When Can We Start Making Plans?

The United States moved one step closer to getting back to normal this week with the first Covid vaccinations of health care workers around the country. While the majority of Americans won’t get their shots until spring, the vaccine rollout is a hopeful sign of better days ahead. We asked Dr. Anthony S. Fauci, as well as several epidemiologists and health and science writers for The Times, for their predictions about the months ahead. Here’s what they had to say.

What advice do you have for families eager to celebrate the holidays with their loved ones?

“Do it by Zoom. Don’t let Junior come home and kill Grandma. Think of this like World War II — our soldiers didn’t get to fly home to eat turkey. My father was at Normandy. My mother was with the Red Cross in occupied Austria. They missed the holidays. Life went on. There were happier years later.” — Donald G. McNeil Jr., health and science reporter

Will we shake hands again?

“I’m not. I don’t know about you. I said that many, many months ago and the newspapers went wild with it. I’m sure people will get back to shaking hands. I think people will probably become more aware of personal hygiene and protecting yourself. That doesn’t mean nobody will shake hands again, nor does it mean everybody will go back to the way we did it again. Probably somewhere in between. Some people will be reluctant to shake hands. Some people will be washing hands a whole lot more than they ever did, even when Covid-19 is no longer around.” — Dr. Anthony S. Fauci

When would you personally feel comfortable returning to the office?

“When I’m vaccinated and everyone around me is.” — McNeil

Is my employer going to require me to be vaccinated?

“Employers do have the right to compel their workers to be vaccinated once a vaccine is formally approved. Many hospital systems, for example, require annual flu shots. But employees can seek exemptions based on medical reasons or religious beliefs. In such cases, employers are supposed to provide a ‘reasonable accommodation’; with a coronavirus vaccine, a worker might be allowed to wear a mask in the office instead, or to work from home.” — Abby Goodnough, national health care correspondent

Will we ever go to a big, crowded, indoor party without a mask again?

“If the level of infection in the community seems substantial, you’re not going to have the parties with friends in congregant settings. If the level of infection is so low that risk is minuscule, you’re going to see back to the normal congregating together, having parties, doing that. If we want to get back to normal it gets back to my message: When the vaccine becomes available, get vaccinated.” — Dr. Fauci

Do we have to wait for 75 percent of the population to be vaccinated before we can travel again?

“I think traveling is going to start easing up as you get much less than that. I think it’s going to be gradual. There is no black and white, light switch on, light switch off.” — Dr. Fauci

How long will we be wearing masks?

“If you get herd immunity where there are no infections around, you wouldn’t have to wear a mask all the time. You might want to wear it if you were in a crowded situation, but you wouldn’t have to have the stringency you have now. Ultimately, I think you’re going to have to transition from wearing all the time, to wearing it under certain circumstances, to perhaps not having to wear it at all.” — Dr. Fauci

How will we know it’s safe to do normal things?

“First of all, it’s going to be expressed by the number of new cases that you see — the test positivity number. You’ve got to go as low as you can get. The best number is zero. It’s never going to be zero, but anywhere close to that is great.” — Dr. Fauci

When can we go to the movies or the theater?

“It depends on the uptake of the vaccine and the level of infection in the community. If you go to April, May, June and you really put on a full-court press and try to vaccinate everybody within a period of a few months, as you go from second to third quarter of the year, then you could likely go to movies, go to theaters, do what you want. However, it’s unlikely, given what we’re hearing about people’s desire to get vaccinated, that we’re going to have that degree of uptake. If it turns out that only 50 percent get vaccinated, then it’s going to take much, much longer to get back to the kind of normality that we’d like to see.” — Dr. Fauci

When will you eat in a restaurant?

