How to Live With Covid When You Are Tired of Living With CovidMichael T. Osterholm, PhD, MPH
The BA.5 surge is a reminder that we need to take precautions to avoid illness, slow the relentless cycle of new variants and minimize the disruption to our daily lives.
The United States is in the midst of another coronavirus surge, this time thanks to the Omicron subvariant BA.5. Scientists warn that the new subvariant appears to be the virus’s most transmissible version to date, and it is reinfecting people who have already dealt with previous variants once or twice, sometimes as recently as a few weeks ago.
The small percentage of people who avoided Covid-19 for two and a half years are also finding out BA.5 has ways of slipping past their defenses. Even President Biden, who had managed to avoid an infection, tested positive on Thursday. Like many Americans, the president and his aides had let their guard down, loosening stringent Covid precautions previously employed at the White House.
Everyone just wants to get back to normal, though polls show that few Americans are sure what living with Covid should really look like. Most cities are unlikely to bring back mask mandates or other protective measures used earlier in the pandemic, or even in the original Omicron surge.
“We’ve had a shift in our baseline,” said Michael Osterholm, an epidemiologist and the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Hospitalizations have roughly doubled since May and more than 400 Americans are dying every day, but these numbers are significantly lower than the peak of the winter Omicron wave.
“Earlier in the pandemic, we would never have accepted these numbers,” Dr. Osterholm said.
There’s also the potential for developing symptoms of long Covid, which researchers are trying to fully understand. Still, experts are weighing in on those concerns.
“We can live our lives knowing very well that this risk exists,” said Dien Ho, a bioethicist at Massachusetts College of Pharmacy and Health Sciences.
The question is, Which public health measures does the nation need to prioritize? And what can you do individually to lower your risk of exposure, slow the relentless cycle of new variants and minimize the disruption to daily life? Here are five steps to take, if you haven’t already.
1. Max out your vaccines and boosters.
If you have not received your booster — or any shots at all — experts say that the current surge is a good reason to schedule an appointment now. Vaccines provide excellent protection against serious illness and booster shots can amplify those benefits. But fewer than half of Americans have received boosters, and less than a third of adults who are eligible for their second booster (or fourth shot) — those who are immunocompromised or above 50 — have received it.
The Centers for Disease Control and Prevention’s use of the term “fully vaccinated” to describe the first two doses of vaccines early in the pandemic has not helped. Although the agency has since switched to saying that people should be “up to date” with all their shots, the early use of “fully vaccinated” has unfortunately stuck.
“A lot of people have said, ‘I’ve had my two shots and I’m done,’” Dr. Osterholm said.
Some people may also be discouraged by new research that shows immunity against infection dips significantly within three months, and the newest Omicron subvariants are much more adept at dodging immunity than earlier versions of the virus, Dr. Osterholm added.
New vaccines more targeted toward Omicron subvariants will likely arrive in the fall, and the Biden administration is considering expanding booster eligibility. But if you are in a high-risk group that is eligible for second boosters, you should not try to game out the timing of your shots. According to the C.D.C., getting vaccinated now “will not prevent you from getting an authorized variant-specific vaccine in the fall or winter when they are recommended for you.”
2. Find your new community Covid-19 indicators.
You should keep an eye on Covid-19 statistics to figure out your own risk and decide when to add more levels of protection. For a majority of the pandemic, the C.D.C.’s color-coded map of community-level risk was a good indicator of cases and transmission rates. But the agency recently changed the way it calculates these risk levels to put more emphasis on local hospitalization rates.
Case numbers no longer closely track with hospitalizations because of the mix of natural or vaccine immunity, home testing and treatments that are available, blurring real-time tracking of the virus. Instead, experts recommend using other ways to stay informed of your community’s Covid-19 risks: Check local news and tap into your social networks.
Talk to your family and friends as well as other members of your community to find out whether they’ve had Covid recently or know anybody who has or recently had Covid, Ajay Sethi, an epidemiologist at the University of Wisconsin-Madison, said. Because you’re more likely to interact with people in your network, you may get a better sense of incidence in your community and what your own risk of getting sick may be.
When more of your close contacts are getting Covid or being reinfected more frequently, like many people across the country are right now, it’s a good indicator that you and your peers should start putting on masks and adding more Covid protections.
