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Two Years Into Covid-19, Where Do We Go From Here?

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Photo: dmbosstone/Flickr CC

Precisely two years ago last week, then-Governor Andrew Cuomo declared a state of emergency in New York as it quickly became clear that the state had become the epicenter of the COVID-19 pandemic. Days later, the World Health Organization declared COVID-19 a global pandemic — with little knowledge about the long-term impacts we might face. Fast forward to today, and it’s difficult to fathom just how far we’ve come: over 963,000 U.S. COVID deaths, 79 million confirmed cases, and hundreds of thousands of hospitalizations.

As the nature of COVID-19 has evolved, so too has our understanding of what it means to live through a deadly pandemic. Social distancing, mask mandates, and vaccinations have become essential tools to combat the virus — in addition to the various COVID treatments now available, and a sprawling testing infrastructure. But two years into the greatest public health threat we’ve seen in over a century, many are wondering: Where do we go from here?

We’re currently in the midst of a key transition period in the pandemic. Case counts and deaths are significantly down, particularly compared to the record-breaking Omicron surge just months ago. Hospitalizations are also at their lowest levels in nearly a year. With heightened immunity today, thanks to vaccine boosters and a less deadly virus strain, scientists believe that COVID-19 can in some instances be less lethal than influenza. The trends are promising.

Video: Two years after New York City recorded its first COVID case, Columbia University Irving Medical Center looks ahead by examining the lessons learned during the pandemic. COVID at Two Years from CUIMC Information on Vimeo.

Reflecting the current situation, New York City Mayor Eric Adams recently ended mask restrictions in public schools and proof of vaccination for indoor dining, gyms, and other venues — declaring that “We are winning. Let’s celebrate.” And these are sentiments expressed across the U.S. as governors and local jurisdictions roll back mandates for vaccinations and masks. But many public health experts are concerned that we are moving too quickly to declare an end to the pandemic. So before we pop the champagne cork, a word or two of caution.

Despite the relatively promising outlook of numbers, there are reasons for concern. The U.S. continues to see 1,200 deaths per day, with the nation quickly approaching one million total deaths since the start of the pandemic. Mutations in the virus also threaten to produce new variants, especially in areas with low vaccination rates where the virus can rapidly mutate.

Globally the situation remains precarious as well. After cases fell steeply in the wake of Omicron surges this winter, case counts are beginning to tick back up in Europe and Asia, particularly since March 1. Western European countries such as Germany are seeing their highest ever number of daily cases, while Russia’s invasion into Ukraine has similarly coincided with high cases in both countries (although Ukraine has ceased reporting daily cases due to the war).

Going forward then, how should we approach this new transition point in the pandemic? In the event of the emergence of a highly contagious new variant, mask and vaccine mandates that have been eased should be snapped back into place. Vaccination campaigns must also remain a central pillar of our strategy, not just across the U.S., but especially in regions of the world where much of the global population remains unvaccinated.

Perhaps equally as important, the U.S. government — including federal, state, and local — needs to prepare for the real possibility of an entirely new pandemic emerging. That means stockpiling emergency medical equipment such as personal protective equipment and life-saving ventilators that were in short supply in early 2020. Moreover, better coordination and leadership is needed from public officials, hospitals and healthcare facilities to streamline data sharing and coordination efforts. And internationally, we need enhanced disease monitoring and global collaboration to rapidly detect future threats and respond collectively.

Incredibly, just last week, the U.S. House of Representatives eliminated the entire COVID-19 budget request that came from the Biden administration. This politically driven budgetary decision makes it impossible for the administration to buy and distribute badly need vaccines, tests and treatments needed by local governments.

While the pandemic remains ongoing, it has already shown how disordered, self-serving, and inequitable the world system can be. But it has also shown how innovative our scientists and businesses can be, how resilient our health care workers and communities can be, and how a deadly pandemic threat can unify a society. If we want to be better equipped to face a new variant, or a new pandemic entirely, we need to lean into addressing the failures of the coordination, preparation, and political leadership that COVID-19 has exposed.

Irwin Redlener, MD, is a senior research scholar at Columbia University’s Climate School and director of the Pandemic Resource and Response Initiative at Columbia University’s National Center for Disaster Preparedness. 

Sean Hansen is a staff associate at the National Center for Disaster Preparedness.

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