Deaths from Covid-19 in the United States are the lowest they’ve been since March 2020, according to the Centers for Disease Control and Prevention’s data tracker. Case rates have similarly plummeted, though infections have become harder to track because of the widespread availability of at-home rapid tests; many of the monitoring systems that were set up at the beginning of the pandemic have also been wound down.
Is this finally the beginning of the end of the pandemic, or just another spring ebb before a new variant initiates a summer wave? (For the past two years, numbers have fallen between March and June, before rising in July.) The New York Times spoke with epidemiologists and infectious disease experts to gauge how they’re thinking about this particular juncture in the pandemic — what the risk is right now, what precautions they’re continuing to take, who is still getting severely ill and dying, and what the future may bring.
Experts agree that the risk from Covid-19 right now is low, and spring 2023 feels different from previous years.
“We’ve reached a stage of stability where people are making choices to return their lives to something closer to normal,” said Dr. Robert Wachter, the chair of the department of medicine at the University of California, San Francisco. “And I think that makes sense. Cases are relatively low; deaths are relatively low.”
The biggest reason for this improvement is that virtually everyone in the United States has some form of immunity now, whether from vaccines, a previous infection or both. Medications like Paxlovid have also significantly reduced the risk of serious illness.
Dr. Taison Bell, an infectious disease physician at the University of Virginia, said that in his intensive care unit, “we will see an occasional Covid-19 case, but we’re not seeing a lot of cases that are leading to people being on the ventilator.” Now, most of the people Dr. Bell is treating for Covid are older and either have pre-existing conditions that compromise their immune systems or lung function, or they haven’t been vaccinated. It’s essential, he said, that people who are at high risk for severe infection get a bivalent booster if they haven’t already (a second dose was also recently authorized for this group).
Another reason things are different this spring is that there have been no new, game-changing variants — “no new Greek letters,” as Dr. Wachter put it — for the last year and a half. Variations of Omicron that have some immune-evading properties, such as the current dominant strain, XBB.1.5, have emerged, but Paxlovid and vaccines are still effective against them.
Despite the good news, experts are still taking some precautions. Because while the numbers are headed in the right direction, roughly 100,000 Americans are still being infected with Covid-19 every week, and more than 150 are dying from the infection every day.
Where, and why, experts are still being careful
Dr. Wachter continues to wear a mask in most crowded indoor settings, like on an airplane or in a museum, he said, but not if he needs to pop into a store quickly.
His main motivation is wanting to avoid long Covid. “Unlike the way I felt two or three years ago, I have no fear that I’m going to die of this thing,” he said. “But I think long Covid is very real. My wife has a mild version of it, so I see it up close and personal.”
Caitlin Rivers, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, who has young children, said that she stopped wearing a mask at the grocery store or in the office, though she still dons one on public transportation. She said that the disruptions Covid and other respiratory infections caused this winter, like missing school and work, were worth avoiding.
The experts especially urged people to keep taking precautions, such as masking and testing before big indoor gatherings, if they or a loved one are at high risk.
“I think we have to do what we can to mitigate risk, not just for ourselves, but also we live in a community,” said Dr. Krutika Kuppalli, an infectious disease physician who still tests herself before going to events. “I don’t know if the person next to me is immunocompromised, and I don’t want to give them Covid.”
Things could change quickly
The experts cautioned that it’s always possible for a new variant to emerge and start another wave.
Dr. Kuppalli said that she was watching Omicron subvariant XBB.1.16, also known as Arcturus, which is driving a surge in India. XBB.1.16 currently accounts for about 12 percent of cases in the United States and comes with a new symptom: conjunctivitis.
Dr. Rivers is paying attention to another new subvariant, XBB.1.9.1, which makes up 9 percent of U.S. infections right now. She expects cases to start rising again as the weather warms, driven by either these variants or one like them. “We generally see a quiet spring followed by a summer resurgence that starts in the South” because people are more likely to gather indoors when it gets too hot, she said.
And this, experts say, is likely our new normal. “The stage where we are now is probably a version of a stage we’ll be in a year from now, maybe two years from now, maybe five years from now,” Dr. Wachter said. “It could get a little worse, in which case I think people and societies change if they’re being rational. I think it’s unlikely to get much better.”