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Welcome to the choose-your-own-adventure phase of the pandemic

Commuters wearing masks travel on the Metro in Washington, DC, on April 14. | Robert Nickelsberg/Getty Images

What the end of plane mask mandates reveals about our new pandemic normal.

Rising coronavirus cases aren’t going to stop much of the country from continuing to move on from the pandemic, leaving many Americans to fend for themselves on the road to a new normal.

Even as cases nationwide have jumped 47 percent over the last two weeks, on Monday a federal judge lifted the mask requirement for air travel and it doesn’t sound as if the Biden administration is putting up a big fight to reinstate it. When people who were literally on a plane heard the news, their response reflected this chaotic new moment in the pandemic, a mixture of cheers and fresh fears.

But if you look at people’s attitudes broadly, Americans have been drifting toward normalcy. According to the Kaiser Family Foundation’s March poll, 27 percent of Americans say they have basically returned to doing what they normally did before the pandemic. Another 14 percent said that they never changed their behavior — meaning nearly half of the country is living as if Covid-19 had never happened. On the other end of the spectrum, 17 percent of Americans say they are still not doing most of the activities they did before the pandemic.

The largest group, 42 percent of the US, is somewhere in the middle. These Americans say they are doing some — but not all — of their pre-pandemic activities. If you combine this group with the people who have returned to normal, more than half of the country is now taking it less seriously, as the government and businesses continue to encourage a return to economic and social activity.

For so many people, that makes this a disorienting period of the pandemic. We’ve moved away from a sharp focus on cases as the most important metric and away from using broad mitigation measures — like mask mandates — to drive down case numbers. But it’s not clear what should replace the old pandemic mindset.

There are obviously still many good reasons to avoid being exposed to Covid-19. Some people, particularly the elderly and immunocompromised, face a higher risk of developing serious symptoms if they get infected. For others, there is an economic and social cost of getting sick, especially if their workplace or school mandates a lengthy isolation period following a positive test.

But it’s hard to avoid exposure when the combined policy response from federal, state, and local authorities is no longer based on helping people do that. In general, the government is now focused almost entirely on limiting hospitalizations and deaths and otherwise allowing a return to pre-pandemic activities. Hospitalizations are currently plateauing nationally after a long decline. Deaths are still dropping from their peak during the winter omicron wave.

With so many vaccinated or previously infected with the virus, we would expect to see fewer severe cases. But the virus is still spreading. The difference now is, the government and businesses are tacitly and overtly acknowledging they can only do so much about that. Delta Air Lines, in its response to the court ruling lifting the mask mandate, initially referred to Covid-19 as an ordinary seasonal disease — before backtracking.

Instead of one cohesive Covid-19 response, people are left making millions of individual decisions that also ultimately limit other people’s ability to steer clear of the virus.

As President Joe Biden said on Tuesday, when asked whether Americans should continue to mask on planes despite the mandate being rescinded: “That’s up to them.”

The uncomfortable truth is there is only so much one person can do now. Wearing masks, avoiding crowded indoor spaces, and staying up to date on vaccinations are still the playbook for reducing your risks from Covid-19. But with so many people moving on, there is not a foolproof plan for avoiding infection.

“We’re in a position where you’d have to have really compelling reasons to try to avoid exposure, given society’s failure to make it easy to avoid exposure,” Justin Feldman, a social epidemiologist at Harvard University, told me.

At previous points in the pandemic, it seemed clear what would need to happen next to start loosening our pandemic rules: cases needed to fall. New tools were arriving all the time to help that happen. First, we were waiting for the vaccines to be approved and then for people to get vaccinated. A few months later, we were waiting for news on booster shots, and the looming omicron wave promised to spread immunity throughout much of the population, albeit at a high cost.

But at this point, few if any new interventions are coming even as cases keep climbing. The toolbox has been stocked — vaccines, therapeutics, tests — and it’s now left to each person to decide how they’ll use the tools.

Society is making a difficult pivot, asking people who have lived through the most extreme social and economic disruption of their lives, all because of the novel coronavirus, to regard it now as part of the milieu. We are transitioning from a world of stay-at-home orders, business closures, and universal masking requirements to a choose-your-own-pandemic experience.

“It feels noisier than ever in terms of how people perceive the virus, its severity, its risks, the risks to others,” Kate Cagney, who researches sociology and public health at the University of Michigan, told me. “We don’t have a consistent algorithm that we’re all following.”

The US is going through a difficult pandemic transition

Not everybody is facing this new normal on equal footing. Elderly Americans and the immunocompromised continue to have good reason to be vigilant about avoiding Covid-19 because it could still pose a serious risk to their health.

