Staying Fit
If there’s one thing we can safely say after two years of living under COVID-19, it’s this: Science isn’t perfect, but it works.
Public health experts made some mistakes before the true nature of the virus was known, from the initial guidance to forgo wearing masks in public to the advice on wiping down groceries and mail. Indeed, at the start of the pandemic, few experts believed it would be as bad as it’s been, says Cameron Wolfe, M.D., an infectious disease specialist and associate professor at the Duke University School of Medicine.
In February 2020, U.S. doctors who deal with “high-consequence pathogens” and disaster medicine were predicting a worst-case scenario of 500,000 U.S. deaths. But they were wrong. As of this writing, the death toll from COVID has surpassed 834,000 Americans, with more than 59 million infected. Roughly 93 percent of those who have died were 50 or older.

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But after two years of both triumphs and missteps, a lot of us have grown frustrated with science. Vaccines are miracles — or they’re not. “Long COVID” is a thing — or it’s not. Omicron, delta and other variants have thrown our best planning and predictions into chaos time and again. And across the country, public health practices are more and more driven by politics, media and culture rather than by science.
It’s confusing. And depressing. And as a result, COVID fatigue has become a real danger to our collective health.
“People are tired of the public health interventions,” says Andrew Badley, M.D., chair of the Mayo Clinic’s COVID-19 Research Task Force. “Masking and social distancing and handwashing and not going to crowded settings. Some people are doing that less and less, and I think that contributes to the spread.” Because we’re letting our guard down, “I think we will be seeing patients with severe COVID disease for years to come,” he says.
So as the two-year anniversary of COVID rolls around, let’s take a step back, get a solid look at just where we are, and answer some serious questions about the future of COVID and how to make 2022 as healthy, safe and productive as it can be.
1. If COVID vaccines are “90 percent effective,” how come so many vaccinated people get sick?
Until the omicron variant emerged, “breakthrough” infections in immunized individuals were rare, according to the Centers for Disease Control and Prevention (CDC), and they happened primarily in those who were immunocompromised. It appears that omicron has a greater ability to circumnavigate the initial vaccine series than other variants. Omicron makes it even more urgent not just to get vaccinated but to add a booster if you have not already done so, and to take extra precautions, especially if you’re over 65 or dealing with any chronic health conditions.
Here are the CDC statistics to keep in mind: Compared to people who are fully vaccinated with a booster, unvaccinated people are 10 times more likely to catch COVID and 20 times more likely to die from it. And for those 50 and older, the risk of forgoing vaccination is even greater.
The fact is, all vaccines — measles, shingles, influenza, pneumonia, what have you — vary in their effectiveness, says Paul Duprex, director of the Center for Vaccine Research at the University of Pittsburgh.
“The goal set for COVID-19 vaccines to be considered effective was 50 percent; they surprised us by hitting over 90 percent.” By comparison, our annual flu shots come in at around 40 to 60 percent each year. So the range of effectiveness of the COVID vaccines really is remarkable.
“Your immune system is like a football team,” says Panagis Galiatsatos, M.D., a pulmonologist and critical care specialist at the Johns Hopkins University School of Medicine. “You practice all week, but you have no idea what exactly you’ll be up against on Sunday. Even with the strongest players, you don’t know how well you’ll play against a team you’ve never seen before. A vaccine gives your football team the opponent’s playbook. So you’re gonna go out there and be more effective.”
That doesn’t mean the other team can’t occasionally win or that you can’t still get sick. But getting vaccinated dramatically stacks the odds in your favor and makes any illness you do experience much less severe.
Rates of COVID-19 Cases by Vaccination Status and Age Group

An interactive version of the CDC's chart is available here.