Experts: 'Living with COVID-19' model unlikely to work in U.S.

Sept. 29 (UPI) -- Several European nations have decided to "live with COVID-19" rather than focus largely on trying to eradicate the virus, but that strategy likely would fail in the United States because case levels vary widely across the country -- and because cases overall are too high right now to try, experts say.

"Comparing the United States with other nations may be difficult at best," public health and health policy expert Dr. Erica Lubetkin told UPI in a phone interview.

"We're seeing a lot of variability across the country in terms of infection and vaccination rates, so while some areas may be ready to try living with virus, others are not," said Lubetkin, an associate professor at the City University of New York School of Medicine.

Even though infections are starting to wane, and the outlook is improved for the next six months, many experts believe that much of the country cannot live safely with the virus, and that people cannot return to many normal activities.

"I do not think we should be relaxing policies in most places yet because you have to actually get to the bottom of the epidemic hill, not just cross its peak," epidemiologist Kacey Ernst told UPI in an email.

"The people most susceptible are just now eligible for booster shots and kids still can't get vaccinated, so there are still a lot of susceptible people in the population," said Ernst, a professor of epidemiology and biostatistics at the University of Arizona.

She, like Lubetkin, advocates maintaining a cautious approach.

"Right now, what we're seeing is really a tale of two states, or two types of states," said Lubetkin, whose research has compared the effects of the pandemic response in several countries.

"States with high vaccination rates have lower infection rates and vice versa -- and until that changes, it doesn't make sense to completely relax restrictions across the country from a public health perspective," she said.

Living with COID-19

Other countries that have seen significant drops in cases, severe illness and death -- Chile, Denmark and Sweden, among others -- have adopted what researchers have called a "living with COVID-19" model.

In these countries, vaccine "passports" have been issued to the fully vaccinated, allowing them to return to normal activities while understanding that the virus remains a constant threat.

However, most of the nations taking this approach have higher vaccination rates than the United States does currently -- above 70% in Chile and Denmark and above 80% in Singapore, for example -- and, likely as a result, lower infection rates, according to Our World in Data.

"If more than 90% of our population was vaccinated, I would think we would be in a much better place," Ernst said of the United States.

"Unfortunately these national-level statistics mask serious heterogeneity -- even if we reach 90%, some communities will have abysmally low rates and will be susceptible to outbreaks," she said.

Still, much of the United States has been living under relaxed pandemic-related restrictions since May, when the Centers for Disease Control and Prevention announced that those fully vaccinated against the virus no longer needed to wear face coverings to limit its spread.

The agency amended that guidance in July to say fully vaccinated people should still wear masks in areas with high infection rates. But major events have been held -- outdoors and in high-risk indoor settings -- in many places across the country anyway.

Schools have opened in most of the country, and events such as Broadway shows in New York City started up again earlier this month, provided theater-goers offer proof of vaccination.

Many of these changes have come too soon, said Patricia W. Stone, director of the Center for Health Policy at Columbia University in New York City.

"We definitely need a higher vaccination rate before we loosen restrictions further," Stone told UPI in an email.

"Many hospitals are full, with the majority of the COVID-19 patients being unvaccinated and many hospitals are back to not doing 'elective' surgeries due to lack of beds and staff," she said.

After averaging more than 125,000 new COVID-19 infections per day through much of August and early September, cases have declined dramatically in recent days, with just over 30,000 reported on Sunday, according to the CDC.

This may be due to an uptick in vaccination rates nationally -- nearly 65% of those eligible to receive the shots have done so, the agency reports.

However, at its worst, Delta variant-fueled spikes killed on average more than 2,000 people daily in the United States, pushing the country past the 675,000-person death toll for the 1918-19 flu pandemic, the CDC estimates.

Prevention beats treatment

In addition, people who hope to resume or continue normal activities in the face of the pandemic have created a spike in demand for monoclonal antibodies, which are lab-made proteins modeled on those created naturally by the immune system to fight off infections.

However, though these treatments appear to prevent serious illness in many of those infected with COVID-19, they also are expensive and are in limited supply, Lubetkin said.

"Preventing infection in the first place, through vaccination and mask-wearing and social distancing, is always going to be more effective from a public health standpoint," Lubetkin said.

"Allowing people to get sick and then treating them is too risky," she said.

Plus, vaccination protects multiple people -- the person vaccinated and all they come in contact with -- while treating those infected with monoclonal antibodies only benefits that one person, Lubetkin added.

What makes the "living with COVID-19" approach more challenging in the United States, with or without monoclonal antibodies, is that it "is a big country," Stone said.

Data from the "PHIGHT COVID" project at the University of Pittsburgh shows that states with the highest vaccination rates and most restrictions in place -- such as requiring proof of vaccination to visit restaurants or attend events -- have the lowest infection rates.

In other words, the experience in one part of the country may be totally different than that of another, meaning individual states and cities could try a "living with COVID-19" approach as infections drop locally, but a national approach is impractical, Stone said.

"The responses need to be regional," she said.