipeline will play a large role in future management.

Data context is also important when forming public health policy. Approximately 10,000 US residents die every day. Roughly 1600 of those are expected to be attributed to viral, bacterial, and respiratory diseases within a range of expected variance at the 95% confidence level.

In formation
of appropriate public health policy the distinction between mortality with COVID and mortality directly related to COVID is important to make.
What's Not to Agree With?
John Zahradnik, MD | Private Infectious Diseases consultant
This editorial supports what myself and a few others have been preaching for the past year. COVID-19 will never leave us for the foreseeable future. Too many people declining to wear masks, denying the disease, and insisting on the uselessness of any vaccine.

I totally agree that the country needs a plan similar to what is presented here. The trouble is roughly half of US elected officials do not believe this is a problem and have long ago accepted influenza deaths as inevitable and not preventable.

I will continue to receive the necessary vaccines and mask
up today and in the future. My family does the same and hopefully will in the future.

Whence "Trust in Government and Belief in the Value of Collective Action"?
Jim Recht, MD | Instructor, Harvard Medical School
Its omission of economics/politics renders this statement practically useless. The authors affirm that "trust in government and public health institutions, and belief in the value of collective action for public good" are pre-requisites for an adequate response to respiratory virus pandemics. But this just begs the question of why our society appears so devoid of trust or shared belief. The authors offer a hint, by comparing our own dismal COVID response to Denmark's. What is it about Denmark that lends itself to trust, collective tolerance, and a sustainable response to widespread serious illness outbreaks?

The answers are pretty elementary:

1. Universal healthcare, and
2. One of the world's lowest income equalities.

These are not extraneous matters. They are crucial to the development and maintenance of a viable public health system.

When are we health professionals going to acknowledge this and act accordingly?

Focus on Improving Personal Health
Eileen Natuzzi, MD, MPH | Trauma surgeon (retired); San Diego Department of Public Health (volunteer)
The authors stay focused on the same measures used throughout this pandemic and do not go beyond those measures or read what community tolerances for those measures have been. Their view is bureaucratic and not from the public's standpoint. It’s not a matter of doing more but rather what was tolerable to the public and what messaging worked. The authors hint at the possibility of lockdown or other severe measures for bad annual flu outbreaks but a weary and mistrusting public will ignore or push back against any additional constraining measures. Instead we need to encourage self-empowering behaviors such as improving one’s personal health risks through weight loss, better dietary habits, and regular exercise.

Part of rebuilding the public health system must include the seamless integration of public health with the healthcare system. That has to include public service announcements and education that focuses on preventing diseases that put people at serious risk of respiratory infections. Two years into this pandemic we know what those risks are but have made no significant headway in helping the public address them.
As the authors write, the vaccines will not take us to zero COVID. And while they have afforded protection from serious illness we are still placing way too much faith in them. The new public health paradigm must promote, not mandate, healthy habits and practices that can empower the public not restrict them. We can not do this with vaccines alone.

No Surrender - Where There's a Will There's a Way
Yaneer Bar-Yam, Ph.D. and Coauthors | World Health Network
The authors propose that, in contrast to a zero COVID policy, we surrender to the pandemic, setting an acceptable level of deaths as policy success. In an accompanying article Michales, Emanuel, and Bright propose this can be achieved by improved vaccination, testing, surveillance, masking, ventilation and distancing.

Preventing exponential growth is the key to any control strategy, including the authors. There is no “level control”; rather the control variable is a growth rate R. Staying at a particular level requires keeping R=1, and if we could keep R=1 we could equally set R a bit lower and go down
to any level we choose.

A surge mentality might reduce the impact of variants or seasons. However, once that can be achieved, it is not only possible to reach elimination, it is easier, just as controlling a fire is easier when it's smaller. The easiest by far is elimination, even if there are new fires that arise from time to time.

