America rethinks its endgame for COVID

Driving the news: Top Biden officials acknowledged in a Senate hearing this week that most Americans will get Omicron at some point.

• "What we need to do is make sure the hospitals can still function, transportation, other essential services are not disrupted while this happens," acting FDA commissioner Janet Woodcock said, according to U.S. News & World Report.

State of play: Under the threat of Omicron and reports of overwhelmed hospitals, many Americans responded by hunkering down in recent weeks.

• But there is a great divide in behaviors. Many Americans decided they were done with COVID a long time ago.
• Preventing serious disease and death have been the most important goals since the very beginning, said Megan Ranney, academic dean at the Brown University School of Public Health, but the vaccines' early success against infection may have inflated expectations.

"We are starting to see a shift among the folks who take COVID seriously and I think it's an uncomfortable shift for many," she told Axios.

• A combination of vaccines, testing and higher-quality masks are helping low-risk Americans safely engage with the world around them.
• Parents have grappled with the safety of daycare or in-person school, weighed against the pitfalls of online learning.
• The approval of antivirals for the treatment of COVID in high-risk individuals is also a factor as individuals consider risk under the latest variant.

"Where I hope we're going is a recognition that these surges will happen, we're going to do what we can to protect ourselves and our families ... with an acceptance that in some shape or form, COVID is going to be part of our lives and we have to have strategies to deal with it," Ranney said.

Yes, but: There are still plenty of people who are immunocompromised who haven't seen the equation change.

• Experts also warn against the risk of Americans becoming complacent at this point, with so many sickened from Omicron and hospitals so packed with patients.
• "There's a lot more complication in the risk calculation," said Tara Kirk Sell, an assistant professor at the Johns Hopkins Bloomberg School of Public Health.
• "But when you look at the hospitalizations, the societal risk is still pretty high," she said. "And you think: Maybe I'm protected against COVID, but what if I get in a car accident? Will I still be able to get a spot in a hospital?"

The bottom line: While the risks are still very real, we're also learning as a country how to live with this virus.

• "We are coming to see as a country and as a world, there is no end in sight," Leana Wen, an emergency physician and public health professor at George Washington University, told Axios.
• "It would not be reasonable to shut down schools or shutter our economy every few months," Wen said.