With President Joe Biden contracting COVID-19 and cases peaking again across the country, it’s fair to ask: Is COVID-19 still worth worrying about?
The answer is yes and no.
Yes, if you or anyone you may come into contact with is over 65, pregnant or immunocompromised. Or if you’re going to an event you don’t want to miss, like a wedding or summer vacation.
If you don’t mind the possibility of getting sick, infecting others, missing a week of work, or missing other obligations or opportunities, then no.
Cases have peaked every summer since the pandemic began in 2020, but have never been as high as in winter, and this summer looks set to be no different.
Wastewater surveillance data, which tracks the viruses we expel when we go to the toilet, has been trending upward for weeks, indicating more Americans are carrying the virus that causes COVID-19.
“COVID-19 doesn’t go away like the flu goes away in the summer,” says Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine in Nashville, Tenn. “It’s like a two-humped camel.”
He noted that people travel more in the summer and spend time in enclosed spaces to cool off, all of which creates “opportunities for the virus to spread.”
As we learned early in the pandemic, not everyone will get sick when exposed to the virus. And since most people have been vaccinated and have had at least one infection, few will develop severe symptoms. This virus is not new to our immune systems, just like it was in 2020.
But people who can’t mount a strong immune response to the virus — people whose immune systems are weakened by age, illness, pregnancy, or genetic problems — remain at risk for severe illness or death if they become infected. The federal government has stopped tracking COVID-19 deaths, but someone is dying from COVID-19 every day in New York City alone, according to local hospital data.
“People aren’t taking the proper precautions,” said Dr. Seth Feltheimer, a physician and associate professor of medicine at Columbia University’s Vagelos School of Medicine, “which makes it even more important to get full immunity with a booster shot.”
How do older adults cope with COVID-19?
Biden is taking a break from campaigning to recover after testing positive for COVID-19 on Wednesday.
At 81, Biden (and his Republican opponent, Donald Trump) are among roughly 60 million Americans who are at higher risk of severe illness from the virus because of their age. The White House has said the president is experiencing “mild symptoms,” but health experts say older people are naturally at higher risk than those under 65 because their immune systems are no longer as strong and protective as they once were.
“If you had to pick one thing that’s most predictive of problems with acute COVID-19, age is the biggest risk factor,” said Dr. Daniel Griffin, an infectious disease specialist and lecturer in clinical medicine at Columbia University.
Feltheimer said that as people age, their immune systems weaken and are no longer able to respond as quickly and powerfully to invading viruses, and people over 65 are also more likely to have underlying health conditions that could be exacerbated by infection.
But the COVID-19 that’s affecting older people is not the same virus that hit the country four years ago.
More than 300,000 people aged 65 or older died from virus-related causes in 2020, according to the Centers for Disease Control and Prevention. Data updated in September projected that about 45,000 deaths will occur in this age group in 2023.
But this group remains the most vulnerable to the worst outcomes from COVID-19, accounting for about 63% of hospitalizations and 90% of deaths in 2023, according to a study published in Morbidity and Mortality Weekly Report in October.
Regular booster vaccinations and prompt treatment with the antiviral drug paxlovir are the best way for older Americans to prevent serious illness.
Biden has technically been infected with COVID-19 twice. He first tested positive for the virus in July 2022. He tested positive a second time a few days after his quarantine period, which was a “rebound” case. It is unclear whether Paxlovid causes a rebound in COVID-19, but rebound can occur even without taking the drug. The CDC recommends taking the antiviral drug, especially for high-risk patients such as the elderly, as evidence shows that the benefits outweigh the risks of a rebound effect.
Vaccines at this stage are not very effective
People at high risk of developing severe symptoms can get a booster shot this summer, but now is not the time for healthy young people to get another shot.
High-risk people are eligible to receive three doses of the vaccine per year, which Schaffner said is effective in preventing cases severe enough to require hospitalization.
According to the CDC, people who are at high risk of developing mild symptoms based on age and other conditions do not need to get the shot more than once a year.
The vaccines currently available were made for last year’s virus, which is circulating this year against a slightly different virus, and a new vaccine is expected to be available in September.
But because the virus tends to peak right after the holidays, it may be best to wait until later in the fall unless you plan to be in large crowds, around vulnerable people, or have an event you can’t miss early. Schaffner recommends getting your annual flu shot and the COVID-19 vaccine together in October for winter protection.
The booster shot takes less time to become fully effective than the first vaccine, just seven to 10 days, Schaffner said.
In the meantime, protect yourself
Vaccines remain the best prevention measure, but other measures are available.
Of course, you can also avoid crowded indoor spaces like bars, concert halls, and airport security lines.
But if you want to enjoy this summer without risking infection, experts recommend doing the same: wearing a mask. They typically wear N95 or KN95 masks, which provide a better seal than the paper masks typically available at doctor’s offices, Schaffner said.
He says most people get used to them quickly, but if the rubber loops irritate their ears, he recommends trying a different brand or a style that goes behind the head.
“If you put the mask under your nose or on your forehead, it won’t work,” Schaffner said, noting that the mask needs to fit snugly around your nose, cheeks and chin.
What to do if you are infected
The advice for anyone with COVID-19 remains the same: stay away from others as much as possible for at least five days.
You don’t know if the strangers you meet are susceptible to infection, so if you don’t want to be responsible for other people’s serious illness, stay home or isolate as much as possible.
If you are at low risk and no one is around you, it may not matter whether you have COVID-19 or not. But if you are at high risk for severe illness, it is important to know you have the virus so that you can receive antiviral medication.
COVID-19 tests are not perfect — they can take a day or more from the time symptoms appear to test positive — and are currently expensive, Schaffner noted.
The antiviral drug Paxlovidone has been shown to reduce the risk of hospitalization in people over 65 with underlying health conditions who haven’t received the COVID-19 vaccine, but it must be given within five days of symptoms starting. If you fall into that high-risk category, Schaffner advised not waiting until your symptoms worsen to contact your doctor.
Unfortunately, the drug does not appear to be much more protective against long COVID, in which symptoms persist for months after the initial infection has subsided, nor does it reduce the number of days that vaccinated people are symptomatic.
In general, Schaffner urged people, especially those at high risk, to continue to be vigilant about COVID-19: “Wear your mask. Get vaccinated again. And have fun while being careful.”
Adrianna Rodriguez can be reached at adrodriguez@usatoday.com.
