Rethinking breakthrough COVID

The New COVID Panic: What vaccinated people should really know about their risk from the delta variant—Susan Matthews at Slate

We need to reconsider how we think about breakthrough COVID cases—vaccinated people who get COVID anyway. Though the vast majority of hospitalized people are unvaccinated, breakthrough cases will “happen with increasing frequency—and we shouldn’t be surprised when they do.”

And, while the vaccines are great at preventing severe illness, we need to rethink how we think about severe illness. Even mild COVID can leave you flat on your back, miserable, feverish, and useless for much of a week. But you’re not in the ICU, and you’re not dead.

All of this is making people—yes, probably mostly vaccinated people—rethink the basic questions they thought their vaccine had answered for them: Can I go to restaurants and bars unmasked? Can I go back to the office? Can I see my grandma? Can I go on vacation? Can I unmask at my people-facing job? Can I have a wedding, or a party? The answer to those questions is not quite as easy as “yes, if you’re vaccinated.” It depends partly on how many in your group are vaccinated, but the actual answer is basically the same as it’s been all pandemic: It depends on your risk tolerance, it depends on what is happening with case counts locally (though, as more people travel, this might become a less reliable tool), and it depends on any unique risk factors in your group. Kass’ perspective felt novel to me: She said she suspects that in the end, a lot of people are going to end up boosting their immunity by suffering through a mild case of COVID. So no one should feel that bad about getting sick after they’re vaxxed. What matters is getting the order right: “If everyone who gets vaccinated still gets COVID but doesn’t die, that’s a success,” she said. The issue is that it doesn’t feel like a success for vaccinated people. Plus, “if you get infected after you’re vaxxed, it’s all you talk about,” she said. And right now, that’s understandably freaking out a lot of vaccinated people who thought they were in the clear.

I’m putting myself indoors, around other people, and unmasked about as often as I did in 2019 and earlier. Probably a little more. On the other hand, I’m by nature an introvert, which means that’s only a few times per week.

My rationale is that federal, state, and local authorities here in San Diego are not recommending masking for vaccinated people. I have spent much of the last 1.5 years rolling my eyes at people who think theyr’e smarter than the pros—I’m not now going to do the same.

However, I’m not a jackass about it. If somebody asks me to mask up, I mask up cheerfully and willingly. Also, we’ve had workmen in the house a couple of times, and I offer to mask up when they’re here, making it clear that I’m fine doing so.

One thought on “Rethinking breakthrough COVID

  1. pimoore:

    @MitchWagner Great post, I agree with both your thoughts and the quote. Forcing ourselves past our own personal risk factor and back into normality will definitely be a challenge, but like you said the risk of ICU and death is what the vaccine is especially meant to prevent. I personally can’t wait to not wear a mask anymore once the regulations are dropped, but I have no problem wearing one either should the need or request arise on occasion.



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