Yet Another Surge

The current surge of Omicron variants (BA.2 and BA.2.12) started in the Northeast and is spreading across the US. Despite what is undoubtedly an undercount—as many people who test positive on home tests do not have their tests reported in official statistics—we have both high case rates and a high (and rising) test positivity. Test positivity is calculated by dividing the number of positive tests by the total number of tests with reported results. Case rates are the number of cases per 100,000 population. In CA, rates in Berkeley are now 49/100,000 which is as high as at any point in the pandemic other than the Omicron surge that peaked in January. Rates for Bay area counties are similarly high.

But aren't we in the green risk level? Yes, we are. This measures the impact on HOSPITALS, not the impact on individuals. Because Collin County has a high vaccination rate, we are not seeing a lot of hospitalizations except among those who are immunocompromised or those (including kids under age 5) who are not eligible for vaccination.

You've likely either had COVID by now or know someone who had. And those who have had COVID in the past 4 months and who were vaccinated, likely told you it was like a bad cold or allergies that came out of the blue. This is true for people who are generally healthy and vaccinated. Unfortunately, for the unvaccinated it can still be a severe illness. Rates of COVID hospitalization among children age 0–4 (i.e. too young to be vaccinated) were 5 times (500%) higher during Omicron as during any other wave of the pandemic. cdc.gov/mmwr/volumes/71/wr/mm7111e2

Further, people who are immunosuppressed—including those with cancer, those who take certain medications to treat arthritis or other rheumatologic conditions, and those who are pregnant—are still at elevated risk of severe COVID, even if they are vaccinated and boosted.

Finally, please don't go out and try to get COVID. Long COVID (formally called Post-Acute Sequelae of COVID) affects at least 5% of vaccinated adults who get COVID, and approximately twice as many unvaccinated adults. Every day I talk to 1 or 2 previously healthy young or middle-aged adults who say things like "I can't carry my laundry up and down the stairs. I get short of breath and have to stop" or "some days I feel 100% and other days I hit a wall of fatigue and have to lie down."

Your best bet is still to try to avoid contracting COVID in the first place:

1. Vaccination reduces risk of getting COVID by at least 50%, and reduces risk of severe COVID by much more.
2. Your risk of being in a group, unmasked, is higher during a surge than when case rates are lower.
3. Testing before getting together with higher-risk people (elderly parents, friends going through chemo) can help.
4. Ventilation: risk when outdoors is very low; open windows if you're indoors.
5. Masking markedly lowers your risk of getting COVID and inadvertently passing it on. CDPH strongly recommends continuing to mask indoors in school settings.

Unlike the first waves of COVID, Omicron can often cause very mild symptoms, particularly among those who are vaccinated and generally healthy. Among adults who are vaccinated, they often start with sore throat and/or feeling like severe allergies, with runny/stuffy nose, and only mild cough and headache. Fever is not always present.

Fortunately we have home tests (rapid antigen tests). Unfortunately, they are often negative for the first 1–3 days of symptoms. Rapid antigen tests are most likely to be positive 4 days after onset of illness, and even then, they are positive only 77% of the time. So if you get symptoms and your first test is negative, put on a mask and plan to retest in 2–3 days.

Schedule a PCR test here. Finally, if for whatever reason you do multiple tests and ANY of them are positive, YOU HAVE COVID! When the community prevalence is high, as it is now, if you have any symptoms and at least one test is positive, you have COVID.

jamanetwork.com — Full article

OK, so you or your child tested positive. If you have mild to moderate symptoms (meaning, you are not sick enough to go to an ER), and you have risk factors for more severe disease, you may qualify for treatment with a medication called PAXLOVID. Paxlovid decreases the risk of hospitalization or death by 88% among people with risk factors—a very significant effect! It's authorized for use in people age 12 and older.

Paxlovid must be started within 5 days after symptoms start (not 5 days after you get test results), so this is another reason to test early and then test again a few days later.

CONTACT YOUR DOCTOR IMMEDIATELY if you are within the 5-day window and have any conditions that put you at higher risk, to see if you qualify for treatment. This is prescription medication.

High-risk conditions include (but are not limited to): overweight or obesity (BMI >30), current or former smoking, moderate or severe asthma, depression or other mental illness; as well as the ones you'd expect (age >65, cancer, liver disease, kidney disease, immunosuppression, diabetes, heart disease, etc.)