As infection rates of Covid-19 rise, or in some cases only plateau, across the United States, experts say those who haven’t gotten their shots yet may be relaxing safeguards too soon.
(CN) — With millions of Covid-19 vaccine doses being given to Americans by the day, and public health officials announcing pieces of normal life that can resume post-vaccination, it’s understandable that many are feeling a sense that, after more than a year, the pandemic’s end is near.
The number of new cases in the United States suggest there’s still a fight to win.
Hospitalization rates for Covid-19 patients remain lower than the peak in early January 2021, according to the Centers for Disease Control and Prevention. But in recent weeks, rates in all age groups have either risen or plateaued.
Doctors and public health experts weighed in on what the recent caseloads suggest about our behavior, including whether talk of increased vaccination is causing some to get complacent, and how to get those who are reluctant to masking up — or just tired of it — to stick with the safety measure.
Vaccination Way Up; Masking Slightly Down
Still two weeks away from the May 1 deadline set by President Joe Biden, by which all American adults should be vaccine-eligible, states remain on track or early to the finish line.
California and Washington state will open up eligibility to all adults on Thursday. In the few days that follow, Virginia, Vermont, Massachusetts, Pennsylvania and Rhode Island will do the same, as will Washington, D.C.
More than 74 million Americans are already fully vaccinated, and 120 million have gotten at least one shot.
But even with vaccination ticking up, doctors and public health experts agree that it’s not time to stop wearing masks, avoiding crowds and taking other precautions to keep the spread of the coronavirus under wraps.
That idea has proved a controversial one in some parts of the country.
Around 90% of Americans are wearing masks, according to a compliance tracker created by researchers at Carnegie Mellon University. The rate is the lowest it’s been in four months.
Regina Davis Moss, associate executive director of public health policy and practice for the American Public Health Association, attributed the decline to the fatigue of having been largely in our homes for more than a year.
With warmer weather, holidays like Mother’s Day, and graduation season all coming up, “there are a lot of milestones that people want to celebrate,” Moss said. Pair that with chatter about the vaccine becoming more widespread, and people may be loosening up their safety measures, taking more liberties than they have over the past months spent isolated and indoors.
Those who consider the vaccine a “get-out-of-jail-free card,” though, may be putting more stake in it than they should.
“What we’re hoping for is, between the people who have contracted [the virus] and the people that have become vaccinated, we’re going to get to herd immunity,” Moss said. “But we’re not there yet.”
Until we are there, Moss said, people will have to remain diligent.
“Every time we’re doing something, remember that the risks are additive,” when it comes to the chances of becoming infected with the virus, Moss said.
“If you don’t have a vaccine, and then you gather indoors, and you don’t wear a mask — every time you do something like that, you’re increasing your chances.”
One Nation of Individuals
Driving the fact that not everyone in the U.S. is willing to follow safety precautions is the individualism of American culture, said Dr. Stephen Bezruchka, an emergency physician and professor at the University of Washington.
“There’s no consensus on how to behave in this country,” Bezruchka said. “It’s sort of an individual decision, and we don’t trust people to tell us what to do.”
While countries like New Zealand present a shining example of how enforcing lockdown can seriously damper the spread of the coronavirus, American culture makes people less likely to trust health officials, Bezruchka said. The U.S. also lacks the “tremendous government support” given to furloughed workers in other countries, to encourage people to stay home, he said.
“In more unequal countries, there is much less trust in the government or authority,” Bezruchka said, noting that “inequality has soared in the last year.”
Lacking both financial support and a unified understanding about pandemic safety, he said, people are more likely to fill in the gaps with whatever they want to hear.
“People sense something is wrong, and there’s this tremendous ability to spread misinformation, or disinformation,” Bezruchka said. On the internet, for instance, “you can find people to support any belief you have — and in this country, people are looking for alternative facts.”
The politicization of masks has left the U.S. more divided over Covid-19 than other major countries, according to Pew survey data.
Since American health officials began recommending everyone wear a mask outside their home, there has been no shortage of viral videos shared online, showing staunch mask opposers: A Texas man slapped a judge who approached him about a mask mandate. A Florida woman coughed on another shopper in defying mask rules, landing her a 30-day prison sentence.
With the knowledge that not everyone will readily mask up and stay away from crowds, researchers have been working to understand what motivates people to change their behavior.
Making the Case for Masks
As long as masking remains optional, public health officials face a challenge in getting people to voluntarily comply with measures to protect health.
Researchers analyzed who was most likely to wear a mask in the U.S., publishing the results last October in the journal Plos One. They found that “wearing a mask increased significantly in age,” and that women were more likely to mask up.
The data, from last summer, also showed that people in rural areas were four times less likely to wear a mask than those in urban and suburban areas.
That may have to do with different risk factors in less densely populated areas, and “obviously there may be some politics playing into that,” said Michael Haischer, a researcher at Marquette University, who led the study.
Some groups of people, like kids in schools, need less of a reminder. “Masks are pretty normalized for kids now,” Haischer said. He noted that for instance, kids are fans of masked Marvel superheroes.
“There’s almost a fun aspect to it,” with different designs kids can compare to their friends’ masks, Haischer said. “It’s almost like a new article of clothing — we’ve been in this for so long now.”
It may be adults that need a reminder, or something stronger, to encourage compliance. Researchers are also working on what that messaging should look like.
Allison Lazard is an associate professor at the University of North Carolina’s Hussman School of Journalism. Her studies with focus groups have demonstrated that positive messaging about protection and safety, rather than punitive, or fear-oriented messaging, is more likely to work for people who are on the fence.
Compliance with mask-wearing, and social distancing, is motivated by the desire to protect other people, Lazard said, and particularly people in one’s own social network.
“There’s a real, strong desire to keep loved ones safe — friends, family, those that we know that are vulnerable,” she said.
For the rest of people not willing to comply, it may come down to a simple mandate.
“If you’re dead-set against this idea that masks are important, then communication’s not really going to get you there,” Lazard said. “But what was effective for these individuals was simple policies.”
In grocery stores, for instance — indoor areas that, as Haischer pointed, out are laid out the similarly in both rural and densely populated areas — requiring masks seems to be the way to go.
“By having a simple ‘mask required’ mandate, you’re empowering businesses, employers and members of the community to keep that community safe,” Lazard said.
Lazard, who also does tobacco prevention research, said that consistent, clear messaging is key.
Similar to the classic “no smoking” sign, public places could adopt a universal signal requiring mask compliance, leaving no room for confusion.
“The ‘no smoking’ sign is simple, clear, iconic,” Lazard said, “and when it’s posted, you know what it means.”