In a new study, researchers predict that lifting coverage and social distance restrictions in March 2022 could lead to a resurgence of Covid-19 deaths in most states, based on predictions from a simulation model.
The study also found that delaying the lifting of restrictions would not prevent an increase in deaths in these states, concluding that there was no “magic moment” for lifting the restrictions.
The study, published Friday in the Journal of the American Medical Association Health Forum, predicted Covid-19 deaths in each of the 50 states, the District of Columbia and Puerto Rico between March 1 and December 31, 2022. The researchers simulated removed restrictions at different times of the year and predicted the number of deaths that would follow using current estimates of infection and vaccination rates, while taking into account differences in risk between age groups.
“There is probably no extra waiting time in any condition after removal [Covid-19 restrictions] “It will not lead to an increase in morbidity and mortality,” the study said.
In almost every state, he says, lifting restrictions anywhere in 2022 would lead to a resumption of the top Covid-19 deaths observed during the Omicron explosion due to the high transmissibility of the circulating variant.
However, when the researchers repeated the analysis using the transmissibility of the less contagious Alpha and Delta variants, they did not see a similar increase in deaths.
“If we did not have Omicron, we would not have this problem,” said Dr. Benjamin Linas, co-leader of the study and professor of medicine at Boston University School of Medicine.
The delay of the lifts had a different effect on the deaths from Covid-19 depending on the state.
In California, Montana, North Carolina and Oregon, extending the restrictions by just one month helped flatten the death curve, although nowhere could an increase in death rates be prevented. However, delaying the lifting of the restrictions could help alleviate the significant burden on hospitals in these states, the authors wrote.
The study found that extending Covid-19 restrictions resulted in higher deaths when the restrictions were to be lifted in Massachusetts, New Jersey, New York and Ohio. Linas said this is most likely due to weakening immunity in states with lower levels of natural immunity, which is the type acquired after infection.
In Florida, Illinois, Michigan, Tennessee and Washington, meanwhile, the projected death toll has remained relatively similar despite modeling delays in lifting restrictions. In these states, extending the restrictions would not change the severity of the disease in the community.
For these states, “the thing that needs to change is this background of vaccination and immunity, and that’s the way out,” Linas said.
Therefore, deciding when orders will be removed requires a cost-benefit analysis, he said. On the one hand, some states will have to weigh the postponement of the increase in deaths and on the other hand it is a return to normalcy.
“I would like policy makers to take part in the study and try to lead the honest debate we need now, that is, what is the goal of our mitigation policies?” said Linas.
The study uses a simulation model in which many assumptions had to be made and can not predict the transmissibility and severity of any future variants of Covid-19. The model also does not take into account interstate travel and the role it can play in transmitting infection.
In addition, it is possible for people to continue to wear masks and keep social distance even after state restrictions are lifted, possibly reducing the peak death toll.