But for others, there may be a tug of war between the pull toward normalcy and wanting to be conscientious about a virus that, even in this relative lull, still kills around 500 Americans every day.

Figuring out a new approach can be a challenge when the government, businesses, and many of the people around you act like Covid-19 is no longer an active concern. People are also making this transition back to more normal activities while contending with ever-changing public health guidance and an increasing lack of real-time information about the actual state of the outbreak.

You see the disorder everywhere. While there was always some variance in how public health experts thought about the pandemic, the divisions feel starker than ever now. When Philadelphia recently decided to put its mask mandate back in effect because local cases were starting to rise, former Baltimore city health commissioner and Washington Post contributor Leana Wen was baffled. She cited the CDC’s own assessment, which classified Philly as an area with low risk. But some of her public health peers quickly pushed back on Wen for doubting the city’s decision to be more proactive about slowing Covid-19’s spread.

You’d be forgiven for being confused. But this kind of dissonance is increasingly common. Newspapers are canceling their White House Correspondent Dinner receptions because of a local increase in Covid-19 cases — but the dinner will go on. Even as local cases are rising, the DC Metro system is ending its masking requirement.

With such a dizzying information environment, it’s no surprise the pandemic is messing with our heads. Experts were warning about decision fatigue a year ago, and research indicates the last two years have made a lot of people’s anxiety worse. One survey-based study in Europe found that people who had a higher interest in the pandemic were more likely to show signs of neuroticism. People with higher levels of anxiety were more likely to perceive a higher level of risk from Covid-19, according to another US-based study.

When something as simple as asking a coworker to go get a drink can feel fraught, people are bound to be stressed out. Every social interaction comes with a complex decision tree: Would that person be comfortable going out in public? I’m supposed to go see my parents this weekend — so if I go out tonight, can I get tested in time?

“It’s a lot of cognitive engagement. Having to engage in that calculus all the time is so wearing that I think it makes people just stay home,” Cagney told me.

Or they may go the other way and largely give up on taking precautions. After all, a lot of other people have.

The reason this part of the pandemic is so disorienting

Part of the reason for all the confusion is that pandemics are partly a social construction.

There is an objective biological phenomenon, but there is also a social component. It’s a pandemic because we collectively decide there is a moral imperative to trying to prevent illness. That was what happened when governments issued shelter-in-place orders and closed most of the economy to contain Covid-19’s spread — and when most people agreed to follow the new public health guidelines.

Ever since, we have been trying to figure our way out of that pandemic mentality. But the nature of this particular emergency, in which Covid-19 will eventually become endemic, has made that harder. David Rehkopf, a social epidemiologist at Stanford University, pointed out to me that most public health risks end up being resolved or limited in some way. A measles outbreak will eventually end. Chronic health issues like obesity or diabetes aren’t infectious; one person’s dietary decisions doesn’t affect someone else’s likelihood of developing those conditions.

But Covid-19 is still present, still infecting people, and yet the official attitude has transitioned from “avoid infection at all cost” to “getting infected is a largely acceptable risk of getting life back to normal.” If you are on the cautious end of the risk tolerance spectrum, the whiplash can be quite disorienting.

“Even if the objective data is troubling, if you don’t have the moral judgment, it’s normative now, that level of death and disease,” Kimberlee Holland, a medical sociologist at Georgetown University, told me. “As society transitions objectively into this endemic rather than pandemic phase, many people themselves have not shifted.”

There is a case for embracing the new normal. We have effective vaccines now and therapeutics that greatly reduce the risk of dying from Covid-19. Many public health experts believe that preventing the worst outcomes is the best we can hope for. It may not be realistic to expect that we can avoid catching a virus that’s become as transmissible as the measles.

For the healthy and vaccinated, it may also not be desirable to take the extreme measures that would be necessary to avoid exposure. Restricting activities in order to slow down the virus can negatively affect not only the general economy but the social networks that help ameliorate the stress many people are feeing during a crisis.

“Our Covid-19 policies must acknowledge that we don’t have just one needle that we are trying to move any longer,” Briana Mezuk, co-director of the Center for Social Epidemiology and Population Health at the University of Michigan, told me. “A singular policy focus on Covid-19 cases is nonsensical at this point in the pandemic.”

Yet in some important ways, our policies are still uniquely focused on Covid-19. Getting infected with the coronavirus might force somebody to enter a mandatory isolation period, but catching the flu wouldn’t necessarily do the same. There is an economic and social cost to getting Covid-19 that is separate from the clinical risk.

We’re still searching for a new equilibrium. It’s been a rocky transition so far. As Rehkopf put it to me: “There’s not a playbook for this kind of middle ground.”

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