A Message to Young People from a Public Health Doctor
(Blog initially published on Tom Frieden’s LinkedIn account: https://www.linkedin.com/pulse/message-young-people-from-public-health-doctor-tom-frieden/)
Young people are facing a lot of stress and uncertainty right now. Schools in many places are closing almost as soon as they reopen. Sports, concerts, and large gatherings are a no-go. Recent college grads are entering a flagging economy.
I received a note the other day from an 18-year-old high school senior who's concerned and feels he may be getting depressed about the future. He asked when he'll be able to attend a sports game or concert again, when he'll be able to visit his grandparents, and if we'll ever get back to normal life. He asked, Will this be forever? Are we doomed?
Anyone who’s definitive about certain things about Covid simply doesn’t know enough about Covid. This is a new virus. It’s spent less than a year living with humans and we’re learning more every day. It's helpful to address what we know right now and with what level of certainty.
Here are a few things we know, and my best take on our level of certainty:
The virus can be deadly, particularly for older people, for some people with underlying health conditions, and, more rarely, for the unlucky people who get very sick or die even without underlying conditions. About this, we are 100% certain.
Wearing a mask protects people around you, particularly if you wear it correctly, and particularly in indoor environments. About this, we are also basically 100% certain. That doesn’t mean masks are 100% protective, it just means that wearing a mask reduces the risk to others.
Wearing a mask may protect you from getting infected, and may possibly protect you from becoming very ill if you do get infected. This is likely, but not certain, and depends in part on what kind of mask you wear and whether you put it on, wear it, and take it off correctly.
People who have gotten very sick from the virus appear to make antibodies, including neutralizing antibodies. This is 100% certain.
Antibodies, particularly neutralizing antibodies, may protect at least some people who have recovered for at least some time against getting infected with Covid again. We hope this is true, but it is not yet proven. Many of us (myself included) think it is the case, but how well these antibodies protect, and for how long—or even if they protect at all—isn’t known. I wrote about the perils and promise of immunity here.
A vaccine that is safe and effective may become available by early 2021. Many people hope this is the case, but we will only know when studies are done.
Now, what does all that mean for the question about whether this will be forever?
First, I would assume that for the next year (at least) masks are going to be important, particularly when indoors and when there are many people in a space that isn’t well ventilated.
Second, I would also assume that, even if we have a vaccine, we’re going to need to adapt our lives in certain ways for at least a few years. That’s because a vaccine isn’t likely to be perfect, nor are 100% of people likely to take it. That doesn’t mean we won’t be able to get much of our former lives back, but it does mean there are likely to be some differences. I shared why we have to accept a new normal and the possible hurdles and limitations of a vaccine. My mother is 91 years old and used to love to sing in chorus, but there’s no way she can go back to doing that any time soon.
So, will we be able to go to an indoor concert safely in 2021? We don’t know. Germany just did a fascinating experiment. They had an indoor concert with everyone wearing masks, but repeated it 3 times—with distancing, with some distancing, and without distancing. We may learn from that.
Will we be able to go to sporting events in 2021? Outside, definitely. Inside—same as the concert, we don’t know. (We do know that the louder people shout or sing, the more they can spread the virus, though much less so if they’re wearing a mask.)
Will we be able to go to indoor concerts and indoor sporting events safely in the next few years? I think yes. By then, we’ll almost certainly have a safe and effective vaccine, and we’ll certainly have better treatment. And I hope we’ll have a better public health system so that we can quickly test, trace, isolate, and quarantine so that when there are cases they don’t become clusters, and clusters don’t become outbreaks.
I don’t think masking will be forever, but I do think there will be some changes in how we go about our lives for the foreseeable future. Handshakes are probably out for a while. We should learn from Asia and wear a mask if we don’t feel well—or, better yet, stay home.
There’s actually an article about how to hug grandparents and other elderly loved ones more safely. And what my brothers and I do is to quarantine for 14 days before we see our mother, and maximize time outside together when we do see her.
We’re definitely not doomed. We—especially young and thoughtful people—have enormous potential to control our future. Even without a vaccine or treatment, communities in countries around the world have stopped the spread of the virus and gone back to life almost as before. With a vaccine and treatment, even more progress will be possible. Ironically, to get our individual freedom back, we need to work together.