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Ignoring COVID-19 is still not an option for most Americans

People who are up to date on vaccines, at low risk for severe complications, and able to access and safely take available treatments can now worry less about COVID-19 — but they are a surprisingly small minority.

Elizabeth Gillander, 78, receiveed a booster shot of the Pfizer-BioNTech COVID-19 vaccine at a mobile clinic set up at Fircrest Senior Living in McMinnville, Ore., on Oct. 6, 2021.ALISA JUCEVIC/NYT

More than three years into the COVID-19 pandemic, many of us can finally walk into a store or sit in a restaurant without the constant looming fear of COVID on our minds. That is a good thing. But for far too many people, COVID remains a dangerous threat.

Although the public health emergency declaration ended in May and prominent public health figures have advocated for most Americans to lower their guard, the stark reality is that we’re still far from the finish line. Too many are still vulnerable to severe COVID infection; namely, those who are elderly or who have other high-risk factors, those who cannot receive the few available treatments, and the hundreds of millions whose vaccinations are out of date.


Despite our intense desire to put COVID in our rearview mirror, it remains with us and continues to evolve. According to the latest data from the Centers for Disease Control and Prevention, COVID remains the fourth leading cause of death in the United States. Moreover, health equity barriers continue to prevent many Americans from returning to pre-pandemic normalcy, as COVID deaths remain disproportionately highest among Native American and Black individuals. And now, infections and hospital admissions are rising again nationwide.

While COVID vaccines have helped curtail the pandemic, too many people are prematurely lowering their guard. Despite over 80 percent of the US population having received at least one dose of a COVID vaccine, less than 20 percent are up-to-date with the latest boosters. This disconnect is especially concerning as protection from vaccination and prior infection can diminish over time.

Ignoring COVID now also means disregarding its impacts on our most vulnerable populations. COVID-19 remains life-threatening to people with the highest risk of severe disease, including elderly adults, people with other risk factors such as asthmas or diabetes, and immunocompromised individuals. A recent CDC analysis found that people aged 65 to 74 were 5 times more likely to be hospitalized and 60 times more likely to die from COVID than adults aged 18 to 29.


Yes, vaccines can provide some protection for people with immunocompromising conditions (cancer, HIV/AIDS, organ transplantation), but the reality is that vaccinated people with suppressed immune systems are about 2.5 times more likely to be hospitalized with COVID and 2.8 times more likely to die from COVID than vaccinated immunocompetent patients. A society that ignores COVID is one that devalues the lives and livelihoods of these fellow humans.

Beyond vaccines, antiviral treatments serve as another crucial line of defense, yet many Americans cannot actually take or access these treatments to regain pre-pandemic peace of mind.

Many of the most medically vulnerable cannot safely take Paxlovid, the only approved oral treatment for COVID, due to known toxic drug-drug interactions with several other medications, including certain anticonvulsants, anti-infectives, or cardiovascular and neuropsychiatric drugs. These medications are commonly prescribed to elderly people, those at high risk, and immunocompromised people, leaving them with limited treatment options and an even higher risk of poor outcomes upon infection.

Furthermore, a recent study revealed alarming socioeconomic barriers to accessing treatment. These data show that Paxlovid is significantly under-prescribed in our most socially vulnerable communities, such as those places with limited access to transportation and crowded housing. Ignoring COVID in these communities is simply not possible.


And perhaps the most glaring reason to not yet ignore COVID is the still mysterious threat of long COVID, as about 23 million Americans have developed burdensome lingering effects from often mild initial infections. Fortunately, the White House and the US Department of Health and Human Services just announced much-needed initiatives and resources to address the growing impacts of long COVID.

I understand we’re all tired of COVID. Some of us, myself included, are fortunate to have access to vaccines, testing, and treatments, allowing a greater sense of normalcy. But “some” isn’t “all.” So we can’t ignore COVID. We must continue to take simple precautions to protect ourselves and others, especially those who don’t yet have the privilege of moving on. We must focus on health equity, and we must advocate for initiatives that enable discovery, development, and accessibility of even better vaccines and improved therapeutics — particularly new oral antivirals — that will allow more of us the future luxury of turning a blind eye to COVID.

Dr. Jerome Adams is a professor and executive director of health equity at Purdue University. He served as the 20th US surgeon general.