As masks come off, experts warn the pandemic isn't over

This week, as many Massachusetts residents marked two years since the pandemic state of emergency by beginning to venture out again without masks, medical experts are warning this newfound sense of security is likely temporary.

The current seven-day average for new COVID cases is under 600, down from over 23,000 two months ago. But experts say seasonal surges and the possibility of new variants mean we're not done with the virus.

"Right now, the burden on health care is being readily handled," said Bill Hanage, director of the Center for Communicable Disease Dynamics at Harvard's T.H. Chan School of Public Health. "That will not necessarily remain the same in the fall and winter. And so I think it's a good idea that folks should be prepared. You know, they take their masks off, but put them away with their winter coats, because they might need them again."

In addition to more Omicron infections when the weather gets cold again and people start gathering indoors without masks, Hanage said he worries about the emergence of new variants.

"The really bad outcome, which we're worried about, would be a new variant with properties that are less pleasant than Omicron's," Hanage said.

The spike in cases of Omicron this winter was much steeper than the two previous surges. Despite that, the rates of hospitalizations and deaths during the Omicron spike were comparable to what the state saw during the Delta variant.

"In many ways, we got lucky with Omicron," said epidemiologist Andrew Lover of UMass Amherst. "There's no reason to think that newer variants will be as mild. We all hope that that will stay the case. But we can't bank on it, necessarily."

With vaccination coverage still low in many parts of the world, Lover said, new variants are likely.

"And so the severity of those, we really can't guess," he said. "But we have to assume that we'll see some challenges in the next few winters."

Also, Lover pointed out, the recent discovery of COVID-19 in deer populations raises concerns those infections could lead to new variants, as well.

There are other reasons the outcomes from the Omicron spike weren't as bad as they could have been, and they offer some hope for the future, according to Dr. Helen Boucher, interim dean of Tufts Medical School and an infectious disease physician at Tufts Medical Center.

For one thing, Boucher pointed out, more than half of those eligible for vaccination in Massachusetts have received a booster dose. And doctors have gotten better at treating the virus.

"When we began two years ago, we didn't have adequate diagnostics and we didn't have adequate therapeutics, we didn't know how to take care of patients with COVID," Boucher said. "We learned later about optimal ways to manage patients in the ICU."

She added that, as the pandemic wore on, "We got the gift of vaccines, which are still the best tool we have."

Boucher noted the arrival of oral medications in addition to other intravenous medications and monoclonal antibodies to fight the virus. "These pills are going to be game changers, and they're part of what's going to allow us to move from the epidemic phase into a more endemic phase with this virus," she said.

Speaking Thursday on a special episode of GBH's "In It Together" program marking two years since Massachusetts' state of emergency, Dr. Cassandra Pierre, the Medical Director of Public Health Programs and the Associate Hospital Epidemiologist at Boston Medical Center, reminded listeners that even now, as COVID rates trend down, there are some who can't let their guard down.

"There are people that continue to be at risk, even in this time — people who are not yet eligible for the vaccination, children under the age of five, those who are immunocompromised," she said. "So this is a time of potential confusion for some of the people who remain at some level of risk."

As to Hanage's advice to pack your mask away with your winter coat, Pierre said it really depends on who you are and what your risk factor is.

"But yes, for the rest of us, I think as long as we are cautious and understand that there are those in our midst that remain at risk, and communities — specifically those that have been hardest hit — that also remain at risk, I think that we can start to bring back a little bit of normalcy and joy to our lives," she said.