COVID is surging in our community. All of us are tired of COVID. We are sick of masks. We are tired of all the constraints that COVID has placed on our lives over the past two-and-a-half years. So, what does the future hold? Are we ever going to really get past COVID? Is this our “new normal”?
Let’s first take stock of where the virus is at present. Like hurricanes, COVID does not run on our schedule. It has an agenda of its own, whether we like it or not.
The current omicron variants of the COVID virus differ significantly from the variants we first encountered in early 2020. Over time, the virus has mutated, or evolved, adapting itself to humans so as to ensure its survival in nature. It has become much more contagious, but it has also become less deadly.
From the virus standpoint, this makes sense.
If the goal is to survive in nature, the virus doesn’t want to kill its victim – it wants its victims to survive so they can spread the virus to others. The same thing happened with the great H1N1 influenza pandemic of 1918, which, like COVID, initially killed millions. Later waves were milder, however, and indeed H1N1 descendants are still with us today.
So, what common sense “rules” should we be following now, with the goal of minimizing the impact of this virus on our lives and the lives of those around us?
RULE 1: If you don’t want to get really sick or die from COVID, make sure you’ve been vaccinated with at least three doses (the initial two + a booster) of either the Pfizer or Moderna vaccines. This rule applies regardless of whether you have ever had COVID or not.
For those who have compromised immune systems, a fourth dose (a second booster) is advised.
While milder than previous variants, omicron still kills, especially among the elderly, the debilitated or the immunocompromised. The vast majority (roughly 90%) of current omicron deaths occur among the unvaccinated, with the rest occurring among those who were vaccinated last year but never boosted.
While the vaccines may not fully protect you from getting COVID, they provide remarkable protection against getting really sick or dying from COVID.
RULE 2: If you don’t want to get COVID, then wear a proper mask (N95 or KN95, which can be ordered online at projectn95.org) whenever you’re in an indoor setting around people, such as in a grocery store.
Cloth masks or even surgical masks do not provide adequate protection. This may be why mask mandates haven’t worked well to stem the tide of COVID. Remember, the current variants are much more contagious – meaning that it’s far easier to catch COVID from someone else than before.
Since masking mandates were lifted, few people are wearing masks. This is precisely the wrong response when facing a virus that’s far more contagious.
No wonder that the percentage of positive COVID tests has shot up in this community from 2% a few weeks ago, to 28% now, as of early June.
More and more people are getting COVID and spreading it to others. This is exactly what the virus wants. The virus, which has no brain, is outsmarting us! We are “done” with COVID, but it is not done with us.
For those who are vaccinated and boosted, the likelihood of getting very sick from COVID is much reduced. One might ask why it’s still important to mask. The simple answer is that having COVID may still be dangerous for those susceptible and interfere with your life in ways you’d want to avoid. You may have to miss work. You may have to cancel or reschedule a long-awaited vacation at the last minute.
Some symptoms, such as losing your sense of taste and smell, would pose a real problem if you like to cook. Other neurologic and cardiac problems are possible.
Finally, you may still get long COVID, with symptoms such as disabling fatigue that may last for months.
The bottom line is that this is not an infection that you want to get if you can prevent it.
RULE 3: Make use of home COVID tests. If you develop symptoms such as sore throat, stuffy nose, cough, chest congestion or body aches, take a home COVID test.
The tests are not perfect, being about 85% accurate. A repeat test the following day, if the first test is negative, improves accuracy. Also, if you are going to an unmasked indoor gathering, such as a family reunion, it’s important for everyone to test on the day of the event to make sure that they are test-negative.
WHERE IS COVID GOING FROM HERE?
Unfortunately, I think that COVID is here to stay. Vaccines have been extraordinarily effective in reducing severe illness and death. But we need new vaccines that provide durable protection against getting infected.
We also need better treatments to lessen the burden of illness. We can all breathe a sigh of relief, however, that if we are vaccinated and boosted and still contract COVID, we are highly unlikely to be hospitalized or die.
We can look forward to enjoying the summer – to outdoor gatherings, outdoor dining, picnics, going to the beach, playing golf, tennis, pickleball, getting out on the boat, fishing and traveling. If we don’t want to get COVID, we just have to wear a proper mask (N95 or KN95) when around other people indoors.
Paul Kamitsuka is an internal medicine/infectious diseases physician with Wilmington Health. He also serves as a clinical associate professor with UNC School of Medicine.
