Now, even as the number of cases starts to rise again and more infections go unreported, the burden has fallen on individual Americans to decide how much they and their neighbors are at risk of coronavirus – and what, if nothing else, to do. for this. For many people, the threats posed by COVID have been dramatically mitigated during the two years of the pandemic. Vaccines reduce the risk of hospitalization or death. Powerful new antiviral pills can help prevent the deterioration of vulnerable people. But not all Americans can count on the same protection. Millions of people with weakened immune systems do not get the full benefits of vaccines. Two-thirds of Americans, and more than a third of those 65 and older, have not received the critical security of an auxiliary shot, with the most worrying rates among blacks and Hispanics. And patients who are poorer or live farther away from doctors and pharmacies face sharp barriers to taking antiviral pills. These vulnerabilities have made it difficult to calculate the risks of a strenuous exercise. A recent suggestion by federal health officials that most Americans could stop wearing masks because of hospitalization numbers was confusing in some areas as to whether the chance of infection had changed, scientists said. “We’re doing a really awesome job of communicating risk,” said Katelyn Jetelina, a public health researcher at the University of Texas Health Science Center in Houston. “I think that’s why people throw their hands in the air and say, ‘Screw it on.’ “They are desperate for some kind of guidance.” To fill this gap, scientists are rethinking how to discuss the dangers of COVID. Some have studied when people could be exposed indoors, if the goal was not only to prevent overcrowding in hospitals, but also to protect people with immunosuppression. Others are working on tools to compare the risks of infection with the risks of a wide range of activities, finding, for example, that the average unvaccinated person 65 and older is about as likely to die from a micron infection as someone from heroin use for 18 months. But how people perceive risk is subjective. No one person has the same sense of the possibility of death from a year and a half of heroin use (about 3%, by one estimate). And beyond that, many scientists have said they are also concerned about this latest phase of the pandemic, which puts people at a disadvantage in making choices to keep themselves and others safe, especially while the tools to combat COVID remained beyond some Americans. “As much as we would not like to believe it,” said Anne Sosin, who is studying health equality at Dartmouth College. vaccination.” Collective measurements While COVID is by far the only threat to America’s health, it remains one of the most important. In March, even when deaths from the first micron wave plummeted, the virus was still the third leading cause of death in the United States, behind only heart disease and cancer. More Americans have died overall than they would normally die, a sign of the large number of viruses. As of the end of February, 7% more Americans were dying than expected in previous years – in contrast to Western European countries such as Britain, where overall deaths were recently lower than expected. The amount of virus circulating in the population is one of the most important measures for people trying to measure their risks, scientists said. That remains true, even though case numbers now count for real infections by a wide margin because so many Americans get tested at home or do not get tested at all, they said. Even with many lost cases, the Centers for Disease Control and Prevention now places most of the northeastern region at “high” levels of virus transmission. In parts of the region, the number of cases, although much lower than during the winter, is approaching the maximum growth rates of the autumn delta variant. Much of the rest of the country has what the CDC describes as “moderate” transmission levels. The amount of virus circulating is critical because it dictates how likely one is to catch the virus and, in turn, roll the dice to a bad result, scientists said. This is part of what makes COVID so different from the flu, scientists say: The coronavirus can infect many more people at the same time, and with the people who are most likely to catch it, the overall chance of a bad outcome increases. “We have never seen a prevalence of influenza – how big it is in the community – in the numbers we have seen with COVID,” said Lucy D’Agostino McGowan, a biostatologist at Wake Forest University. COVID vs. driving Even two years after the pandemic, the coronavirus remains young enough and its long-term effects quite unpredictable, so measuring the threat posed by an infection is a thorny problem, scientists said. An unknown number of people who become infected will develop COVID for a long time, leaving them severely debilitated. The risks of transmitting COVID also extend to others, potentially in poor health, who may consequently be exposed. However, with much greater immunity in the population than ever before, some public health researchers have sought to make risk calculations more accessible by comparing the virus to everyday risks. The comparisons are particularly strange in the United States: The country does not conduct the random sampling studies needed to estimate infection levels, which makes it difficult to know what percentage of infected people die. Jetelina, who published a series of comparisons in her newsletter Your Local Epidemiologist, said the exercise highlighted how difficult risk calculations remained for everyone, including public health researchers. For example, he estimated that the average vaccinated and fortified person who was at least 65 years old was at risk of dying from a COVID-19 infection slightly higher than the risk of death during one year of military service in Afghanistan in 2011. He used a standard risk unit known as the micromort, which represents a one in a million death chance. However, her calculations, however sketchy, included only recorded cases, rather than unreported and generally milder infections. And it did not take into account the lag between cases and deaths, looking at data from a week in January. Each of these variables could have shifted risk estimates. “All of these nuances underscore how difficult it is for individuals to calculate risk,” he said. “Epidemiologists also face a challenge with this.” For children under 5, he found, the risk of dying from a COVID infection was about the same as the risk of mothers dying in childbirth in the United States. This comparison, however, highlights other difficulties in describing the risk: Mean numbers can hide large differences between groups. Black women, for example, are almost three times more likely than white women to die in childbirth, which partly reflects differences in the quality of medical care and racial prejudice within the health system. Cameron Byerley, Assistant Professor of Mathematics Education at the University of Georgia, has developed an online tool called COVID-Taser, which allows people to adjust their age, vaccine status and health background to predict the risk of the virus. . Her team used estimates from earlier in the pandemic of the rate of infections that led to poor results. Her research has shown that people find it difficult to interpret percentages, Byerley said. She recalled that her 69-year-old mother-in-law was not sure if she should have worried about the pandemic earlier, as a news program reported that people her age had a 10% risk of dying from infection. Byerley suggested to her mother-in-law to imagine if, one in 10 times she used the toilet on a given day, she would die. “Oh, 10% is terrible,” she remembers her mother-in-law saying. Byerley estimates, for example, that an average 40-year-old who was vaccinated six months ago had about the same chances of being hospitalized after an infection as someone who died in a car accident during 170 road trips across the country. . (Newer vaccines provide better protection than older ones, complicating these predictions.) For immunocompromised individuals, the risks are higher. An unvaccinated 61-year-old with an organ transplant, Byerley estimates, is three times more likely to die from an infection than to die within five years of being diagnosed with stage 1 breast cancer. And this transplant recipient is twice as likely to die. dies from COVID than one dies while climbing Mount Everest. With the most vulnerable in mind, Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston, began last month determining how low cases would have to fall for people to stop the mask indoors without putting it on. at risk are people with extremely weakened immune systems. Imagine a hypothetical person who had no benefit from vaccines, wore a good mask, took difficult preventative medications, attended occasional gatherings and shopped but did not work in person. He set a goal of keeping vulnerable people at less than 1% in a four-month period. To meet that limit, he said, the country would have to keep indoor coverage until transmission fell below 50 weekly cases per 100,000 people – a stricter limit than what the CDC currently uses, but a limit it said nevertheless offered a point of reference to aim at. “If you just say, ‘We’ll take masks off when things get better’ – that’s true …