COVID-19 Pandemic 2-Year Anniversary: Where Do We Go From Here?

ACROSS AMERICA — There are no greeting cards for this milestone many Americans hoped would never come — and in some cases buried their heads about, turning a public health emergency into a defining political moment:

On Friday, we’re officially two years into the COVID-19 pandemic.

The World Health Organization declared widespread coronavirus outbreaks a global pandemic on March 11, 2020. COVID-19 has taken a staggering toll in the 730 days since, killing more than 6 million people — nearly 1 million of them in the United States — strangling world economies, setting back academic achievement, and triggering seismic shifts in how Americans work, play and go about their lives.

Americans have reason to be hopeful, but at the same time cautious, as the pandemic enters year three.

Nationally, new cases continue to fall after a wintertime omicron variant spike. Hospitalizations are down, too. The White House said in a new coronavirus road map that people who test positive for COVID-19 at pharmacies will be able to get anti-viral pills "on the spot." The new national COVID-19 preparedness plan must be approved and funded by Congress, but formalizes pledges President Joe Biden outlined in his State of the Union speech to make the virus threat more manageable.

And although Centers for Disease Control and Prevention officials expect the virus will continue to circulate in the United States and around the world for years to come, it is also likely to behave like seasonal flu, Dr. Rochelle Walensky, the agency’s director, told NBC News this week.

“The next six months, the next year, will really inform us in terms of what living with this virus is going to look like,” Dr. Henry Walke, the director of the CDC’s Center for Preparedness and Response, told NBC.

And society is more than ready to move past “The Rona,” “covideo” meetups with family and friends, and “covidiots” on opposing sides of what for two years has been relentless political theater — these linguistic tweaks in themselves a coping mechanism that throughout history has served people well in challenging times.

“Our nation is suffering a type of battle fatigue from our long fight with COVID, and the full impact of this pandemic on our national psyche may not be known until long after this difficult period ends,” Dr. Gerald E. Harmon, the president of the American Medical Association, told reporters last month at a gathering of the National Press Club.

“Every one of us is eager to bring this painful chapter to a close,” he said. “But how we emerge from this pandemic — the lessons we learn and apply moving forward, the causes we fight for — will go a long way toward preventing the next great health crisis from gripping our country.”

Poll: Worst Is Over — For Now

Most adults think the worst of the pandemic is behind us and are ready for things to get back to normal, though they’re divided on what exactly that means, according to the Kaiser Family Foundation’s monthly poll for February released last week.

Still, concerns linger that a loosening of restrictions allows the virus to spread unchecked among unvaccinated Americans, who account for about 23.5 percent of the eligible population, according to CDC data.

The Kaiser poll showed 6 in 10 Americans worry that immunocompromised people are being left behind, and almost half think lifting pandemic restrictions will lead to more death, as well as limit their access to health care at overwhelmed hospitals.

At the same time, nearly two-thirds of respondents think the mental health of teenagers would suffer without the loosening of mask guidance and other COVID-19 restrictions or that local businesses would suffer; and about 40 percent fear their financial situations would get worse.

To show just how ready Americans are to move on from COVID-19, the health emergency that upended almost every aspect of Americans’ lives is a non-starter in the midterm elections, the poll found.

Large majorities of Americans say issues such as the economy and inflation, voting rights, foreign policy, health care costs, and immigration are important considerations as they decide how to vote, but COVID-19 didn’t rank among top priorities for any group of voters.

‘We’re In A Very Different Place’

The pandemic isn’t over, virologist Paul Duprex of the University of Pittsburgh told the CBS news magazine “60 Minutes” on Sunday. “But,” he said, “we’re in a very different place today than we were a year ago.”

The availability of vaccines to everyone in the country except the very young children has changed the landscape, Duprex said.

Some 19 million children ages 6 months to 5 years remain unvaccinated. Now that their parents are getting back to work, and they’re returning to day care centers, babies and small children remain at risk of becoming infected with and spreading COVID-19.

