COVID is entering year 4. And I’m starting to hear … optimism?

We are about to enter year four of the COVID-19 pandemic. Year four.

Jan. 20 marks the third anniversary of the day the United States reported its first COVID diagnosis. So much that’s happened since has been unfathomable: More than 1 million people in the U.S. have died, millions more have long COVID, and tens of thousands of children lost a parent or key caregiver — including more than 4,000 in Pennsylvania.

As I said, it’s all unfathomable.

But here’s what’s also unfathomable — in a good way.

The first vaccines — grounded in a scientific process discovered at Penn — got a green light from the Food and Drug Administration less than one year after the first COVID case was diagnosed. (Vaccine development usually takes five to 10 years.) The vaccines weren’t just developed quickly — they were amazing. If you cut through all the noise and politics around the shots, data consistently show that the COVID-19 vaccines dramatically reduce the risk of severe disease or death. The more than 665 million doses administered in this country have saved countless lives.

But, as an op-ed in the Washington Post reminds us, COVID isn’t “done with us” quite yet. A recent variant, XBB.1.5, is responsible for more than 75% of infections in New York and New Jersey, and may help explain the rise in cases in our area after the holidays (besides, you know, people getting together during the holidays). But as long as the new variant doesn’t cause spikes in deaths and hospitalizations or other serious consequences, it doesn’t have to be cause for concern. (Although repeat COVID infections may increase the risk of developing long COVID.) So far, I haven’t seen data to suggest XBB.1.5 is any more severe than what we’ve seen before.

And there is something else I’m seeing now that I haven’t seen since Jan. 20, 2020: optimism.

You read that right.

“I think we’re doing great,” Paul Offit, a prominent immunization expert at Children’s Hospital of Philadelphia, told me recently, noting the rapid development of vaccines and treatments that work against the virus. Although it’s “extremely unlikely” COVID will go away anytime soon (it’s even in local deer), as long as we continue to avoid steep climbs in hospitalizations or deaths, the impact of COVID could “get a little less with each passing year,” predicted Frederic Bushman, chair of microbiology at the University of Pennsylvania’s Perelman School of Medicine and codirector of the Penn Center for Research on Coronavirus and Other Emerging Pathogens.

“If you had asked me in September, I would have thought we’d be seeing double the number of cases than what we are seeing now,” David Rubin, director of PolicyLab at Children’s Hospital of Philadelphia, told me this week. In that way, he said, COVID may be starting to transition from a “pandemic” to an “endemic” virus — meaning, the amount present from year to year stays relatively steady and predictable, perhaps peaking during colder months, with an “acceptable level of risk.” In other words, an endemic virus still kills people, just in predictable numbers that society is willing to shrug off.

The sad truth is that endemic viruses like influenza have been killing people long before COVID got here, particularly during this time of year. But that didn’t matter much to our society — we deemed the heightened risk to some of us as “acceptable,” and didn’t let it stop most of us from living our lives. That looks a lot like our approach to COVID lately.

Around 400 people are dying of COVID each day — 9 out of 10 of whom, according to a Washington Post analysis of CDC data, are 65 or older. In a popular comparison, that’s roughly equivalent to a full 747 airplane crashing to the ground, every single day. But since most of the passengers of these doomed aircraft are old, it doesn’t seem to bother us.

So when we shrug off the ongoing risk of COVID as “acceptable,” we are really shrugging off the ongoing risk of COVID to the elderly, who remain vulnerable because of their weakened immune systems. To be frank, we’ve never prioritized the health of older people. Every year, thousands of people over the age of 65 die from flu in the U.S. People don’t really talk about that. I was a science writer for 25 years, and even I didn’t realize how deadly the flu is to the elderly until my father entered a nursing home in 2019, and that winter, the walls of the hallways and elevators were dotted with signs begging visitors to wash their hands and cover their coughs. A virus has always been able to wipe out an entire community in this country. We’ve just chosen not to think about it.

Even if the general public looks away from the ongoing risk of COVID and other viruses to certain people, our health officials can’t, and they must do a better job of keeping our elderly residents up to date on their vaccines. At the end of December, only 3 out of 10 Pennsylvania nursing homes said at least 75% of their residents were current with their COVID shots; in Philly, the numbers were even worse.

We could plaster the halls of every building in winter with the signs I saw in my dad’s nursing home to remind people that their kid’s sniffle could kill their 90-year-old grandmother, so maybe they should skip that family party or wear a mask. But the most effective public health measures, according to Usama Bilal, an epidemiology and public health expert at Drexel, are the ones that don’t require people to change their behavior. To him, the best way to protect everyone from COVID and other viruses would be to invest in better air ventilation systems — especially at schools, where any costs would be offset by fewer cases of asthma and other illnesses, which also force caregivers to take off work. “It’s an investment that’s going to pay off,” he told me.

The bottom line, of course, is that society has to care. We have to care that even if COVID becomes endemic, it can still kill, and not stop caring about the people who remain vulnerable.

But I’m not optimistic about that.