Beware Pitfalls of Reopening Too Quickly

Infection Control Today, Infection Control Today, April 2021 (Vol. 25 No.3), Volume 25, Issue 03

As more people become vaccinated, we will be navigating the aspects of a partially vaccinated public. This will be especially challenging as we learn more about prevention of infection and not just severe disease.

There’s been a lot of talk about things reopening. From restaurants to schools and so many places in between, it seems as if we’re moving full steam ahead. Vaccines are being deployed and cases of coronavirus disease 2019 (COVID-19) are down, which we’ve been working toward and should celebrate. Two things come to mind, though: Are we being cautiously optimistic or blindly optimistic? Also, how do we handle this challenging time where developments are trending in the right direction but there are still many unknowns and much work to be done?

First, vaccine distribution is increasing as several states have successfully administered a first dose to at least 17% of their population.1 Now is the time that we work to deploy more doses and address perhaps one of the bigger issues we knew would occur—vaccine hesitancy. This is not a new issue and with a pandemic and vaccine development process that was so politicized, it’s not surprising this would be a biproduct.

Data on vaccine distribution, specifically demographics, have been lagging and the data we do have access to have shed light on significant disparities in recipients. As a recent article in Politico points out, “Limited data continues to show that people in hard-hit minority communities are getting vaccinated at a much slower pace than people in wealthier white ones.”2 Coupled with hesitancy, we have a long road to go. Vaccine equity is a global issue, and the variants are a prime reason why we should be emphasizing this. As the United States and many industrialized countries distribute their vaccines, there is a still a huge disparity as many countries are struggling to gain access.3 These larger issues are important as we look to the future and what the next few months or even years will look like.

One of the trends I’ve noticed is that, as states reopen, they have often failed to do so in an incremental manner. We learned this in Arizona, and unfortunately, the United States has a bad habit of rushing things when the case counts start to decrease the burden on public health and health care. As more people become vaccinated, we will be navigating the aspects of a partially vaccinated public. This will be especially challenging as we learn more about prevention of infection and not just severe disease. As virologist Angela Rasmussen, PhD, noted recently in The New York Times: “Many scientists are reluctant to say with certainty that the vaccines prevent transmission of the virus from one person to another. This can be misinterpreted as an admission that the vaccines do not work. That’s not the case. The limited data available suggest the vaccines will at least partly reduce transmission, and the studies to determine this with more clarity are underway. There should be more data within the next couple of months. Until then, precautionary measures like masking and distancing in the presence of unvaccinated people will remain important.”4 While we wade through this optimistic but unknown period in COVID-19 response, it’s important to continue vigilance and patience in these reopening efforts—both within the hospital and in the public.

References:

  1. Huang P, Carlsen A. How is the COVID-19 vaccination campaign going in your state? National Public Radio. Accessed March 1, 2021. https://www.npr.org/sections/health-shots/2021/01/28/960901166/how-is-the-covid-19-vaccination-campaign-going-in-your-state
  2. Kenen J, Ehley B. Urgency to ramp up vaccination clashes with Biden’s equity focus. Politico. February 22, 2021. Accessed February 25, 2021. https://www.politico.com/news/2021/02/22/covid-vaccine-racial-disparities-470361
  3. McGregor G. Is the global distribution of COVID-19 vaccines about to get more equal? Fortune. February 24, 2021. Accessed February 27, 2021. https://fortune.com/2021/02/24/covid-vaccine-who-covax-first-shipment-poor-country-ghana/
  4. Rasmussen AL. Does the vaccine stop transmission? The New York Times. February 23, 2021. Accessed February 27, 2021. https://www.nytimes.com/2021/02/23/opinion/covid-vaccines-transmission.html
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