Two sources I've been reading on the endgame here: (1) Circuit-breaker criteria for interventions (vax mandates, mask mandates, indoor gathering restrictions,

Two sources I've been reading on the endgame here: (1) Circuit-breaker criteria for interventions (vax mandates, mask mandates, indoor gathering restrictions, etc): https://alexanderjxchen.github.io/circuitbreaker/ https://alexanderjxchen.github.io/circuitbreaker/ This chart has helped me understand how public-health entities could explain future interventions. The major issue it illustrates is the choices of the voluntarily unvaccinated can affect everyone by clogging hospital availability for everyone. Targeted interventions can reduce this impact. This is, notably imho, different from attempting to protect medically at-risk people who cannot be vaccinated. (2) Ian Mackay's recent post has helped me imagine what the shift to SARS-CoV-2 as an endemic illness will feel like: https://virologydownunder.com/living-next-door-to-alice/ https://virologydownunder.com/living-next-door-to-alice/ Mackay says that, whether or not we want this outcome, the world is making public-policy choices that will lead to humans living alongside endemic SARS-CoV-2 forever. He says the turning point will come when there is no longer a number to put on the wall: > And at some point soon, testing levels will drop as the public realise there is little point in queueing and getting swabbed or paying for rapid antigen tests (RAT) when there are few conditions in place to do anything with those results. Slowly those who are sick “enough” or need evidence that they are infected will get tested. Fever clinics and drive through testing will slow down and pack away. We will know only very approximately how many cases are in the community from at that point. This is a significant shift from the super intense scrutiny of case numbers we’ve had in Australia. Then the media will also stop caring as much. While he's writing about Australia, and I think writing in the context of a public-health expert who is dispirited by seeing a case explosion accompany the lifting of restrictions, his point resonates -- my feeling is that the pandemic will be "over" in the US when nytimes.com no longer has the little sparklines with covid case counts. Mackay suggests that the shift to endemic illness means some people who are currently being protected will die: > Even with a great vaccine, there will be those with waning immunity. There will be new birth cohorts with no immunity. There will be those who don’t get vaccinated. There will be those with immune systems that don’t work as well as needed. There will be some with risk factors that may override the protection afforded by vaccine immunity, subjecting them to a baseline of worse outcomes. Together these people will likely see more severe COVID-19. This is a tale that can also be told about other infectious diseases. There is always a proportion we can’t protect. He highlights post-covid conditions as the remaining wild card. What fraction of people who are infected and recover will have long-term health impacts? Will we have to adjust society to accommodate those people? I found Mackay's early 2020 blog posts helpful in wrapping my head around what we were about to experience and thought they held up pretty well ( https://virologydownunder.com/past-time-to-tell-the-public-it-will-probably-go-pandemic-and-we-should-all-prepare-now/ https://virologydownunder.com/past-time-to-tell-the-public-i... , https://virologydownunder.com/so-you-think-youve-about-to-be-in-a-pandemic/ https://virologydownunder.com/so-you-think-youve-about-to-be... ). I also thought his "Swiss cheese" diagram ( https://virologydownunder.com/the-swiss-cheese-infographic-that-went-viral/ https://virologydownunder.com/the-swiss-cheese-infographic-t... ) did a good job of communicating why classrooms should have 5-6 air changes per hour of MERV13 filtered or outdoor air and how that fits in with other ways of reducing all sorts of respiratory illness (even beyond covid).