With a downturn in COVID-19 cases and deaths in the United States, officials and others are considering how many COVID deaths are acceptable moving forward:

Implicit in a decision to drop the last remaining safety rules is a willingness to abide the current mortality rate. Over the last week, COVID-19 has claimed an average of 626 lives in the U.S. each day. That’s fewer than the roughly 1,900 who die of heart disease and the 1,650 who die of cancer each day, on average, but well above the 147 are lost to influenza and pneumonia combined.

For public health experts, the calculus is more explicit. Mortality and morbidity — the words their profession uses for death and illness — are on one side of the equation, and tools like seat belts, blood pressure medication, smoking-cessation programs and vaccines are on the other.

Those tools vary in cost, intrusiveness and political acceptability. Despite public health campaigns and legal mandates, Americans continue to drive drunk and leave seatbelts unfastened. Tobacco kills more than 480,000 people a year in the United States, yet 34.2 million adults continue to smoke. Diabetes claims more than 100,000 lives a year, but efforts to discourage the sale and consumption of sugary drinks — a significant contributor — have met fierce resistance.

At some point, all efforts to limit preventable deaths will hit the hard wall of funding constraints, medication availability, and people’s willingness to take steps to protect themselves and others. That’s where the number of deaths that is “acceptable” comes into focus…

The CDC and other federal agencies are still deciding on the criteria they’ll use to determine when the pandemic has ended. There’s still time — Dr. Rochelle Walensky, the agency’s director, said as recently as last week that we’re not there yet.

What I would highlight here as a sociologist:

1. The relative risk of different illnesses or behaviors are not just determined by numbers. The first paragraph cited above highlights the number of people who die each day in the US due to different conditions. But, this does not mean each of these illnesses is experienced the same nor is thought of as the same kind of threat. See earlier posts on the acceptable deaths due to driving (and pedestrians).
2. Decisions like these are made by a constellation of actors with a variety of interests. The public is involved in how leaders think the public will perceive changes, pressure the public can place on officials to make particular decisions, and in how the public responds. This is a process with numerous organizations and institutions involved.

Declaring an end to the COVID-19 pandemic is not easy nor is addressing the illness beyond the official end of a pandemic. Like much involving health, policies and behavior depends on social conditions and influences.