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Minneapolis and St. Paul just lifted their mask mandates. Is it OK to stop worrying about COVID?

Now that the surge of omicron cases seems to be winding down, a lot of people — even those who were pretty careful throughout the course of the pandemic — are talking about being done with always masking indoors, avoiding crowds and mostly staying home.

Governments are relaxing rules, too.

On Thursday, the mayors of Minneapolis and St. Paul each lifted the indoor mask mandates in their respective cities (though masks are still required in government buildings). The U.K. is removing its remaining restrictions designed to slow the spread of the virus. California Gov. Gavin Newsom has said it’s time to live with the virus, and is putting resources into trying to detect and quash outbreaks.

Even institutions that have long maintained COVID-19 mitigation measures are starting to let them go: The DFL-controlled Minnesota House, which has long mandated masks, is now only requesting they be worn (few appear to be taking that guidance). Target, which had required masks for employees and recommended them for customers in high-transmission areas since August, rescinded that policy this week and will follow local guidelines.

Case counts in Minnesota are down significantly from their omicron-driven peak. Is COVID over? Or, at least, is it okay to stop worrying quite so much about it?

What the data show

For more than six months, Minnesotans have been living in a seemingly-endless wave of COVID-19 cases. This was kicked off by the spread of the delta variant late in the summer. Then, it was amplified by the faster-spreading (and more vaccine-evasive) omicron variant, which became dominant in December and dragged the wave out through February.

Finally, the state seems to be on the other side of that wave. Both COVID-19 case numbers and wastewater data suggest levels of COVID-19 in Minnesota are at levels not seen since summer.

New COVID-19 cases per 100,000 people by day
Source: Minnesota Department of Health

In a statement, the Minnesota Department of Health expressed cautious optimism that things are getting better: “We all hope we are approaching the end of the most disruptive phase of COVID-19 and that the decrease in positivity rate as well as hospitalizations will continue. It is encouraging to see a reduced rate of transmission, but we also must keep in mind that the amount of virus in our communities remains elevated, and we are not in the clear yet.”

MDH further cautioned that the virus will continue to mutate, and infection-preventing immunity doesn’t appear to last a lifetime, so Minnesotans need to be prepared for potential future waves.

But at this point in the pandemic, things are, in some ways, different.

“I think it’s very rational to be, ‘once this is over, life has to start returning to normal,’” said Dr. said Rebecca Wurtz, the director of the Public Health Administration and Policy program at the University of Minnesota School of Public Health. “It’s a new normal, as lots of people have said.”

What does that mean?

Between all the infections (many from the omicron surge), vaccines that the majority of the population now have and people who have both gotten the vaccine and the virus, a large share of the population have some level of immunity to the COVID-19 virus. Some estimates put that number at 80 percent, Wurtz said, something that differentiates the point we’re in now from prior parts of the pandemic.

“I think over time, we’ll probably get away from this heightened anxiety about COVID,” Wurtz said. While COVID-19 isn’t the flu, people will start to think about the virus more like they think about the flu, although Wurtz said she thinks many people will probably remain more conscious and thoughtful about respiratory viruses overall.

Harm-reduction

Dr. Jill Foster, a pediatric infectious disease physician at the U of M Medical School and M Health Fairview, thinks of approaching COVID-19 at this point in the pandemic in terms of harm reduction, a set of principles that dictate public health approaches to things like drug use and sexually transmitted disease prevention.

“It was always, what’s the most dangerous thing you could do? And then what’s the safest thing you can do? And then what’s in between that?” she said.

With COVID-19, too, it’s not all or nothing. Depending on caseloads, personal vulnerability and the vulnerability of the people you’re spending time with, there are ways to mitigate spread, Foster said.

“I’m viewing it like threading a needle. So we just had a surge, and we’re going to have another surge but we’re in the time in between. So we can probably loosen things up a little bit,” Foster said.

Remaining thoughtful about people who are immunocompromised and managing exposure to them will remain important, Wurtz said. But that is possible by taking steps not to be exposed to COVID-19 and other respiratory viruses, not visiting people when sick and perhaps taking a rapid test right before seeing people who are immunocompromised as an extra precaution.

Looking ahead

The future of the virus is uncertain in some ways, and less-so in others.

For one thing, Foster said, there will be more waves — we just don’t know what they’ll look like.

“Pandemics don’t just end, they just sort of level off … [there’s] more space in between the surges and eventually the surges are less and less severe,” she said. “Let’s hope for that pattern.”

But the question of mutations remains.

“The question is, what will the virus be then? It could be one that is just a really wimpy virus,” she said.

For now, with cases low and immunity more widespread, Wurtz said it’s OK to start getting back to a new, albeit more conscientious, ‘normal.’

“For people’s mental health and for people’s economic health, and for people’s relations with family and friends, I think we have to start emerging and out into the into the world and just to do that with thoughtfulness and caution and with respect for the immunocompromised people, or the people who choose to continue wearing a mask,” she said.

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