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Illustration: Annelise Capossela/Axios

The pandemic may not be over, but Americans are over the pandemic — and it's starting to show in our collective willingness to cooperate with public health guidance.

Why it matters: Over the last several weeks, the Delta variant dashed hopes of getting back to normal at a time when our patience for safety measures — and sometimes, each other — is already wearing thin.

What they're saying: "I certainly feel it, myself," said Anthony Santella, director of the doctorate of health sciences program for the University of New Haven School of Health Sciences.

  • "Unfortunately, it's not just a feeling. It's impacting people's health behaviors," said Santella, the university's COVID coordinator. "It'd be one thing if this fatigue and burden didn't have an impact on the pandemic, but it clearly does."

The big picture: Public health measures often rely on people doing what's best for the collective good. For instance, the CDC asked unvaccinated Americans to avoid traveling this Labor Day weekend — and suggested the vaccinated still take precautions.

Yes, but: That's getting harder.

  • Politics around the response become more entrenched — sparking sometimes violent fights over mask mandates in schools and in industries like air travel.
  • As the pandemic closes in on its second year, experts say COVID fatigue is becoming more widespread. It's causing many people to stop taking precautions, like proper hand hygiene or social distancing, or assessing risk the way they once did.
  • "People have let down their guard. There's a whole segment of the population that believes the pandemic is over," said Leana Wen, an emergency physician and public health professor at George Washington University.

What's happening: One of the big problems is our expectations — and how often they've been forced to shift.

  • Most people were sent home in March 2020 expecting to be back in a couple of weeks.
  • In the spring of 2021, the CDC announced the vaccinated could remove their masks. Then, at the end of July, scientists began telling the vaccinated to start using masks again as new data showed they could transmit the virus and hospitalizations began to skyrocket among the unvaccinated due to Delta.
  • "For a lot of us, the hope was that this summer would be a good one and we would be entering the fall with a low level of infection," Wen said.

By the numbers: It's taken a hit on our collective psyche. The share of Americans who say they feel hopeful right now has plummeted to 34%, from 48% in March, according to the latest installment of the Axios-Ipsos Coronavirus Index.

But, but, but: The number of Americans saying they feel motivated, energized, inspired or resilient has risen by at least as much.

  • That suggests that, rather than giving up, these Americans are reassessing their expectations about how quick a fix the first generation of vaccines alone can be— and resolving to do what it takes over the long haul.

The big picture: "We are in a very confusing time in the pandemic where people are making very different choices depending on their own family circumstances, their risk tolerance, as well as the activities that are most important to them," Wen said. "It makes navigating life very challenging and leads to individuals questioning one another for the choices they're making."

  • The way she thinks about it is, if you are vaccinated, you should be able to make the choices that make sense for you.

The bottom line: We may all need to take a step back and reassess our expectations for how long it may take to get back to normal — and understand that timeline may change based on how much we're all willing to do to get there.

Go deeper

Updated Dec 8, 2021 - Axios Events

Watch: A conversation on pandemic-era innovations' impact on health care

On Wednesday, December 8th, Axios health care reporter Caitlin Owens discussed pandemic-era innovations and the impact on health care in 2022 and beyond, featuring Scripps Research President & CEO Dr. Pete Schultz and Rep. Cathy McMorris Rodgers (R-Wash.).

Dr. Pete Schultz highlighted promising uses of mRNA in developing future disease treatments and vaccines, how lessons from the pandemic accelerated the speed in which new therapies receive use authorization, and recent progress on antiviral treatments.

  • On the pandemic’s acceleration of testing and authorization for new therapies: “I think that was a very interesting case of the entire scientific community turning its attention to a major health problem, and along with that came a huge increase in speed in which you could test new therapies and get to emergency use authorization of new therapies...it’ll be interesting to see how that impacts other diseases like cancer and heart disease.”
  • On optimism surrounding future antiviral therapies for coronavirus: “I think now there’s a lot of optimism that we can get to that kind of combination therapy and that combination therapy is what works, worked with HIV, and it’s what worked with HCV. Both of those have killed huge numbers of people, and I think there is now optimism we can get there with coronavirus in the next two years.”

Rep. Cathy McMorris Rodgers described how government leaders can make preparations now for the next pandemic and how pandemic-era lessons can be applied to innovations in other disease areas.

  • On how the pandemic underscored American innovation: “I think that there’s a lot of lessons that we can learn from that as to what reforms need to take place within the FDA. One of the big takeaways was the importance of real time review, whereas in years past it would take longer to bring that kind of a vaccine to market and be able to distribute it as quickly as we did.”
  • On the importance of transparency in public health messaging: “There’s just been too many examples that have resulted in trust being broken. I would urge the leadership at these agencies to be transparent...we need to be open to where the science is evolving and making sure that we’re being transparent with Americans along the way.”

Axios Co-founder & President Roy Schwartz hosted a View from the Top segment with PhRMA President & CEO Stephen J. Ubl, who described which health care priorities are at top of mind for many Americans going into 2022.

  • “When we ask Americans what they care most about in the health care system, two things rise quickly to the top. The first is their insurance-related costs, specifically their out-of-pocket costs for things like insurance premiums, deductibles, and co-pays are closely related. Second place is ending the pandemic, which of course, our industry has played a key role in the development of vaccines and therapeutics.”

Thank you PhRMA for sponsoring this event.

Airlines call for Biden admin's "immediate intervention" in 5G deployment

Photo: Tayfun Coskun/Anadolu Agency via Getty Images

The CEOs of leading U.S. air cargo and passenger carriers on Monday warned the Biden administration there could be "catastrophic disruption" after AT&T and Verizon deploy a new 5G service this week.

Driving the news: They said in a letter to Transportation Secretary Pete Buttigieg and other top federal officials ahead of the C-Band 5G service's deployment Wednesday that "the nation's commerce will grind to a halt" and "could potentially strand tens of thousands of Americans overseas."

Updated 3 hours ago - Energy & Environment

Thousands without power as "hazardous" winter storm lashes East Coast

Satellite imagery of the Northeastern U.S. taken by NOAA on Jan. 17. Photo: NOAA

A major winter storm lashed much of the East Coast Sunday and Monday, causing widespread power outages and disrupting travel over the holiday weekend.

The latest: Authorities in North Carolina confirmed that two people died in a car crash and that they responded 600 vehicle accidents during the storm on Sunday, per the Washington Post.

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