‘Swiss cheese’ model is key to protecting the most vulnerable as COVID restrictions end

With the omicron wave receding, many places are starting to remove at least some of their remaining pandemic restrictions.

This shift could have large benefits. It could reduce the isolation and disruption that have contributed to a long list of societal ills, like rising mental-health problems, drug overdoses, violent crime and, as Substack’s Matthew Yglesias has written, “all kinds of bad behavior.”

But the removal of restrictions has downsides, too. Millions of Americans remain vulnerable to COVID-19. The largest group of the vulnerable, by far, is the unvaccinated, who have the ability to protect themselves and have chosen not to. Another group of people, however, have done what they can to stay healthy — by getting vaccinated — and yet remain vulnerable. They include the elderly and people with immunodeficiencies that put them at greater COVID-19 risk. According to the Centers for Disease Control and Prevention, more than 75% of vaccinated people who have died from COVID had at least four medical risk factors.

At this point in the pandemic, there is a strong argument that a targeted approach — lifting restrictions while taking specific measures to protect the vulnerable — can maximize public health. The right approach, Jennifer Nuzzo, a public health researcher at Johns Hopkins University, said, involves “moving away from broad, blunt tools to more precision tools.”