Neighbor Tuesdays: COVID, masks, and boosters
If I had a penny this week for people who said, “Wait, are we in a surge?”. This COVID surge has caught people by surprise, especially if you’ve got COVID, because it’s not talked about that much anymore. I definitely think the media and health systems should be talking more about these surges. But here we are. Let me give you my take on the current surge, of course with data, and how we can be neighbors to each other that are still at risk.
CASES AND POSITIVITY RATES
2 weeks ago, the US positivity rate was 8.3%.
This week the positivity rate is 10.6% and rising. Positivity rates in 4 regions of the country are more than 10%, with the TX/LA/NM/OK/AR already higher than 15%. Yikes! Also note that the pandemic prevention measures (masking, vaccine update, etc) are the lowest in the South - so there’s a lot of COVID circulating in those regions still. If you live in Region 6, definitely make sure you’re up on your booster and it’s a good time to wear that mask (more on that later).
Remember we want positivity rates to be below 5% for pandemic control. No wonder this surge is hitting people by surprise! An alert would have been great to go out when those regions hit 5%. But, alas. Yes, we have boosters and Paxlovid (we’ll talk about those in a minute) - but those do not protect entirely from long COVID (ugh) or among some high-risk populations.
If we look at wastewater data (yuk, but thank you to the people who do that job!), we also see a rise in cases. Some of those cases might have gone undetected or had a positive at-home rapid test and not captured in the data in the above map. SO, the combination of the increasing positivity rates and wastewater data means in simple terms - there’s quite a bit of COVID in the US right now and increasing.
ED VISITS AND HOSPITALIZATIONS
If we look at ED visits and hospitalizations for COVID, those are also increasing. I have several ED friends and they are definitely noticing the uptick in cases and people needing help. Over the past week, ED visits for COVID increased by 21.4% and were mainly in the South and Washington state. Hospital admissions related to COVID increased by 12.5% in the last week as well, topping out at 9,056 admissions within the week. Y’all, that’s a lot of people in the hospitals - a lot of people needing hospital care for COVID.
Now, I do want to note that deaths are still low for COVID thanks to vaccines and treatments. BUT, the last week has seen a 10% increase in deaths due to COVID in the US with at least 600 deaths per week over the past few weeks.
MASKS, BOOSTERS, AND PAXLOVID
What about masking? I think it’s a good idea to put one back on if you’re in those 4 regions, or if you’re high-risk, or are protecting someone at high-risk - even if you are fully vaccinated. Although vaccines are awesome, they don’t protect entirely from long COVID (ugh) or getting infected and then passing on to others that are more high-risk for complications despite vaccines.
If you’re due for a booster, you can either get the current one that is available or wait for the fall one. They will be slightly different than each other. Keep in mind that BOTH vaccines work against Omicron. Think of Omicron as a big umbrella with several types underneath it - BA.4, BA.5, XBB1.5, EG.5 (Eris) are all part of Omicron. Here’s where you can see the different types of Omicron. Do you notice EG.5 and XBB? They are the dominant ones circulating in the US.
We get really worried if any of these types OR if a new ‘umbrella’ do not match our vaccines. We’ve been really lucky when the ‘umbrellas’ have changed from Beta to Delta to Omicron and still fit the vaccines relatively well. The more virus circulating though, the more likely that it can mutate into an umbrella that is not a good match for the vaccines. This is all the more reason to keep cases LOW through boosters and masking, even though we are keeping people out of the hospital more.
Ok, back to the vaccines.
The current one is bivalent - this means that it provides protection against the TWO (hence, bivalent) variants of the virus that were widely circulating in 2022 and 2023. If you’re fancy and you want to know the names of the variants, they are BA.4/BA.5 (BOTH under the Omicron umbrella) and the original strain of COVID.
The new booster hopping on the scene hopefully soon (come on, FDA/CDC! We are ready!) will be slightly different. It will be MORE effective against the current variant circulating, XBB1.5 - which is also still an Omicron variant. Scroll up a bit and find XBB1.5 in the list - see where it makes up 10% of all cases?
Should you wait to get the new one if you’re due for a booster? That’s tricky and depends on how high-risk you are, when your last one was, where you live, etc. I would definitely talk to a trusted healthcare provider to see what they say given your specific situation.
What about the Eris? Eris, EG.5, is the dominant strain circulating in the US right now. It is still an Omicron variant but has a funky part of it that makes it a poorer match for the current bivalent vaccines. (And, I said a poorer match, not a terrible or useless match.) The fall booster will be a better match for Eris than the current one.
If you want another article I found helpful, Goats and Soda is always great!
Paxlovid - If you are 65 or older or eligible for Paxlovid due to a health condition, GET IT if you get COVID (of course, unless you have a medical reason not to). For the medication to be effective, you need to take it within 5 days of when your symptoms first appeared. (This is similar to needing to take Tamiflu in the first few days of being sick with seasonal influenza.) So, get tested quickly so you can start that medicine. It’s a game-changer for keeping people out of the hospital or getting super-duper sick with COVID. I’ve heard from several people in emails that their doctor won’t give it to them (anecdotally, these were all people living in the South). Ask another doctor then! Be a good advocate for yourself or your loved one however you can get it. Paxlovid is out there and available for you.
Which brings me to the neighbor part…
BEING A GOOD NEIGHBOR
I can’t tell you how many of you have written to me about how hard it is to have a high-risk child or parent or be high-risk themselves right now. It has been a long 3 years for you all. Can I provide some space to you and say that you are seen and very loved from a lot of us!
In addition, getting COVID is still a disruption to us if you get sick. You’ll still be home, hopefully, recovering and not able to go to work. Then there’s long COVID. Goodness, friends. Estimates of those suffering from long COVID is at least 500,000 to as many as 4 million. 27% report that long COVID significantly impacts their ability to do day-to-day activities or work. That’s a LOT of people! I think at this point, we all know someone who has been affected by long COVID and how devastating it can be.
People with long COVID are also more likely to have financial insecurity, food insufficiency, mental health hardships, housing insecurity, and job insecurities.
Why do I bring all of this up again? Because masking, getting boosted when I can, staying home if I’m sick means that I neighbor well. I can still provide protection for those that are not protected by thinking and then acting like a neighbor. It’s very clear from the last two figures who our neighbors are that are at risk of long COVID. And it’s clear who our neighbors are that are at high risk of complications from COVID. Even if we ourselves do not identify as someone living under the poverty line or with food insufficiencies or have a high-risk child, we can still be good neighbors. Masks and vaccines are powerful tools to do so.
Don’t listen to the junk saying masks don’t work or vaccines are 5G. As an example, be super careful of info coming from RFK Jr, Ty and Charlene Bollinger, Joseph Mercola, and the rest of the Disinformation Dozen. (The Disinformation Dozen are 12 people responsible for MOST of the disinformation junk out there. They are also profiting millions doing it and increasing antisemitic and racist talk. ugh.) They are sneaky too and have infiltrated mainstream media on some networks. So be wise and brave. Masks work and vaccines do too. If you see outlets or stories saying otherwise, look behind the curtain to see who wrote it, the credentials of the person, and how it was funded.
Can I also give some encouragement? At this point in the pandemic, it’s been a long haul, hasn’t it? It’s definitely not over, but not as bad as it was. And, still. It can be exhausting. I have found that reframing the why of wearing a mask and getting a vaccine has been a great motivator for my kids and friends. In particular, this can help give them an anchor to doing something that goes against the current, especially if you live in areas that have low masking or vaccine update. And, hopefully gives kids courage to be brave while they are learning to be neighbors. So, consider reframing why we are putting masks back on and center on our neighbors.
A quick note on comments - these posts always generate lots of comments and questions on Facebook. I can’t get to those, but I do respond to comments here on Substack.
-In solidarity,
FNE
Thanks so much for this update on Covid situations in the US. Although I live in the mid-Atlantic area (in the green), the positivity numbers are definitely up here. We are preparing to travel west (in the yellow) in a few weeks to visit elderly family, and we will certainly mask during our flights, but now I’m wondering if we should mask indoors while we are there… For our Covid boosters we are trying to time it just right so that we will still be covered when we go on a cruise in February which sails from a southern port (currently in the orange). I have read that protection after a booster is thought to last about 4 months—is that accurate? Since my husband and I are now both in our early 60s we are trying to optimize our protection. We want to be vaccinated for flu, Covid, and RSV, but I’m not sure if it is better to get them all at once, or one at a time. If one at a time, in what order and with what interval? It seems quite tricky.
What a breath of fresh air, as always- it may not be what we want to hear but need to hear. Please take care of yourself!