Some people may feel hesitant to share that they have the virus, Dr. Sethi added, either because they feel like an outlier, are embarrassed that they caught it or know the stigma attached to having relatives with differing pandemic ideologies. But “that’s kind of the opposite of what we need to be doing,” he said.
3. Mask up, and not just indoors.
Wear good quality masks in public places where you need to protect yourself, whether you have been infected with Covid-19 or not. Each infection may still bring the risk of developing debilitating long Covid symptoms, said Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security.
“For me, the thought process hasn’t changed too much,” Dr. Rivers said. “I continue to wear a mask whenever I’m indoors and try to move as many activities as I can outdoors.”
Other experts agree that if you want to go maskless, outdoor air will be considerably safer than indoor spaces. But even outdoors, the closer people are together, the higher the risk of catching the virus.
“As infectious as BA.5 is, we have to acknowledge that it’s important that you’re not in crowded conditions with limited air,” Dr. Osterholm said.
If you are hosting a summer barbecue, for instance, you may want to invite fewer guests to reduce the risk of virus transmission. You can also check that everyone is vaccinated and has recently tested negative. At bigger gatherings, such as outdoor concerts or weddings where you have less control, you should mask up and monitor yourself for new symptoms for a few days afterward, Dr. Osterholm said.
4. Keep rapid tests on hand — and use them.
Rapid tests are an effective tool to combat the spread of Covid-19 if you regularly use them. If you are only testing after you’ve had a potential exposure, then you’re doing it wrong, Dr. Sethi said. Instead, bookend social events by testing before and three to five days after large gatherings to best protect yourself and those you meet with, he said.
Keep a stash of rapid tests at home, especially if you don’t have access to a public testing site or tests through your workplace, said Alyssa Bilinski, a health policy expert at Brown University. Each household can order three rounds of free tests — or 16 tests in total — from the government. People with insurance can also be reimbursed for eight free tests a month.
Just remember that you can test negative even if you have symptoms of Covid-19, Dr. Sethi said. Quarantine if you think you may be sick. Test again a day or two after your negative result to be sure. And if you have Covid-19, test after your symptoms have eased or even disappeared. A positive antigen test is a fairly reliable indication that you are still contagious, even if your symptoms have eased or disappeared.
When people don’t use them often enough, rapid tests end up being less useful from a public health standpoint, Dr. Sethi said.
5. If you’re traveling, find out how to get treatment.
Before you leave, prepare for the possibility of getting infected during a trip.
“It’s a good idea to travel with a printed list of all of your current medications, your medical and vaccination history and your provider’s contact information in case you need to seek medical care while traveling,” said Dr. Annie Luetkemeyer, a professor of infectious diseases at the University of California, San Francisco.
Keep plenty of room on your credit card and read your health or travel insurance policies carefully to see which expenses they will cover if you have to extend your trip because of Covid-19. And do a little research into clinics and pharmacies at your destination.
Although you cannot get Paxlovid, an antiviral treatment for Covid-19, preemptively without a diagnosis, you can use the Test to Treat locator to find places where testing and immediate treatment are available in the United States. Pharmacists can also prescribe Paxlovid directly to patients who test positive but are not able to see a medical provider, said Kuldip Patel, the senior associate chief pharmacy officer at Duke University Hospital in North Carolina.
Outside the United States, however, availability of treatment will depend on where you are. Both Paxlovid and another antiviral called molnupiravir are on the World Health Organization’s list of recommended drugs for treating Covid-19 and are approved for use in several countries.
But you can also avoid the uncertainty of finding medication abroad. If you are at high risk for Covid-19 complications or may be immunocompromised and at risk for lower vaccine efficacy, you can talk to your doctor about getting the monoclonal antibody treatment Evusheld before you travel, Dr. Luetkemeyer said. You may also want to carry over-the-counter drugs — like acetaminophen, ibuprofen, cough suppressants and throat lozenges — to help ease symptoms if you get sick.
You can choose which steps will mitigate the most harm right now, and those calculations may be different for different people. The country is “struggling to recast what the risk of Covid looks like,” Dr. Bilinski said. But that doesn’t mean we should give up entirely on measures that will keep us safe, she added. The BA.5 surge can be a reminder that there is a middle ground between having Covid precautions dominate your life and pretending that the pandemic is over.