Scientists prepare for the next phase of learning to live with Covid.

Scientists prepare for the next phase of learning to live with Covid.

As the Omicron wave subsides in regions across the world, more governments, politicians and health officials are telling us that it’s time to start “living with the virus.”

But what does that mean? And how do we do that?

For guidance, The Times asked more than a dozen epidemiologists about the next phase of the pandemic and how they’re approaching it.

Living with the virus “is an acknowledgment that eradication of SARS-CoV-2, like what we did with smallpox, is not feasible,” said Maria Sundaram, an infectious disease epidemiologist at the Marshfield Clinic Research Institute.

Instead, we’ll need to rely on an arsenal of tools — including vaccines, paid sick leave and masks — to coexist with the virus while reducing our own risk and protecting others.

Eventually, the thinking goes, we’ll get to a point where the coronavirus is incorporated into other common viruses we are used to dealing with all the time, said Pia MacDonald, an infectious disease epidemiologist at RTI International, a nonprofit research institute. “We should each reflect on how we live with other viruses that routinely circulate, such as influenza, respiratory syncytial virus, noroviruses and others.”

That’s going to require a huge mental shift and acceptance of “a new element of manageable risk in our lives,” said Eduardo Franco, the director of the Division of Cancer Epidemiology at McGill University. “It means reacquiring behaviors, attitudes and social norms,” that have always been part of who we are.

In practice, this readjustment will vary widely for different people depending on our personal health circumstances and the needs of those closest to us.

“My family has moved away from restricting our activities as the Omicron surge has receded,” said Kate Eisenberg, an assistant professor of family medicine at the University of Rochester. “We do not have anyone with high-risk health conditions in the household, and we’re all vaccinated and boosted.”

Ms. Eisenberg is currently planning some family trips, including air travel, and she is allowing her 12- and 15-year-old children to participate in most social activities. She has been avoiding indoor dining and crowded indoor settings, but as cases continue to come down, she plans to go out more.

“I am taking my daughter to a Billie Eilish concert this weekend, which we’ve really been looking forward to,” she said. “We do still wear well-fitting masks, take home tests before getting together with friends and family, and assess the level of risk and local case levels before we go out.”

For Ms. MacDonald, the drop in cases has made her more comfortable entering other people’s homes without a mask, and having her older parents over for visits.

“I will still wear a mask to the grocery store for the foreseeable future and opt for restaurants that have good ventilation and where tables are well spaced out,” she said. “So long as cases are not surging locally, I will take advantage of mixing with my community at music, movie, theater and other venues, though will likely wear a mask out of habit.”

For many Americans, however, any big adjustments are still on hold until young children can get vaccinated.

“Our children are both in child care, and we’ll go into uncrowded shops, museums and libraries with masks on, though we don’t do any indoor dining and haven’t flown on a plane,” said Julianne Meisner, a clinical assistant professor at the University of Washington School of Public Health.

But after her 1- and 3-year old are vaccinated, she said, “we’re planning to resume indoor dining and take some trips to visit family and take some outdoorsy vacations. But we’ll have our eye on what’s going on and be ready to revisit plans if local transmission goes up or health care capacity begins to suffer.”

After we’ve spent two years of living in fear of the virus, being asked to “live with” it now may seem daunting. But in many ways, we’ve been preparing for this moment since the outbreak and it can be easy to forget how far we’ve come.

“For the first year of the pandemic, I routinely received questions from friends, family, patients and acquaintances about how to think about risk in different situations before making decisions,” Ms. Eisenberg said. “Now, hardly anyone asks those questions and most people have settled on their own conclusions about what works for them.”

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