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COVID will be with us for the next several years, says UCSF Medicine chair


We're going to start today by thinking about what could be the lasting effects of the COVID-19 pandemic. The pandemic has claimed more than 700,000 lives in the U.S. alone. It's altered how we perform daily activities, and it's had a lasting effect on the economy. In some areas, cases are still ticking upward.

But as we adjust to the new routines of distancing, masking and vaccination, many people have wondered what that new normal will look like. So that's where we want to focus our attention. For that, we've called Dr. Robert Wachter for his thoughts and expertise on the subject. Dr. Wachter is the chair of the department of medicine at the University of California, San Francisco, and he's with us now.

Welcome, Dr. Wachter. Thanks so much for joining us.

ROBERT WACHTER: It's my pleasure. Thank you.

MARTIN: So here we are, well into our second year of this pandemic. And there is not a nationwide surge, but COVID-19 is still spreading. It's affecting daily activities. How should we think about that? I mean, I think that, you know, some people are saying, this is what it's going to be like. This is the new normal.

WACHTER: Yeah. I think I'm increasingly in that boat. And to make clear, I don't think that's a good new normal. I'd love us to be in a place where COVID was receded as a part of our lives and we were back to 2019. But I think it's increasingly clear that that's not likely to happen, that this is going to be with us for the foreseeable future. And we're going to be on this roller coaster where cases go up, and then they come down, and then they go up again.

And so my thinking has shifted a little bit in the last several months. I - for the last year and a half, I've been very, very conservative. I still do not want to get COVID. I still worry about getting long COVID, if you get it. But if COVID's going to be with us for the next several years and maybe forever, at least my own mindset is, you know, if I'm not going to do it now and I'm fully vaccinated and I've gotten my booster, I sort of feel like I'm saying to myself, OK, I'm not going to do that next year, the year after. Conditions may not be all that different.

And so things like visiting my elderly parents in Florida or holding a conference in San Francisco in person with everyone masked and with a vaccine requirement, I wouldn't have done it six months or a year ago. And today, it feels like, are we going to forego that activity and some of the things that give us joy in life forever? Forever's a long time. But I think for the next, at least, several years, COVID's here to stay.

MARTIN: So how are you calculating personal risk these days? I mean, how should we think about this individually?

WACHTER: For me, part of my calculus six months ago was, this is going to get much, much, much better. Let's hunker down and wait for the cavalry. What changed about that were really two things over the last six or eight months. One is the delta variant, which is twice as good at its job as the old virus. And the second is the fact that it looks like 30 or 40% of Americans are not going to get vaccinated, which I still find flabbergasting but seems to be a fact of life.

So personally, what I do - first of all, as I said, fully vaccinated and I - and got a booster. And I think that's very important. I think there's pretty good evidence the vaccine efficacy is waning. And if you're eligible, you should definitely get the booster. So I feel like I'm as protected as I can be. I will now, in San Francisco, go to an indoor restaurant with friends. I think twice about it. But as long as the cases here are relatively low, and they are, I'm willing to do that. I'm willing to get on an airplane and go to important business or personal functions.

Outside, I'm - I feel like things are quite safe. I don't wear a mask outside walking the dog. And two days ago, I played poker with a group of eight friends, all in our 60s, all fully vaccinated, all boosted, not wearing masks. I would not have done that a few months ago. But it was that theme, which is, if I'm not going to do it now, I'm probably making a cognitive statement that I'm not going to do it forever. And I enjoy it and, you know, lost money again. But it felt like something that - it was time to begin re-engaging. Now, if the cases skyrocket again, and they might, I'll probably rethink those things. But that's where I am right now.

MARTIN: So before we let you go, it's obviously - some precautions that people are taking around COVID have become very controversial for reasons that, you know, we could all debate. But I'm just wondering if you have a sense of which COVID precautions do you think should be phased out and which ones, in your opinion, should we continue perhaps permanently? Or is that going to be one of those things where it really has to be on a place-by-place, situation-by-situation basis?

WACHTER: Yeah. It's not only probably place by place but also your own personal risk tolerance and your own personal risk. We're all going to have to sort of grapple with these things. But I do believe that, in my own thinking, and I think those of most epidemiologists and public health experts, we're now in a mode that because of delta and because of the percentage of people who are staying unvaccinated, we have to make calculations about how do we keep ourselves as safe as possible while enjoying life and recognizing that the hunkering-down stage, waiting for this to go away, now has to move on to a different way of thinking where COVID is probably going to be with us for the next several years and maybe forever?

MARTIN: Dr. Robert Wachter is the chair of the department of medicine at the University of California, San Francisco. Dr. Wachter, thank you so much for speaking with us.

WACHTER: My pleasure, Michel. Thank you. Transcript provided by NPR, Copyright NPR.