COVID is coming back

Shh. It's bad enough that the economy is falling apart. Don't tell anyone, but COVID is coming back.

I've been spending too much time in doctors' offices, where they still wear masks, doing deferred maintenance, as it were. And everywhere I go - from one -ologist to the next - the message is the same.

Have you gotten your boosters? Plural, my friends.

Have you heard the news?

The news is that the positivity rate is going up quickly. The news is that the intensive care units are filling up. The news is that more people are being hospitalized. The news in Los Angeles County is that the case rate has gone up over 40% in the last week. Cedars Sinai, the hospital of choice for glitterati and lucky regular people, has no ICU beds available.

The solace in all this is that the number of deaths is not going up at the same rate.

Not to say that it couldn't. But better care and vaccinations mitigate the harms, at least for those not suffering from serious preexisting conditions.

COVID has killed 1 million of our fellow Americans. It can still kill you.

But for most of us, thankfully, the question is how to live with COVID.

It's not an easy question to answer. You can be careful. But presumably, the president's daughter and the secretary of Health and Human Services were being careful and are still today's headliners of the "who tested positive" sweepstakes.

Health officials where I live are warning that the risk level has gone from low to medium in a matter of days and are urging people to take the kind of precautions that were once routine. Like masking. Social distancing. Not seeing people.

Fat chance.

We appear headed for a spike, and no one wants to go back. By back, I mean back to the bad old days when no one smiled at any one, we avoided all unnecessary social contact, and we ate too many instant noodles. By back, I mean back to the bad old days of isolation and suspicion, of wondering whether people who said they were being careful were really being careful, of contact-tracing and quarantining and the like.

Thinking back, it almost seems surreal.

Thinking of going back is beyond surreal.

How we survived is another story, and not one we are ready to tell, much less relive.

We know how to hide from a pandemic, with mixed success.

But who will tell us how to confront one?

The problem health officials face in the coming weeks, if indeed the spike is real, is that almost no one trusts them. One of the casualties of COVID, in addition to the unfathomable human loss, has been the loss of confidence in government - in all the alphabet agencies, with their confusing and sometimes politicized decision-making; in political leaders, especially those who seemed to offer leadership while cooking the books; even in science, that thing that everyone claimed to be following in opposite directions.

The way past this spike cannot be backward but forward. It is about living with the risk of COVID, minimizing that risk in ways that still feel like living, and managing that risk by taking the steps we can take to improve our own odds. What is stunning about the vaccination numbers is not how well we have done but how many Americans are still not fully vaccinated or, if they are, aren't boosted. Haven't we learned that COVID shots are more like flu shots - temporary, even seasonal, in their effectiveness - than like the vaccines of our childhood?

COVID is not a memory that can start to fade, but a reality to be addressed forthrightly in the interest of living fully. The lasting lesson of COVID, the one we should never forget, is how much poorer life was in isolation. There is a very good reason we must move forward and not backward, however difficult that may be.

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