Vaccines for children under 5 are held up in trials — a fairly common occurrence, Dr. Paul Spearman, director of the division of infectious diseases at Cincinnati Children's Hospital Medical Center, told ProPublica, because children’s immune systems are different from adults’, meaning vaccine dosages can’t just be kid-sized to match their smaller bodies.

“There's more care taken about safety and finding a precise dose, and more scrutiny, because it's a vulnerable population,” Spearman said.

Vaccination rates also remain low among children 5-11, and vaccine hesitancy among adults isn’t likely to change, health experts say.

Troubling Signs Remain

But even with the positive signals, epidemiologists and other health experts say a victory lap is premature, and that complacency and vaccine hesitancy give new variants a chance to develop.

That’s one of the reasons an expert group convened by the World Health Organization this week walked back its earlier insistence that vaccine boosters were unnecessary and contributed to vaccine inequity, saying in a statement it now “strongly supports urgent and broad access” to booster shots, concluding that full vaccination provides high levels of protection against severe disease and death from the hugely contagious omicron variant.

Also new, the Transportation Security Administration is extending the requirement for masks on airplanes on public transportation until April 18. It’s the third extension of the mandate, which was most recently set to expire March 18.

• Related: As Spring Break Approaches, TSA Insists On Masks

The extension is contrary to the CDC’s recently changed guidance that COVID-19 masks are unnecessary as long as COVID-19 hospitalizations in their communities remain low.

The TSA’s stance is emblematic of the worry nagging Americans that the virus that has upended everyone’s lives for the last two years could roar back. The agency put “continue to wear a face mask” at the top of its list of 10 tips to get through security quickly, released ahead of the busy spring break travel period.

Another troubling sign:

In New York City, BA.2 subvariant cases have tripled in recent weeks. The so-called “stealth omicron” — an omicron mutation within the omicron variant — appears to be “inherently more transmissible than BA.1,” according to the WHO.

• Related: New Omicron COVID Sublineage Triples In New York, Data Shows

The U.N. agency said, though, that the difference in transmissibility is much smaller than between the omicron and delta variants, and that infections overall are declining.

New York City — the epicenter of COVID-19 in the early days of the pandemic — saw 393 new COVID-19 cases Monday, according to state data. That’s far below the daily peak of 46,000 during the omicron surge's height.

How To Live With COVID-19

Living with COVID-19 as an endemic disease depends in large part on human behavior. And that’s tricky, Katherine Wu — a science writer for The Atlantic who has a doctorate in microbiology and immunobiology from Harvard University — told Oregon Public Radio station KMHD.

“Human behavior is one of the largest factors dictating what sort of cast endemicity takes on,” Wu said. “It’s so easy to say, a virus can go endemic. Where are we in that equation? Really, it’s about what endemic future could we be shaping for this virus?”

Americans already are deciding for themselves how to navigate the pandemic, and Wu expects that to continue as COVID-19 becomes more endemic. Some people have accepted a return to a pre-pandemic lifestyle is out of reach and how they live now is “just kind of going to be it from now on,” Wu said.

“Maybe the degree to which they follow pandemic behaviors will toggle up and down, maybe it’s with local case rates or what have you, whatever they’re doing to sort of gauge their level of safety,” Wu said. “But yeah, it may just fundamentally affect the way they live their lives for the rest of this.”

Others are living their lives as they were in 2019, before the pandemic turned everything upside down.

“This is very complicated,” Wu said, “and I think for people who are trying to decide which lane they want to be in for the foreseeable future, or anything beyond that, it is really difficult.”

Harmon, the American Medical Association president, said in his talk before the National Press Club that the lessons of the pandemic should be reflected in public health measures and national health policy.

Harmon touched on the need to replenish the national stockpile of personal protection equipment, boost public health funding, develop more partnerships for rapid development of vaccines, and build out telehealth infrastructure. But he also said it’s time to take a good, hard look at the “extraordinary pressure” the pandemic put on the nation’s medical workers.

“We have come too far as a nation,” he said, “not to learn from the past two years."