An Updated COVID Guide

For four different types of households.

An Updated COVID Guide

By David Leonhardt, NY Times

The new C.D.C. guidance has excited many Americans and scared many others. Some people feel both emotions, understandably enough: They’re excited to start returning to more normal daily life and still scared by a pandemic that is killing about 600 Americans a day.

This morning, I want to think through the real-world implications of the new guidelines for individual families. Those guidelines mostly allow people to behave more freely. But they will also lead some to take new precautions.

I am going to break down households into four categories, depending on vaccination status:

1. The fully vaccinated

This is the easiest category. If everybody in your household is at least two weeks past their full vaccine dose (the second Pfizer or Moderna shot; or the sole Johnson & Johnson shot), you can comfortably resume prepandemic activities.

The vaccine virtually eliminates serious versions of Covid-19 and radically reduces the chances you could contract or spread the virus. For you, Covid is akin to a mild flu that you probably won’t get. You are not at any meaningful risk from a maskless person in the supermarket who may or may not be vaccinated. You face much more danger from the vehicles in the parking lot.

One nuance to keep in mind: If you come down with flulike symptoms, you should consider staying home, or put on a mask when you go out. Even before Covid, that behavior was common in many parts of Asia. It makes extra sense during a pandemic, because symptoms increase the (still small) chances you have a rare “breakthrough” Covid infection that could infect somebody else.

The C.D.C. has also said that vaccinated people should continue to wear masks when visiting hospitals, nursing homes, prisons and homeless shelters or while traveling. And some immunocompromised people will remain vulnerable to Covid, as well as to other health risks.

2. The almost-vaccinated

Many other families are close to being fully vaccinated but not quite there: At least one person — perhaps a 12- to 15-year-old child — is in the process of getting vaccinated but not yet two weeks beyond the full dose.

There is a strong argument for the unvaccinated members of these families to be cautious, especially as society starts to reopen. They should wear masks when indoors or in close conversation with somebody outdoors. They may want to avoid discretionary trips to indoor spaces.

Why? The cost of a few more weeks of precautions is pretty low. To put it another way, you have almost reached the point of safely resuming normal activities. Finish the job.

3. Families with young children

These are some of the hardest cases, because children under 12 seem to be months away from being vaccinated.

There are a few reassuring facts for these families. First, in many of the places where children spend time, Covid transmission is uncommon. It is extremely rare outdoors, and springtime is a good time to be outdoors. The number of outbreaks in schools has also been quite low worldwide, perhaps because children may be less likely to infect others even when they have Covid.

Most reassuring is the fact that Covid is no more serious for children on average than the flu. I have written an article, with charts, that goes into more detail. As I explain, some parents may still choose to be extremely cautious, while others will be more comfortable with normalcy. Both decisions are defensible. Here’s an interview from that article:

Jennifer Nuzzo, an epidemiologist at Johns Hopkins, told me that she viewed decisions about children’s activities as a matter of personal choice that different parents would make differently. In her family, she said she was worried about how a year of pandemic life had hurt her children, by making them less comfortable in social situations. Once all the adults are vaccinated, she plans to restart more activities.

“I can accept the risks of my kids getting Covid, in part because I compare it to the risk of them getting other infectious diseases and the risk seems very, very small,” Dr. Nuzzo said. “I feel that if my kids were to get Covid, they would be OK. I also see the direct harms of their not having a normal life.”

4. The unvaccinated

About 40 percent of U.S. adults have not yet received a vaccine shot. For the country to reduce that number as rapidly as possible, it’s important to acknowledge reality: The vast majority are unvaccinated by choice.

They do not have health problems that prevent them from getting a shot, and they have not been stymied by the logistics of getting a shot. Yes, there are people in both of those groups, and they will need special help as society begins to reopen. Among other things, the Biden administration, state officials and employers will need to keep pushing to make vaccination even more convenient.

But the much larger issue is vaccine skepticism.

In the most recent poll by the Kaiser Family Foundation, 15 percent of adults said they did not want to get a shot until they knew more about how it affected other people. Another 6 percent said they would get a shot only if required (say, by their employer), and an additional 13 percent said they would definitely not get a shot. Put those three numbers together, and you get 34 percent — which, again, accounts for most of the unvaccinated 40 percent.

Unvaccinated people do face some additional risk from the hypothetical example that many people have been talking about since the C.D.C. changed its guidelines: the unvaccinated person who was wearing a mask in stores and avoiding restaurants until last week but no longer will.

It’s unclear how many such people exist. In large parts of the country, Americans have been going maskless for months, as I saw when I went on a 1,600-mile road trip in January. Binyamin Appelbaum of the Times editorial board recently tweeted: “In this country we have two kinds of people: Those who don’t need masks but wear them, and those who need masks but don’t wear them.” He was exaggerating for effect, but he had a point.

There is no better way to crush the pandemic in coming weeks than to persuade the vaccine-skeptical to get a shot. It is the best way for them to protect themselves from the risk of Covid hospitalization and death. “If you are not vaccinated, you are not safe,” Dr. Rochelle Walensky, the C.D.C. director, said yesterday. More vaccinations are also the best way to protect children and the immunocompromised.

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