With President Joe Biden sick with COVID-19 and infections spiking again across the country, it’s natural to wonder: Is COVID-19 still worth worrying about?
The answer: yes and no.
Yes, if you or someone you may come into contact with is 65 or older, pregnant, or immunocompromised. Or if you are going to an event you don’t want to miss, like a wedding or summer vacation.
If the possibility of getting sick, infecting others, missing a week of work, or neglecting other obligations or opportunities doesn’t bother you, then no.
Since the pandemic began in 2020, infections have peaked every summer, although never as high as in winter. This summer seems to be the same.
Wastewater surveillance data, which tracks the viruses we all shed when we go to the bathroom, has been trending upward for weeks, indicating that more Americans are carrying the virus that causes COVID-19.
“COVID doesn’t go away like the flu does in the summer,” said Dr. William Schaffner, an infectious disease specialist 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 cool off, he noted, which provides “all the 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 isn’t new to our immune systems like it was in 2020.
But people who fail to mount a strong immune response to the virus — those with weakened immune systems due to age, illness, pregnancy or hereditary conditions — remain at risk of serious illness or even death if they contract the disease. Although the federal government has stopped tracking COVID-19 deaths, one person dies of COVID-19 every day in New York City alone, according to data from local hospitals.
“People aren’t taking the necessary precautions,” said Dr. Seth Feltheimer, an internist and associate professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons. “So it’s even more important to be fully vaccinated with the boosters.”
How do older people behave in the face of COVID-19?
Biden is taking a break from campaigning to recover from COVID-19 after testing positive on Wednesday.
At 81, Biden (and his opponent, Republican candidate Donald Trump) are among the roughly 60 million Americans who are at high risk of developing severe illness from the virus because of their age. The White House says the president is experiencing “mild symptoms,” but health experts note that older people are naturally at higher risk than those under 65 because their immune systems are not as robust and protective as they once were.
“If you have to pick one thing that is most predictive of acute COVID-related problems, age is the most important risk factor,” said Dr. Daniel Griffin, an infectious disease specialist and clinical professor of medicine at Columbia University.
As people age, their immune systems slow down and can no longer respond to an invading virus as quickly and as strongly as they once did, Feltheimer said. People 65 and older are also more likely to have underlying conditions that worsen if they become infected.
But the COVID-19 that older people are suffering from is not the same new virus that ravaged the country four years ago.
In 2020, more than 300,000 people aged 65 and older died from causes related to 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 outcomes of COVID-19, accounting for about 63% of hospitalizations and 90% of deaths in 2023, according to a study published in the October Morbidity and Mortality Weekly Report.
Staying up to date on booster shots and getting prompt treatment, using the antiviral drug Paxlovid, are the best ways to prevent serious illness among older Americans.
Biden has technically had COVID-19 twice. He first tested positive for the virus in July 2022. He tested positive a second time a few days into his isolation period in a “rebound” case. It’s unclear whether Paxlovid causes rebound cases of COVID-19, which can also occur without the drug. The CDC recommends that high-risk patients take the antiviral, especially older adults, because evidence suggests the benefits outweigh any risk of rebound effects.
Vaccines are not very effective at this time of year
People at high risk of serious infection can get an additional booster dose this summer, but now is not the time for healthy young people to get another shot.
People at high risk can get vaccinated three times a year, which Schaffner said is effective in preventing cases severe enough to require hospitalization.
According to the CDC, anyone who is likely to get mildly ill, based on their age and other conditions, does not need to be vaccinated more than once a year.
The vaccines currently available target last year’s virus and the one circulating this year is somewhat different. The new vaccine is expected to be available in September.
However, since the virus tends to peak right after the holidays, it might be best to wait until later in the fall unless you plan to be in a large crowd, near a vulnerable person, or have a must-attend event earlier.. Schaffner recommends getting the flu and COVID-19 vaccine at the same time each year, in October, for winter protection.
A booster takes less time to become fully effective than an initial vaccine – just 7 to 10 days, Schaffner said.
Protect yourself while waiting
Vaccines remain the best protection but there are other tools available.
Of course, you can avoid crowded indoor spaces, like bars, concert halls, and lines at airport security checkpoints.
But if you still want to have fun this summer without risking infection, experts advise you to do as they do and wear a face mask. They typically wear N95 or KN95 masks, which provide a better seal than the paper masks typically available in doctor’s offices, Schaffner said.
Most people can get used to wearing one, he said. For people whose ears are irritated by the elastic loops, he suggests trying another brand or a version that fits behind the head.
“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 are infected
The advice for people who catch COVID-19 remains the same: stay as far away from others as possible for at least five days.
You never know if a stranger you meet might be vulnerable and if you don’t want to be responsible for someone else’s serious illness, stay home or isolate yourself as much as possible.
It may not matter if you have COVID-19, are not at risk, and are not in contact with anyone else. But if you are at high risk of developing severe illness, it is important to know that you have the virus so that you can get an antiviral.
COVID-19 tests aren’t perfect — they can take a day or more after symptoms appear before turning positive — and they’re now expensive, Schaffner noted.
The antiviral drug Paxlovid has been shown to reduce the risk of hospitalization in medically vulnerable people over 65 who are not up to date on their COVID-19 vaccines, but it must be given within five days of symptom onset. Don’t wait until your symptoms get worse to call your doctor if you’re in this high-risk category, Schaffner advises.
Unfortunately, the drug does not appear to offer strong protection against long-term COVID, in which symptoms last for months after the initial infection resolves, nor does it reduce the number of days a vaccinated person has symptoms.
Overall, Schaffner urged caution around COVID-19, especially for those at high risk. “Wear your mask. Get revaccinated and have fun while being safe.”
You can contact Adrianna Rodriguez at Adrodriguez@usatoday.com.