The U.S. Centers for Disease Control and Prevention (CDC) reports that we may need to continue social distancing and hand washing for years to come. The significant reduction in non-COVID-19 respiratory infections this year could decrease the number of people who are immune to other respiratory viruses, and increase the frequency and severity of other respiratory infections in the future (Proceed of the Nat Acad of Sci, December 1, 2020).

• Positive influenza tests in December 2020 are a little less than 1/100 of those reported in December 2019. Influenza regularly infects between 3 to 11 percent of the U.S. population, kills about 36,000 people, and hospitalizes almost half a million. Adult flu deaths this season are down considerably from the 2018-2019 flu season, in which an estimated 34,200 people died. The number of children in the U.S. who have died of the flu this season is less than 10, compared to the usual 100 to 200 per year (CDC Weekly Report, Sept 18, 2020;69(37);1305–1309).

• Positive Respiratory Syncytial Virus (RSV) cases are 1/200 of those a year earlier. Last year there were only 120 RSV cases, compared with 24,280 the year before (Lancet, September 18, 2020).

• Researchers found that the number of pediatric patients hospitalized for respiratory illnesses in 44 children’s hospitals is down by more than 62 percent (J Hosp Med, March 8, 2021).

Recommendations for People Who are Vaccinated and Immune to COVID-19
The CDC released recommendations for fully vaccinated people who are two weeks past their second injection of the Moderna or Pfizer COVID-19 vaccines, or have had the one-dose Johnson & Johnson vaccine (JAMA, March 10, 2021). As of April 5, 2021, more than 62 million people (almost 19 percent of the U.S. population) had completed these vaccines. Fully-vaccinated people may continue to shed the virus, even though they are protected from blood-borne infections, and so may still be able to infect others. Fully vaccinated people may still acquire the virus, but are at markedly reduced likelihood to suffer severe disease, be hospitalized or die, or to transmit the virus to unvaccinated people. The CDC estimates that approximately one third of U.S. adults do not want to get vaccinated. It is likely that, as with polio and smallpox, the pandemic will persist until a large percentage of the population are immunized.

Most people who have recovered from COVID-19 appear to gain immunity for more than six months (Science, 2021;371(6529):eabf4063). Since vaccination helps to prevent infection from the SARS-CoV-2 variants that have been found so far, the CDC recommends that individuals who have recovered from COVID-19 should receive at least one injection of a COVID-19 vaccine. The CDC’s other recommendations are listed here: Guidelines for COVID-19 Fully Vaccinated People

My Recommendations
COVID-19 has reminded us how easy it is to spread germs in our everyday lives, and how our simple changes of behavior can help to protect us. Even when the current pandemic subsides, these behaviors should stay with us:
• Be selective about going to indoor events and places where large numbers of people congregate.
• Wear a face mask when you expect to be with large numbers of people.
• Try to stay at least three feet away from other people’s faces.
• Wash your hands frequently and use hand sanitizers.
• The habits of not shaking hands or hugging that you have learned during COVID-19 can be maintained permanently. Continue to use fist bumps instead, and restrict hugging to members of your family or close social group.