Baylor College of Medicine

Back to Normal?


March 24, 2021


Dear Members of the Baylor College of Medicine Community,
It is getting increasingly difficult to be a COVID-19 pessimist.
To be sure, there are still plenty of important areas of concern. What happens if a new variant emerges that is not vaccine sensitive? What impact will spring break revelers have in the spread of the virus? Will we have a fourth wave?
However, the mounting good news is hard to ignore. Nationally, with a few exceptions, new case rates and hospitalizations continue to fall. Across Texas, in January virtually every county had a high new case rate and high test positivity rate. Today, the overall state dynamics have clearly improved. Locally, the data from the TMC shows at worst a plateauing of new cases, and steady decline in COVID-19 hospitalizations, with a test positivity rate approaching 5%. Our numbers our good – not great – but trending in the right direction.
The real cause for optimism is our national progress on vaccinations. We are vaccinating people at a rate of about 2.5 million per day, and nearly one out of every four Texans has received at least one dose, and with that dose at least partial immunity. Significantly, effective next Monday, March 29, the state will make all adults vaccine eligible. (Note: it will take some time for supply to catch up with the widely inclusive criteria.) Goodbye to “1A” and “1B.” This means that within a couple of weeks we will be able to vaccinate literally every employee, faculty member or learner who wants to be vaccinated. Our little herd will start to look increasingly immune.
The natural next question is already being asked: If we are all (or mostly all) vaccinated, when can we return to normal? This is a question that College leadership will work to responsibly answer in the coming weeks. As you might imagine, the decision to migrate back to normal clinical, research, educational and business practices is complex. Normalcy will not occur next week or next month. I know it is coming, but my crystal ball is hazy.
Collectively, we have been the victim of a major traumatic event, and recovery will be complex. By way of analogy, imagine someone who lives in a major city and generally walks around without fear – day and night, alone or in groups, well-lit streets and dark alleys. This is their normal. Now imagine our hypothetical urban dweller is the victim of a mugging. When would they return to normal? Perhaps they would take a self-defense class first. They may pay more careful attention to the data from crime reports to get a sense of when it is safe to venture out again. Maybe their behavior would be altered, sticking to busy streets, or always walking with a group.
This is how our journey back to normal will progress. We will need to see evidence of wide-spread community vaccination (our self-defense class). The COVID-19 community data will need to be consistent with true community control (sustained low case rates, sustained low test positivity rates). We will need to be sensitive to the fact that we have been engaged in cautious behavior for a year – while some will be chomping at the bit to fill up restaurants, auditoriums and arenas to capacity, others will be inherently more cautious. 
These are dynamics that will be at play for all businesses. In addition, Baylor must live up to additional responsibilities. As a provider of health care services, we will remain appropriately conservative in our clinical environments. As a leader in the community, we need to be aware that others will look at the decisions we make. We need to set a strong example for others to follow.
The path back to normalcy will be a process, not an event. It will move too fast for some, and creep along for others. Baylor leadership will work to strike the correct balance as we move into what I hope is the terminal phase of the pandemic. For now, we will continue to wear our masks, and continue to maintain our physical distancing as we work to get our entire community vaccinated. 

Stay tuned.
James T. McDeavitt, M.D.
Senior Vice President and Dean of Clinical Affairs

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