A case of Covid-19 doesn’t mean what it used to if you are vaccinated. Most breakthrough infections, which will grow as the number of vaccinated people increases, so far remain mild.

Thankfully the variant is arriving in a different pandemic landscape in the United States: one in which vaccines, tests and, soon, oral treatments are available. The country will need a new framework for thinking about what comes next, and in highly vaccinated areas, focusing on a different set of numbers, hospitalizations, rather than case counts, can better tell us how we’re doing.

America is in the slow process of accepting that Covid-19 will become endemic — meaning it will always be present in the population at varying levels. But the United States has effective tools to deal with that reality when it happens in the future.

Learning to live with the virus in the long term will require changes in both mind-set and policy. Relying on Covid-19 hospitalizations as the most important metric to track closely will provide the most reliable picture of how an area is faring with the virus. And by focusing attention on the number of hospitalizations, health professionals can better focus on reducing them.

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