The authors may have the misconception that there is a tradeoff with economic costs or individual freedom, debunked by economists widely, including those of the IMF [1-3]. Economic losses are higher and freedom restrictions more severe due to the need to eventually control a conflagration rather than relying primarily on contact tracing for a limited number of local outbreaks. Indeed, states in Australia that abandoned elimination aren’t returning to pre-pandemic mobility (Capital territory -27% in Q4, Victoria -20%, New South Wales -19%) measured by Google mobility data (Workplace % change from early 2020). Deaths are up and mobility is down. They are losing on all fronts. On the contrary, where elimination continued to be the goal, mobilities in Q4 had a slight increase (+2% Northern Territory or Queensland vs 5 weeks in early 2020) or a slight decrease (-3% South Australia) [4].

Also missing from their considerations is accumulation of long covid over time, with widespread loss of normal life, organ damage, and disability.

Or perhaps the authors are fatalistic about elimination. Despite the rapid transmission of Omicron, the recommendations they make—a surveillance system with widely available testing—are sufficient. Testing four times a week with self-isolation is enough. Even better would be twice daily saliva tests leading to a more rapid decline than Omicron’s growth. Combining this with other mentioned methods—N95/KN95 masks, distancing, ventilation—would make this even easier.

We are proposing the same actions, but with a different goal: more ambitious, more compassionate, and more, rather than less, feasible—and a strategy for this pandemic and the next one.

Not everyone may participate, but all-in participation is unnecessary for success, which is not guaranteed. Still, this is a robust strategy. Even if not all goals are reached, striving for elimination is the path paved with greater success along the way.

Where there is a will, there is a way.

We cannot surrender to COVID. A level of “acceptable deaths” is a euphemism for saying it is acceptable that immunocompromised people and those with risk factors that make them vulnerable to severe disease can die.

Y Bar-Yam {1,6}

S Bilodeau {2,6}

C Philippe {3,6}

MF Schneider {4,6}

SK Raina {5,6}

EL Ding {1,6}

NN Taleb {1,6}



2} Smart Phases, USA

Institut économique Molinari, France 4} Physics Dept, Tech Univ of Dortmund, Germany 5} Dr. RP Govt. Medical College, India 6} World Health Network


1] SARS-CoV-2 elimination, not mitigation, creates best outcomes for health, the economy, and civil liberties Oliu-Barton, Miquel et al.The Lancet, Volume 397, Issue 10291, 2234 - 2236.

2] https://www.institutmolinari.org/wp-content/uploads/2021/09/zero-covid-whn-sept2021.pdf 

3] https://www.imf.org/en/Publications/WEO/Issues/2020/09/30/world-economic-outlook-october-2020 

4] Google COVID-19 Mobility Reports - https://www.google.com/covid19/mobility/

In an Advanced Nation This would be Possible
Christopher Cervantes, MD | Urgent Care
I agree with Professor Livesey.

To put it bluntly, these suggestions are painful fantasies for a nation as backward-looking as the United States. I am lucky to live and practice in a municipality that has made a valiant effort resisting the deliberate sabotage of public health measures by politicians and judges at the state and federal level, but we’re not the kind of nation that believes in the same set of facts, much less the same threats or the collective actions required to meet those threats.

I recommend JAMA emphasize strategy pieces that can be implemented
locally in a highly fragmented society. This is our reality.
Towards a Better US Public Health System – Alert Levels, Alliances, & Advocacy
Maria Schletzbaum, MD / PhD Epidemiology (candidate, MSTP Program) | University of Wisconsin School of Medicine and Public Health
Drs. Emanuel, Osterholm, and Gounder present key social and biological reasons underlying the likelihood that in the US and elsewhere we will need to adapt to living with SARS-CoV-2, crucially moving past biomedicine’s historical preoccupation with pathogen elimination. While laudable, it should be noted that eradication has succeeded only twice and, as the authors allude to, under vastly different biological parameters.

Perhaps most importantly, the authors present four key elements for building the US public health infrastructure. While the authors highlight some of the most pressing holes identified by the pandemic – data infrastructure, personnel, and trust –
three vital points should be expanded upon as necessary to implementing the outlined vision for US public health:

1. Regarding the “national risk level” and “risk threshold[ing],” we can do, and other countries have done, much better than having a single level based on weekly national counts of cases, hospitalizations, and mortality. The development of a public health alert level system, such as the one used by New Zealand (1), could be implemented at not just national but also state and local levels. Critically, the alert levels should be tied to public health actions, such as mask mandates or gathering restrictions. This will bring transparency, consistency, and a greater ability to anticipate future public health guidance, addressing criticisms currently brought against public health messaging in the US. These alert levels can be based on multiple objective metrics derived from local data, providing real-time risk information to the public, and should be shielded from real or perceived political influence.

