In US, pandemic鈥檚 end is in sight. Are Americans ready?
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Noah Robertson Staff writer
Brooke McDonald鈥檚 walk to work begins at her dorm on Boston College鈥檚 campus. The school maintains specific safety rules for its students, including an outdoor mask mandate. So as she exits, her mask stays on.听
But as she rounds Chestnut Hill Reservoir and enters Brighton, those rules expire. Per , face coverings are no longer required outdoors in Massachusetts. If she wanted to, Ms. McDonald could doff her mask the rest of the way to Cityside Tavern, where she works as a server.听
Walk two more blocks east, though, and the rules change again. , the neighboring town of Brookline chose to maintain its universal mandate. Socially distanced or not, Ms. McDonald would need to mask up once more.
Why We Wrote This
Why does Brookline, Massachusetts, still require masks outdoors, despite CDC guidance? Different people are comfortable with different levels of risk and change, scientists say, urging empathy as U.S. towns unmask at their own pace.
The rules, she says, 鈥渒ind of [depend] on where you are.鈥�
Ms. McDonald doesn鈥檛 mind the area鈥檚 mosaic of safety protocols, but she struggles to keep up. With so many rules for so many areas, she tends to just match the behavior of those around her. When in Brookline, do as the Brooklinians do.听聽
Emblematic in her mile-long trip to work are the idiosyncrasies of America鈥檚 current phase in the pandemic. suggest the country is in the early stages of bidding the health crisis goodbye. Yet out of reach 鈥� even in New England, home to the highest vaccination rates in the country 鈥� uncertainties remain.
More broadly, there鈥檚 no playbook for ending a pandemic. The coming months will likely involve a national effort to write one in real time, with approaches that are likely to differ across state, city, or even local lines.听
鈥淲e haven鈥檛 done this for 100 years,鈥� says Georges Benjamin, director of the American Public Health Association.听
鈥淲e鈥檙e evolving back to a degree of openness,鈥� he says. 鈥淏ut we don鈥檛 know exactly what that will look like.鈥�
The are no longer as stark across red-blue lines either. Florida, Alabama, and Mississippi 鈥� which lag in vaccination rates 鈥� are reopening their states, but soon New York, New Jersey, and Connecticut will too.听And on Thursday, the Centers for Disease Control and Prevention changed its guidance to allow vaccinated Americans to be unmasked indoors in most situations.
But Dr. Benjamin doesn鈥檛 expect the process of moving on to be uniform. There are about in the United States, ranging in size from federal to municipal. Laws vary by state, but the system is decentralized, meaning decisions are more often made at the bottom than the top. To wit, CDC releases on COVID-19 come in the form of . Unless the issue crosses state lines, states and counties are free to follow that guidance or not.听
鈥淧ublic health is governed at the local level,鈥� says Dr. Benjamin.
For example, after the CDC鈥檚 Thursday announcement both Massachusetts and Boston said they would , for now.
While that system itself is not flawed, he says, it does involve higher variance. Members of the public who don鈥檛 routinely check state and local regulations are bound to get confused, especially with troves of misinformation and scenes of major outbreaks abroad circulating at a fingertip. At once, risks might appear higher or lower than they actually are.听
鈥淔or the average person, it must be baffling to be constantly hit by shifting standards,鈥� says Steven Taylor, who studies the psychology of pandemics at the University of British Columbia.听
Such confusion comes even as the country has made real progress this spring. Since a peak in January, daily and have plummeted, returning to rates not seen since last September. The even steeper declines in cases and deaths by midsummer.听
Yet there鈥檚 a continued sense among many that the country isn鈥檛 out of the woods, evident in policy and public behavior.听
鈥淢ost people haven鈥檛 changed their precautions all that much since early January,鈥� says Zo毛 McLaren, an associate professor of public policy at the University of Maryland, Baltimore County, who focuses on infectious disease.
From a pure risk-reward point of view, that consistency may not make sense, but Dr. McLaren says the hesitancy is inevitable. Each time regulations and guidance change, the public takes time to ponder them and decide whether, and how much, to alter their precautions.听
鈥淭he risk level has come down a ton over the past couple of months, and we know that that means the optimal behavior should also shift quite a lot during that period,鈥� says Dr. McLaren. 鈥淵et we see that the behavior hasn鈥檛 shifted.鈥�
Risk tolerance differs by area
Overall, the same is true in terms of policy. Some states have blitzed toward reopening, but most are iteratively relaxing precautions as cases and deaths fall.听
鈥淲hat you鈥檙e seeing in terms of [each state鈥檚] governor who鈥檚 making decisions is it鈥檚 less about political ideology,鈥� says Dr. McLaren. 鈥淚t鈥檚 less about even the specific current vaccination rates, and more about tolerance for risk.鈥澛�
Dr. Swannie Jett, director of health and human services for Brookline, which kept its outdoor mask mandate indefinitely, says his town has consistently been one of the most cautious in the country throughout the pandemic, including being one of the first areas with a mask mandate. Given Brookline鈥檚 tight shopping districts and otherwise crowded restaurants, he says, more conservative rules are appropriate 鈥� regardless of national recommendations.听
鈥淭hroughout the pandemic, CDC has often made changes,鈥� says Dr. Jett. 鈥淪o I鈥檇 rather use a precautionary principle and be safe rather than sorry.鈥澛犅�
On the opposite end, policymakers have sometimes relaxed rules before their area feels ready. In late April, Washington Mayor Muriel Bowser widely loosened mask requirements for vaccinated adults, .听
Policymakers are left searching for a Goldilocks zone that allows fewer restrictions, while still making sure cases continue to fall and the public feels safe. Different areas have different solutions, and that process requires confronting the same uncertainty present at the pandemic鈥檚 beginning, says Dr. Taylor, of the University of British Columbia. Even if people have spent the last year fantasizing about a return to 鈥渘ormal,鈥� disrupting routines now considered commonplace will involve taking away a sense of security for many. Uncertainty is uncomfortable.听
鈥淚n early 2020 it was the norm not to wear a mask,鈥� says Dr. Taylor. 鈥淣ow it鈥檚 normal to wear masks. So what is normal?鈥�
鈥淓ndings tend to be messy鈥�
With that hesitancy in mind, public health officials should approach this phase with empathy, says Dr. McLaren. Some members of the public may be slow to adjust. Even if there are costs to being overly cautious, she says, that鈥檚 OK. Transition phases take a while.听
鈥淓ndings tend to be messy, and they鈥檙e not clear cut or neat,鈥� says Dr. Taylor. 鈥淭hey tend to drag out, and then there鈥檚 that ambiguity again.鈥�
Facing such ambiguity in Brighton, Ms. McDonald is ready for the pandemic to end. But she鈥檚 in no rush. Despite the often contradictory rules around her, she prefers a more careful approach and has felt safe throughout the semester.
Still as restrictions loosen, she says she鈥檒l be ready. She works at a summer camp and hopes to have some mask-free moments. She misses social gatherings and wants a regular year of college.听
But until then, she鈥檒l keep watching other people鈥檚 behavior on her walks to work. Recently those have involved fewer masked faces. Ms. McDonald doesn鈥檛 mind.
鈥淚 think the end is in sight, which is exciting,鈥� she says.