“If more than half the population is vaccinated, I would feel a little less stressed and anxious when heading out to do errands I normally do. I might actually feel comfortable to eat in a restaurant or see friends again one day if this is possible.”— Vijaya L. Seegulam, research project manager, Boston University

Covid-19 Vaccines ›

Answers to Your Vaccine Questions

With distribution of a coronavirus vaccine beginning in the U.S., here are answers to some questions you may be wondering about:

• • If I live in the U.S., when can I get the vaccine? While the exact order of vaccine recipients may vary by state, most will likely put medical workers and residents of long-term care facilities first. If you want to understand how this decision is getting made, this article will help.
  • When can I return to normal life after being vaccinated? Life will return to normal only when society as a whole gains enough protection against the coronavirus. Once countries authorize a vaccine, they’ll only be able to vaccinate a few percent of their citizens at most in the first couple months. The unvaccinated majority will still remain vulnerable to getting infected. A growing number of coronavirus vaccines are showing robust protection against becoming sick. But it’s also possible for people to spread the virus without even knowing they’re infected because they experience only mild symptoms or none at all. Scientists don’t yet know if the vaccines also block the transmission of the coronavirus. So for the time being, even vaccinated people will need to wear masks, avoid indoor crowds, and so on. Once enough people get vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we as a society achieve that goal, life might start approaching something like normal by the fall 2021.
  • If I’ve been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. The coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to keep the vaccinated person from getting ill. But what’s not clear is whether it’s possible for the virus to bloom in the nose — and be sneezed or breathed out to infect others — even as antibodies elsewhere in the body have mobilized to prevent the vaccinated person from getting sick. The vaccine clinical trials were designed to determine whether vaccinated people are protected from illness — not to find out whether they could still spread the coronavirus. Based on studies of flu vaccine and even patients infected with Covid-19, researchers have reason to be hopeful that vaccinated people won’t spread the virus, but more research is needed. In the meantime, everyone — even vaccinated people — will need to think of themselves as possible silent spreaders and keep wearing a mask. Read more here.
  • Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is delivered as a shot in the arm, like other typical vaccines. The injection into your arm won’t feel different than any other vaccine, but the rate of short-lived side effects does appear higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported any serious health problems. The side effects, which can resemble the symptoms of Covid-19, last about a day and appear more likely after the second dose. Early reports from vaccine trials suggest some people might need to take a day off from work because they feel lousy after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences aren’t pleasant, they are a good sign that your own immune system is mounting a potent response to the vaccine that will provide long-lasting immunity.
  • Will mRNA vaccines change my genes? No. The vaccines from Moderna and Pfizer use a genetic molecule to prime the immune system. That molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse to a cell, allowing the molecule to slip in. The cell uses the mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any moment, each of our cells may contain hundreds of thousands of mRNA molecules, which they produce in order to make proteins of their own. Once those proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules our cells make can only survive a matter of minutes. The mRNA in vaccines is engineered to withstand the cell’s enzymes a bit longer, so that the cells can make extra virus proteins and prompt a stronger immune response. But the mRNA can only last for a few days at most before they are destroyed.

When will you feel comfortable in a crowd?

“Once my family and I are vaccinated, I would change behaviors, except I can’t imagine being in a crowd or attending any crowded events until at least 80 percent of the population is vaccinated.”— Julie Bettinger, associate professor, University of British Columbia

When will restrictions start to ease up?

“I think widespread availability of vaccines will result in the further relaxation of most precautions by mid- to late summer 2021.” — Michael Webster-Clark, postdoctoral researcher, University of North Carolina at Chapel Hill

What will the new normal look like?

“The new normal will be continued masking for the next 12 to 18 months and possibly the next few years. This is a paradigm shift.” — Roberta Bruhn, epidemiology core co-director, Vitalant Research Institute

What will never return to normal?

“My relationships with people who have taken this pandemic lightly and ignored public health messages and recommendations.” — Victoria Holt, professor emeritus, University of Washington

What did you learn from pandemic life?

“Staying home with my children has taught me that life with fewer errands to run and activities to partake in is kind of nice. I think in the future we will cut down on our family obligations.” — Jennifer Nuzzo, associate professor, Johns Hopkins

What pandemic habit will you keep?

“I’m going to keep my mask, and wear it in crowds and on subways, particularly during cold and flu season. I used to get sick all the time, but I haven’t had a cold or sore throat in months. I really like not getting sick!”

What’s one thing you’ll never take for granted again?

“I won’t take traveling to my extended family for granted.” — Alicia Allen, assistant professor, University of Arizona

What has forever changed in your daily life?

“I will never again have to explain what an epidemiologist is.” — Janet Rich-Edwards, associate professor, Harvard

Contributors: Margot Sanger-Katz, Claire Cain Miller and Quoctrung Bui

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