2. We need to acknowledge that past US pandemic strategies have been too narrowly focused on the public health system and short-term threats, with little attention paid to other systems that keep society moving, especially over prolonged periods of time. Part of the building of American’s public health infrastructure must include greater integration with other systems, including healthcare organizations, schools, non-profits, businesses, and industry. It is not just public health that needs a pandemic plan, but every organization, institution, company, and level of government that needs guidance and altering of operations under public health emergencies.

3. The authors rightly highlight the ‘collective action problem’ that faces public health. Done well, public health benefits nearly everyone (though not necessarily equally) in ways that are imperceptible. Thus, public health does not have concentrated interest groups lobbying for it, but there are often powerful concentrated interest groups lobbying against specific public health-oriented actions or policies. At times, some of the fiercest opposition to expanded public health infrastructure has come from physician professional organizations and the healthcare industry. Implementing some of the programs the authors mention (school health expansion, real-time data sharing) will require concessions and support from these powerful groups. In medicine, it will be crucial for us to move beyond the protection of our professional sphere in order to lend our powerful voices to improving the health of the American public by endorsing the building of America’s public health infrastructure.


1) New Zealand Government. History of the COVID-19 Alert System. https://covid19.govt.nz/about-our-covid-19-response/history-of-the-covid-19-alert-system/#alert-levels. Updated December 3rd 2021. Accessed January 18, 2022.

Public Health and Public Trust
Michael Akers, Pharm.D. | Retired
While the essay by Ezekiel et al provides a framework for moving forward with COVID in America, it does not address conceptions of individual freedom. The authors' fourth point suggests that elevating the level of trust in public health institutions will allow for more robust collective action for public health in America. Denmark is then highlighted as exemplary for their level of trust for public health. The accompanying citation does not include any discussion of Denmark’s level of trust for public health. In fact, the only country specifically mentioned in the citation is China. This adds an interesting twist when speaking of social trust, because can social trust be accurately measured in China when compliance is required as opposed to optional?

People often do not understand the pushback regarding public health policy in America. It is because while any policy may provide benefit for some individuals, there is no way it can provide benefit for all individuals. No public health policy will affect everyone equally. Individuals are the only ones who can and should be making decisions regarding their health. Does that mean that guidance should not be offered when individuals need health care? Of course not, but the ultimate decisions should be up to the individual.
Daniel Krell, MD | Retired PCP
I’m pleased with this article and with many of the comments, and have thoughts about one aspect mentioned, building public trust. It would be very helpful if news media and influencers are better schooled in the realities of epidemics and pandemics, and infectious diseases in general. I feel disappointment and anger every time a media personality or influencer asks a speaker (epidemiologist, infectious disease expert, CDC or NIH representative, the president, others) to opine when this will be over, and/or when we will be able to return to normal. I have even heard more than one interviewer use the term, "date certain" for when masks, immunizations and other mitigating strategies will no longer be necessary.

There is no "date certain"; we have no idea when the urgency will be over. Given the lack of adequate global vaccination; global travel; organized resistance to mitigation measures; hand-puppet politicians; and mistrust of government and "science, it's not hard to envision national and regional new viral variants that quickly become global. We lucked out with omicron but there is no guarantee that the next global variant will not be distinctly worse. If an informed speaker opines about an estimated timeframe, they will likely be wrong. If the speaker commits the sin of saying, "I don't know," they will be responding honestly but may not be asked again, or asked back, based on their honesty. The interviewer puts the speaker in a lose-lose situation if they demand specifics.

Thus, media personalities and influencers have a responsibility to avoid direct questions about timetables for return to normal, but to work to educate their audiences about the uncertainties at play. I know that such interviewers are motivated to have interesting and provocative interviews to keep their audiences and sponsors attentive and happy, but they do a disservice to the speaker and ultimately the public and the national effort to constructively engage with the pandemic.