Is Covid-19 rising? Our expert explains the preparation

A spike in cases earlier this year was caused by subvariant BA.2 Omicron. Now, the US Centers for Disease Control and Prevention reports that two other subvariants, BA.4 and BA.5, account for more than 70% of new infections in the country. These subvariants can partially escape the immunity generated by the vaccine and by previous infection, although vaccination is likely to still protect against serious illness.

These developments are occurring as more people resume travel and other pre-pandemic activities. How should people now think about their risk from Covid-19? If vaccinated and boosted, are they safe? What about those who have recently had Covid-19? What precautions should people take if they still want to avoid Covid-19? And if someone tests positive for the coronavirus, should that person isolate anyway?

To help with these questions, I spoke to CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management in the School of Public Health at George Washington University’s Milken Institute. She is also the author of Lifelines: A Doctor’s Journey in the Fight for Public Health.

CNN: Do current Covid-19 trends suggest there is another surge in cases in the United States?

dr Leana Wen: I’m not sure if this would qualify as another increase as the numbers haven’t really gone down from the previous increase. During the winter, from December 2021 to around February 2022, we saw a huge increase in cases from the original Omicron subvariant BA.1. There was a little pause; then came BA.2 with this spike in cases. Now BA.4 and BA.5 displace earlier Omicron subvariants and cause most infections in the US. Many places are seeing a surge in infections from a high caseload.

Covid-19 reinfections can increase the likelihood of new health problems
We also have to keep in mind that the number of reported cases is much lower than the actual number of cases. I think we could have five to ten times as many cases as are reported given how many cases are diagnosed through home antigen testing and go unreported to health officials.

The good news is that these recent spikes have not been accompanied by hospital congestion, showing the powerful impact of vaccines in largely decoupling infection and serious illness.

CNN: Given these kinds of numbers, how should people feel about their Covid-19 risk? Does that mean people should cancel trips and bring back restrictions?

Whom: I don’t think most people need to change their daily activities, but I do think people need to be aware of their risk of contracting Covid-19 if they don’t take extra precautions.

The good news is that vaccines and boosters continue to provide excellent protection against serious illness. However, we also know that immunity wears off over time, and there seems to be some immunity (bypass) in BA.4 and BA.5 in particular. This means that people who are vaccinated and up-to-date are unlikely to become seriously ill if they contract Covid-19, but they could still contract it.

Some commuters wear masks at the Times Square subway station in New York last week.

The question people should be asking is: how badly do they still want to avoid infection? There are so many viruses around us and the variants are so contagious. This means that avoiding infection requires additional consideration. Many people may no longer want to plan their lives around Covid-19 precautions, especially if they are generally healthy and well protected from serious illnesses.

On the other hand, many people may still prioritize not contracting Covid-19 due to the risk of long-distance symptoms. They may also have underlying medical conditions that lead to more serious consequences themselves, or they may live with others who are more vulnerable and wish to reduce their risk to those around them.

CNN: What do you recommend for people who want to be careful?

Whom: First, for individuals who want to make reducing their risk of contracting Covid-19 infection a priority, I would advise that they follow CDC guidelines and keep up to date with their booster shots. Anyone over the age of 5 can receive a first refresher course. People aged 50 and over can get a second refresher for a total of four shots.
Should parents get the vaccination for their children under the age of 5?
Certain people (who are moderately or severely immunocompromised) can receive five shots. (These people should also find out if they are eligible for Evusheld, the preventative antibody that may help further reduce the progression of a serious condition.)

I would also strongly advise that they wear a good quality N95 mask or equivalent in crowded indoor areas. The lifting of the mask requirement does not mean that people should not wear masks. Many people find masks uncomfortable. If that is the case, I would continue to wear masks in all indoor public spaces. For those who find masks uncomfortable, I would recommend wearing masks in the highest risk environments – for example wearing a mask in a crowded airport security line and when boarding and disembarking.

When do we get another shot?

Of course, keep in mind that outdoor gatherings continue to pose a much lower risk than indoor ones. People who want to be very cautious should try to go to outdoor gatherings when possible, and then only go to indoor gatherings if everyone else tests negative that day.

CNN: A lot of people are tired of hearing about these precautions. What if they just want to live their lives but don’t want to infect vulnerable people?

Whom: I definitely understand that feeling. It’s very hard for society to impose restrictions on individuals, asking people to put gatherings like weddings and birthday parties on hold forever, or to give up activities they love like restaurants and gyms. My best advice here is to realize that you can catch Covid-19 if you go indoors. Be aware of your risk and take appropriate precautions.

For example, maybe you can live your life the way you want, but before you visit grandma in the nursing home, take a rapid test the same day. If you’re going to a crowded indoor wedding, take a test a few days later to make sure you haven’t contracted the coronavirus. And if at any point you have symptoms, test right away and don’t expose others around you.

CNN: Are you sure if you recently had Covid-19?

Whom: A recent infection produces some protection that probably lasts about three months. However, reinfection can certainly occur, and some studies suggest that purchasing the original Omicron BA.1 does not protect against the newer variants. Getting vaccinated on top of your recent recovery offers better protection, so make sure you’re up to date with your vaccines and booster shots even if you’ve had Covid-19.

CNN: And what if you test positive — should you still isolate?

Whom: Yes, because you don’t want to spread Covid-19 to others. CDC guidance says you isolate for five days, then wear a mask around others for another five days if symptoms improve. I think a testing policy is even better because people stay infected for different lengths of time. I would encourage people to do daily home testing from day four and stop isolation as soon as their home rapid antigen test is negative. Now it’s time to make sure you have plenty of home tests!