With super-infectious Omicron subvariants spreading across California, it’s hard to know what activities are still safe — or smart — to do.
Experts agree that people who are vaccinated and up-to-date on boosters are still well protected against serious illnesses. But given the now-dominant BA.5 subvariant, which is particularly good at evading vaccine immunity or recent Omicron infection, these groups are still susceptible to COVID-19.
“Everyone should be wary of it — of BA.5 and these newer variants — but not be afraid of it,” said Dr. Peter Chin-Hong, an infectious disease expert at UC San Francisco. “If you’re up to date on your vaccines, it won’t make you very sick.”
But for those who haven’t been vaccinated or haven’t been vaccinated at all, Chin-Hong said the risk of serious illness remains a concern even during this wave, which has been less deadly than previous ones. This unprotected group currently makes up the majority of COVID-positive intensive care patients, he said.
Experts say there are a host of reasons why people should step up other protections, including masking, testing and increasing ventilation, when transmission is so high:
- to minimize the risk of long COVID, which some studies have shown affects nearly 25% of those infected
- to avoid second COVID infections, which have been linked to an increase in other negative health outcomes
- protect vulnerable members of the community, such as the immunocompromised or the elderly, who are most at risk of illness or death
- to avoid interruptions to daily life, including childcare arrangements, absences from work, or travel plans
- to reduce the possibilities of developing new variants
“When transmission is really high, we would be foolish to be complacent. … It’s a dangerous virus,” said Los Angeles County Public Health Director Barbara Ferrer. “If we can slow transmission, we have a good chance of preventing some people from dying in the coming months.”
Ferrer could implement a countywide indoor mask mandate this week unless cases and hospitalizations drop in the coming days. And while this may change the precautions taken in indoor public spaces, it still leaves plenty of room for people to make decisions about gatherings with friends and family, dining out, summer trips and more. .
“Being vaccinated and masking indoors are two relatively benign things that carry a lot of weight,” said Dr. Peter Katona, professor of epidemiology at UCLA. “Ultimately, it’s your risk tolerance that decides what you do or don’t do.”
Even among public health experts, there are differences in what might be considered risky during this latest wave. But in general, health officials have said that when deciding where to go and how to interact, people should consider the transmissibility of the virus – which is very high at the moment – how close they will be. of others in a particular setting and how well the surrounding air circulates.
“We’re stuck in the ‘everyone wants this to go away,’ but it’s not going to go away,” said Dr. Kimberly Shriner, an infectious disease specialist at Huntington Hospital. She said during this wave and all future ones, people should be prepared to go back to using tools for better protection until cases start to drop.
“Just like in rainy weather, you can walk in or use an umbrella,” Shriner said. “We are in the middle of the wave, I will step up some things to protect myself. … We have the tools to deal with it, even if our tools are not perfect.”
“If you really think about it, you don’t have to avoid [indoor dining] like before because you have so many tools – even for an unvaccinated person,” Chin-Hong said. He recommended choosing a place that is spacious and ideally with some air circulation, such as near an open window, and wearing a mask while moving around the restaurant, such as when using the bathroom.
Dr. Robert Wachter, chairman of the department of medicine at UC San Francisco, said he was still not comfortable eating in a covered, crowded restaurant – although he said it wasn’t. was not unreasonable for people to do so. He said that given that about 5% of hospital patients test positive for COVID-19, even when not seeking treatment for COVID, he doesn’t like the chances of dining out right now.
“In a crowd of 50, it’s almost certain that at least one person has COVID,” Wachter said.
Shriner said people need to think of the next few weeks as a wave that will pass but could come back — like bad weather.
“In restaurants, people are talking loudly and they’re close together, and this particular variant, BA.5, is even more contagious than measles,” Shriner said. “For the next seven to 10 days this is the peak of the surge; now is not the time to go to a covered restaurant.
Public health experts agree that outdoor gatherings remain the safest option, even though the latest subvariants are so contagious they can spread outdoors. But no exterior masking recommended, except in an exceptionally crowded space.
“I still think it’s relatively safe,” Chin-Hong said, though he did come up with a scenario — “a Coachella mosh pit on a windless day” — that might raise concerns.
Wachter agreed but said there are levels of security even outside. “Outside is much better than inside, but better with more space, better if people aren’t yelling at you, better with a breeze.”
He said if he was in a ballpark, he would have a mask in his pocket in case the bathroom or the hot dog line felt stuffy and crowded.
Shriner said for larger events — even outdoors — it might make sense to delay them by about a week or ask people to test ahead.
“An outdoor wedding that’s a bit spaced out, has a nice breeze blowing…it’s a lot safer,” Shriner said. “Is it absolutely safe? Nope.”
Large indoor events
Experts recommend wearing a properly fitted mask at large indoor events. But Wachter said there are other precautions people and places can take, such as increasing ventilation with fans, open windows or air filters and asking people to take a quick test before showing up. .
“You can make them safer, but you can’t make them completely safe,” he said.
Chin-Hong said she has heard of people strategically planning booster shots to increase protection before a big event or trip. He also recommended planning how and where to get Paxlovid, Pfizer’s COVID pill that can reduce the worst symptoms, if someone ends up infected after a big event. He said if someone lives with grandparents or other high-risk people, it’s also a good idea to test after the events for a few days and monitor for symptoms.
“You have these multiple tools. You don’t go crazy, but you use them…and engage in life,” Chin-Hong said.
Trips or summer camp
For air travel, experts recommend wearing a mask at the airport and on an airplane, especially when taking off and landing.
“I don’t worry about flying on the plane as much as I do about the airport,” Shriner said. “We are all probably exposed to the virus all the time, but you have to have a certain amount of virus to get infected.”
Katona said there is no reason to cancel or stop traveling, but there are ways to be smart, like opening windows and wearing masks in a taxi or Uber.
“The car looks very focused,” he said.
Both Ferrer and Chin-Hong said it’s a good idea to test before you go on a big trip, and to do the same for kids going to summer camp — and when they return.
“The best advice really is to vaccinate your children and then boost them if they’re eligible,” Chin-Hong said. “It will give you peace of mind that they won’t get terribly sick.”
Bars or clubs
Going out to crowded bars or nightclubs remains the riskiest activity for catching and spreading the coronavirus, health experts warn.
“These are very high risk gathering environments. You have people who are really close to each other, they’re having a great time, they’re maybe a little uninhibited,” Shriner said. She’s heard some people say they might as well “get it and be done with it,” but she called that rationale flawed, especially now.
“It doesn’t work because with this variant, you can go out and get it over and over and over again,” Shriner said.
Chin-Hong, however, said there are ways to make going out safer. He recommended avoiding crowded and poorly ventilated bars and staying farther away from crowds.
“There’s still a lot of joy you can have on the edge or outside,” said Chin-Hong, who recommended sitting near windows or in an outdoor section.