When will normal life return? Maybe by summer — with luck and the right steps

With the rate of depression and anxiety soaring in the U.S. and around the world, everyone is asking and thinking the same thing — when will this massive pandemic be over? And, when will we be able to return to normal, or at least to a new normal, which will likely still include wearing a mask in public?

Too few are willing to accept the real answer to this question: Much of it is in our own hands. With COVID-19 hospitalizations dropping under 100,000 and new cases averaging under 150,000 per day here in the U.S., now is our last big chance to pull together as a society and exhibit a uniform public health response. There is a narrow window of total compliance ahead if we are to emerge from this frigid winter with a spring and summer of opportunity before us. 

What should we do? 

All of us should wear surgical masks if N95s aren’t available. Dr. Julian Tang, one of the top respiratory virologists in the world and associate professor at the University of Leicester in the United Kingdom, has extensively studied mask use to protect against the SARS-CoV-2 virus. He told me this week on “Doctor Radio Reports” on SiriusXM that he estimates that surgical masks, when worn by two people in proximity (socially distanced), decreases the risk of transmission by at least eight times. Combine this with limited or no gatherings, restricted travel, and vastly increased home self-testing, isolation and contact tracing, and the numbers of cases should continue to fall. Moreover, the Department of Health and Human Services (HHS) has just invested $231.8 million in Ellume’s accurate home self test. 

It is a race against time, as new highly contagious variants of the virus swarm and dominate. Coronaviruses (single-stranded RNA) have a “proofreading” mechanism against error and don’t mutate as much as flu or HIV, for example, and yet, when there is this much virus around, variants emerge and those with a survival advantage (such as being more transmissible) can predominate. 

We need a high degree of compliance to the new vaccines in order to stamp down the virus before more new variants emerge and to help us control the variants we do have. If the current MRNA vaccines do not fully cover the new strains, they can be quickly adjusted and boosters can be produced, as Moderna and Pfizer/BioNTech are doing now. 

With the potential addition of the Johnson & Johnson and the Novavax vaccines to our armamentarium, there is reason to hope that almost everyone who wants to be vaccinated can be by the summer. This will mean, hopefully, increasing administered doses from 1.5 million per day to 3 million, as Dr. Paul Offit, director of the vaccine center at Children’s Hospital of Philadelphia and a member of the Federal Drug Administration’s vaccine advisory group, said to me this week on “Doctor Radio.” Offit said that a serious rate-limiting step to ramped-up production is the precise, delicate process needed to produce the nanoparticle lipid covering of the MRNA. This process takes time.

Vaccine compliance coupled with consistently applied public health measures is clearly the path out of the pandemic. The latest survey from the Kaiser Family Foundation that only 47 percent of those surveyed are eager to take a COVID-19 vaccine (including 6 percent who have taken it already) is deeply disturbing.  

Beyond word-of-mouth encouragement that the vaccines are safe and well-tolerated, we need additional motivation. Once the vaccines have been shown to decrease transmission as well as prevent clinical disease, our government can create incentives for people being vaccinated by allowing a vaccine certificate to sanction travel rather than simply imposing mandatory testing or quarantine. Offit also said he believes that 75 million people in the U.S. have had some form of COVID-19, three times the number who have tested positive. Advanced serological assays (including binding and neutralizing antibodies) can be used to help affirm immunity in this group and the vaccinated group. Together these two groups — when large enough —should present a barrier to spread.

With these tools we can start to emerge from the pandemic by summer, provided we learn to comply as a country. It isn’t a matter of simply adhering to punitive costly lockdowns — it’s a matter of voluntary compliance to public health restrictions and immunizations as we learn to become more responsible members of a global health community.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent and author of the new book, “COVID; the Politics of Fear and the Power of Science.”