UCSF doctor: I'm about done being cautious because of COVID

AP Photo/Eric Gay

I’m sure a lot of people are thinking they were done with COVID a year ago or longer. What’s significant here is that this is coming from a doctor who has spent the entire pandemic urging caution on Twitter. Bob Wachter has been warning his 250,000 followers that the pandemic is not over while posting snapshots of data from the hospital where he works. But recently he’s started changing his tune based on what he’s seeing from omicron and that has been jarring for some of his very cautious followers. It started with this tweet last Tuesday.

In an interview published a week ago, Wachter explained why he’s finally ready to be done with COVID.

I believe it’s likeliest that it peaks soon and comes down in February, and we’ll find ourselves in a world where the risk to fully vaccinated individuals is quite low, and it gets low for a few reasons. For one, everyone should have some immunity because with the unvaccinated, most if not all will have been infected by the time this wave ends. This variant of the virus, which is now dominant, is more mild on average. And the risk is lower for immunocompromised and high-risk individuals because of the increasing availability of medications that decrease the chance they’ll get super sick…

I also think the “it’s been two years” thing has meaning. If we’re in a better spot and we know that COVID is going to be around forever, and you’re still looking at the world and saying, “I’m not comfortable visiting family, I’m not comfortable going on vacation,” what you’re basically saying is, “I’m never going to do that again.” How can that be a good life? If after two years you look around and say, “I’m still in hunker-down mode,” you’re going to be that way forever.

And I am not going to do that. I’m looking at risk levels to determine what allows for normal life, and I think it’s likelier than not that’s going to happen in the next month.

As for the blowback he received from some people on Twitter, Wachter says people who trusted him when he said there was a risk should continue to trust him when he says there isn’t:

What’s shocking in the blowback I received is people saying, “I trusted you, but not anymore.” It’s sad, but I hope they trust me if, in my judgment, I say we can soon do things we’ve been very careful about not doing. I’m 64 years old, so it’s hard to change the way I do anything, but the way I weigh risks in my life is locked in.

He also says the concern about young children and the immunocompromised is overblown. At some point, you can’t ask everyone to stop living because of the minute chance it might impact a small minority of people:

…counting on people in the community to do things to minimize the chances of exposing kids under 5 is too much to ask of community members, especially when the risk to kids that age is so small.

And that analogy is true of the immunocompromised too. If I know I’m interacting with someone who is immunocompromised, I will happily wear a mask. But there are 7 million people in the U.S. who can be classified as immunocompromised. That’s 7 million out of 350 million. To ask everyone else in the 350 million to be much more careful in their lives than the situation would dictate for them in order to protect the 7 million, that’s a lot to ask.

From the beginning of the pandemic it has been clear that differing people have very different views of how much risk is acceptable. Dr. Wachter has been a voice of caution and even last week he was still warning we needed to wait a few more weeks until the omicron peak was over. Still, even for someone advising people be extremely careful, his advice is now shifting to something like get vaccinated and be done with COVID.

When even the very cautions among us are saying it’s over, our public policy ought to reflect that, i.e. stop with the mask mandates for adults and little kids and get teachers back to schools. And there’s some indication that even in California we’re finally heading in that direction: