(CNN) — A long-awaited slowdown in coronavirus cases over the summer is unlikely as Covid-19 infections continue to rise in much of the US.
An earlier increase in cases this year was driven by Omicron’s BA.2 sub-variant. Now, the US Centers for Disease Control and Prevention (CDC) has identified two other subtypes, BA.4 and BA.5, More than 70% of new infections in the country. These subvariants can partially circumvent the immunity produced by the vaccine and previous infection, although the vaccine will still protect against severe disease.
The evolution comes as more people resume travel and other pre-pandemic activities.
How should people now think about their risk of contracting Covid-19? If they are vaccinated and encouraged, are they safe? What about people who have recently been vaccinated against Covid-19? What precautions should people take if they still want to avoid Covid-19? If someone tests positive for the coronavirus, should they continue to self-isolate?
To answer these questions, we spoke to Dr. Lena Wen, a CNN clinical analyst, emergency room physician, and professor of health policy and management at George Washington University’s Milken Institute School of Public Health. She is also a teacher “Lifelines: A Doctor’s Journey in the Fight for Public Health”.
CNN: Do current Covid-19 trends indicate we’re facing another surge in cases in the US?
Dr. Lena Wen: I’m not sure this is another increase as the numbers aren’t really lower than the previous increase. During the winter, from December 2021 to February 2022, we saw the largest increase in the incidence of Omicron’s original subtype BA.1. There was a short pause; Later came BA2 with increasing number of cases. Now, the BA.4 and BA.5 subtypes have replaced the earlier Omicron subtypes and cause most infections in the United States. In many places, there is an increase in infections from the large number of cases.
It should also be noted that the number of reported cases is far less than the actual number of cases. Considering that many cases are detected through home antigen tests and not reported to public health authorities, I think we may have five to 10 times more cases than reported.
The good news is that these recent advances have not been accompanied by a saturation of hospitals, which explains the powerful effect of vaccines in differentiating infectious from severe disease.
CNN: With these kinds of numbers, how should people think about their Covid-19 risk? Does that mean people should cancel travel and reimpose restrictions?
When: I don’t think most people should change their daily activities, but I do think people should be aware of the risk of contracting Covid-19 if they don’t take extra precautions.
The good news is that vaccines and boosters offer better protection against serious diseases. However, we also know that immunity wanes over time, and there appears to be some (evasion) of immunity, particularly with BA.4 and BA.5. This means that if vaccinated and immunized people get Covid-19, they are unlikely to get seriously ill, but they can still be infected.
Some commuters wore masks in New York’s Times Square subway station last week.
The question people should ask themselves is this: To what extent do they want to avoid infection? There are many viruses around us, and variants are highly contagious. That means extra care is needed to avoid infection. Many people may not want to plan their lives following Covid-19 precautions, especially if they are generally healthy and well protected from serious illnesses.
On the other hand, many people may still prefer not to get COVID-19 because of the risk of long-term symptoms. They may have underlying medical conditions that lead to more serious outcomes, or they may live with others who are more vulnerable and want to minimize the risk to those around them.
CNN: For people who want to be cautious, what do you recommend?
When: For people who want to prioritize reducing their risk of Covid-19 infection, I first advise them to follow CDC guidelines and stay up-to-date on vaccinations. Anyone 5 years and older can get the first booster. People over 50 can get a second booster for a total of four shots.
Some people (moderately or severely immunocompromised) may receive five vaccines. (They also need to find out if they can get it evusheldinhibitory antibody to further slow the progression of severe disease).
I also ask you to wear a high-quality N95 mask or equivalent in closed and crowded places. Just because mask mandates are lifted doesn’t mean people shouldn’t wear them. Many people don’t consider masks to be an inconvenience. If so, I will continue to wear a mask in all closed public places. For those of you who find them uncomfortable, I encourage you to use them in high-risk situations, for example, airport security lines and during boarding and disembarking.
Of course, remember that outdoor gatherings are still less dangerous than indoor ones. Those who want to be extra cautious should try to attend outdoor meetings if possible, and only attend indoor meetings if everyone else tests negative that day.
CNN: A lot of people are sick of hearing about these precautions. What if they want to live their lives but don’t want to affect vulnerable people?
When: I certainly understand this sentiment. It is very difficult for society to impose restrictions on individuals and ask people to permanently suspend gatherings such as weddings and birthday parties, or to give up going to activities they love, such as closed restaurants and gyms. My best advice is that if you go indoors, you may be exposed to Covid-19. Be aware of the risk you are running and take the necessary precautions.
For example, you can live your life however you want, but before you visit grandma in a nursing home, do a quick check-up that day. If you attend a wedding with many guests in a closed space, get tested after a few days to make sure you are not infected with the coronavirus. Anytime you have symptoms, get tested immediately and don’t expose others around you.
CNN: Are you safe if you’ve recently contracted Covid-19?
When: A recent infection produces some protection, which lasts for three months. However, reinfection can occur, and some studies suggest that infection with the original omicron subvariant (BA.1) does not protect against new variants. Vaccination and recent recovery offer the best protection, so make sure you’re up-to-date on your shots and boosters, even if you’ve contracted Covid-19.
CNN: If you test positive, should you self-isolate?
When: Yes, because you don’t want to infect others with Covid-19. The CDC’s guideline is to self-isolate for five days and wear a mask around others for another five days if symptoms improve.
I think a testing policy is better than this because people get infected at different times. I would encourage people to do daily home testing starting on day four and end isolation if the home rapid antigen test is negative. Now is the time to make sure you have plenty of home tests.
