With President Joe Biden sick with COVID-19 and infections peaking again across the country, it’s natural to ask: Is COVID-19 still worth worrying about?
The answer: yes and no.
Yes, if you or someone you’re likely to come into contact with is 65 or older, pregnant or immuno-compromised. Or if you’re headed to an event you don’t want to miss, such as a wedding or a summer vacation.
If you don’t mind the possibility of getting sick, infecting others, missing a week of work or slacking on other obligations or opportunities, then no.
Every summer since the pandemic began in 2020, there’s been a peak in infections, though it hasn’t ever been as high as those in the winter. This summer looks to be the same.
Wastewater surveillance data, which tracks the viruses we all shed when we go to the bathroom, has been trending higher for weeks, indicating that more Americans are carrying around the virus that causes COVID-19.
“COVID does not disappear the way influenza does during the summer,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University School of Medicine in Nashville, Tennessee. “It’s like a two-humped camel.”
People travel a lot in the summer and spend time in enclosed spaces to get cool, he noted, which are “all opportunities for the virus to spread.”
Not everyone will get sick if exposed to the virus, as we learned early in the pandemic. And most people, now that they’ve been vaccinated and infected at least once, won’t get very sick. The virus is not new to our immune systems as it was in 2020.
But the people who can’t mount a strong immune response to the virus ‒ those with compromised immune systems due to age, sickness, pregnancy or inherited problems ‒ remain at risk of severe disease and even death if they get the disease. Although the federal government has stopped tracking COVID-19 deaths, someone dies every day from COVID-19 in New York City alone, local hospital data shows.
“People are not taking the appropriate precautions,” said Dr. Seth Feltheimer, internist and associate professor of medicine at Columbia University Vagelos College of Physicians and Surgeons. “It makes it more important to be fully immunized with the boosters.”
How do older adults fare against COVID?
Biden is taking a break from the campaign trail to recover from COVID-19 after he tested positive Wednesday.
At 81, Biden (and his opponent, Republican nominee Donald Trump) fall into the group of about 60 million Americans at high risk of developing severe disease from the virus due to their age. The White House says the president is experiencing “mild symptoms,” however, health experts note that older folks are naturally more at risk than those under 65 because their immune systems are no longer as robust and protective as they once were.
“If you’re going to pick one thing that is the most predictive of problems with acute COVID, age is the biggest risk factor,” said Dr. Daniel Griffin, an infectious disease specialist and clinical instructor of medicine at Columbia University.
As people age, their immune systems slow down and cannot respond to an invading virus as fast and strong as they once could, Feltheimer said. People 65 and older are also more likely to have underlying diseases that worsen with an infection.
But the COVID-19 that older adults are getting is not the same novel virus that ravaged the country four years ago.
In 2020, more than 300,000 people 65 and older died from causes involving the virus, according to the Centers for Disease Control and Prevention. In 2023, about 45,000 people died in that age group according to data updated in September.
However, this population remains by far the most vulnerable to the worst COVID-19 outcomes, accounting for about 63% of hospitalizations and 90% of deaths in 2023, according to a study published in October’s Morbidity and Mortality Weekly Report.
Staying up to date on booster shots and getting prompt treatment, using the antiviral Paxlovid, are the best ways to stave off severe disease in older Americans.
Biden has technically had COVID-19 twice. He first tested positive for the virus in July 2022. He tested positive for a second time days after his isolation period in a “rebound” case. It’s unclear if Paxlovid causes rebound cases of COVID-19, which can also occur without the medication. The CDC recommends high-risk patients take the antiviral, especially older adults, as evidence suggests the benefits outweigh any risk of rebound effects.
Vaccines aren’t great this time of year
People at high risk of a severe infection can get an additional booster this summer, but now is not the time for healthy, young people to get another shot.
People at higher risk are eligible to get vaccinated three times a year, which Schaffner said is effective at preventing cases serious enough to require hospitalization.
Anyone likely to get mildly sick, based on their age and other conditions, does not need a shot more than once a year, according to the CDC.
The shots available now are targeted against last year’s virus and the one circulating this year is somewhat different. The new vaccine should become available in September.
Though because the virus tends to peak right after the holidays, it might be best to wait until later in the fall, unless you expect to be in a large crowd, around a vulnerable person or have a can’t-miss event sooner. Schaffner recommends getting annual flu and COVID-19 vaccines together in October for winter protection.
A booster takes less time to become fully effective than an initial vaccine ‒ just 7 to 10 days, according to Schaffner.
Protecting yourself in the meantime
Vaccines remain the best protection but there are other tools available.
Of course, you can avoid crowded indoor spaces, like bars, concert halls and airport security lines.
But if you still want to have fun this summer without risking infection, experts suggest you do what they do and wear a face mask. They typically wear N95 or KN95 masks, which provide a better seal than the paper ones typically available at the doctor’s office, Schaffner said.
Most people can get used to wearing one, he said. For people whose ears get irritated by the elastic loops, he suggest you try another brand or a version that goes behind the head instead.
“If you wear them under your nose or on your forehead, they don’t work,” Schaffner said, noting that masks should fit snugly around the nose, cheeks and chin.
What to do if you do get infected
The advice for people who catch COVID-19 remains the same: stay away from others as much as possible for at least five days.
You never know if a stranger you encounter might be vulnerable and if you don’t want to be responsible for someone else’s severe illness, stay home or isolate as much as possible.
It may not matter if it’s COVID-19, if you’re at low risk and not around anyone else. But if you’re at high risk for severe disease, it’s important to know that you have the virus so you can get an antiviral.
COVID-19 tests aren’t perfect ‒ they can take a day or longer after symptoms appear before they turn positive – and they’re now expensive, Schaffner noted.
The antiviral Paxlovid has been shown to reduce the risk of hospitalization for medically vulnerable people over 65 and not up-to-date on their COVID-19 vaccines, but it must be given within five days of the start of symptoms. Don’t wait until your symptoms get bad to call the doctor if you’re in that high-risk category, Schaffner advised.
Unfortunately, the medication doesn’t seem to be highly protective against long COVID, in which symptoms last months after the initial infection resolves, nor does it decrease the number of days a vaccinated person has symptoms.
In general, Schaffner urged continued caution against COVID-19, particularly for people at high risk. “Wear the mask. Get yourself revaccinated and enjoy yourself while being careful.”
Adrianna Rodriguez can be reached at Adrodriguez@usatoday.com.
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