Sick Woman Lying In Bed With Tissues (Getty Images/Obradovic)
SARS-CoV-2, the virus that causes COVID, is devastating precisely because it can worm its way into so many different organs and systems in the body. That manifests as different symptoms, from fever to trouble breathing, although an infection can be asymptomatic, too — that is, no symptoms at all.
Throughout the pandemic, there have been a few telltale signs of COVID infection. The loss of sense of smell and taste were chief among them. But as the virus has mutated again and again, creating new strains like Typhon (BQ.1) and Gryphon (XBB) which can evade some of our tools to fight it, it seem that the symptoms of COVID may have changed as well.
Recent estimates published by the Centers for Disease Control and Prevention on Friday pegged Typhon and its close relative Cerberus (BQ.1.1) as making up 27 percent of cases, an 11 percent increase from last week. Meanwhile, cases of BA.5, the strain that has dominated cases for the majority of summer, dipped below 50 percent for the first time in months.
Indeed, emerging data suggests the symptoms of COVID are changing with new variants. And, they can differ regardless of whether you’ve been vaccinated or not, or previously infected. Newly released data from the ZOE Health Study, which maintains the COVID Symptom Tracker app, finds that the dominant symptoms have shifted.
The app was originally launched in March 2020. It quickly logged one million users, who typed in how COVID was making them feel, allowing researchers to pin down some of the most common COVID symptoms. It was part of the reason why it became well-known that anosmia (loss of smell and taste) is a key symptom of the original COVID strain.
More recently, ZOE crunched the data from over 4.8 million users and found that after two vaccinations, the top-ranking symptoms were sore throat, runny nose, blocked nose, persistent cough, headache, in that order. (Vaccines can protect against severe disease, which generally means hospitalization or death, but breakthrough infections are not unheard of, although far less severe than infections in the unvaccinated.)
Loss of smell has slipped to the number nine slot, while shortness of breath is down at number 30 for this group. ZOE says this indicates “the symptoms as recorded previously are changing with the evolving variants of the virus.”
Just one dose of a vaccine can shift the order of most common symptoms to headache, runny nose, sore throat, sneezing and then persistent cough. For those who haven’t received a vaccine at all, the symptoms are generally closer to the original ranking from 2020: headache, sore throat, runny nose, fever and persistent cough.
However, loss of smell has slipped to the number nine slot, while shortness of breath is down at number 30 for this group. ZOE says this indicates “the symptoms as recorded previously are changing with the evolving variants of the virus.”
Just because SARS-2 appears to be evolving does not mean that it will become more “mild” — and it’s definitely nothing like the flu or a regular cold. The virus indiscriminately attacks the inner lining of blood vessels, causing injuries to the heart and lungs, and can cause literal brain damage. Given the broad range of debilitating symptoms known as long COVID, it doesn’t really make sense to call this “mild.”
Additionally, repeat infections could have unknown consequences — experts aren’t entirely sure what happens when you get COVID two, three or more times. That’s why watching out for new symptoms are so important. COVID may manifest differently because different viral strains sometimes impact different parts of the body. The delta strain, for example, found its niche in the lower respiratory tract, while omicron BA.2 tends to prefer the upper airway.
But it’s also critical to note that the data from ZOE is self-reported and doesn’t take into account demographic information or which variant caused the infection. It’s also using averages to report the most common symptoms — everyone is different and there is no guarantee here the disease will follow a certain course.
Nonetheless, the data gives a good idea of what to expect and people should be aware of these changes in order to best protect themselves. And the tools to fight COVID haven’t really changed: testing, masking, indoor ventilation, drugs like Paxlovid and, of course, the vaccines are all powerful strategies we should be using more to prevent this winter wave from becoming extremely deadly.
The Biden Administration warned this week that an estimated 30–70,000 Americans could die from the virus this winter. But even a small wave could cause supply chain disruptions and sicken millions. One thing that could make this winter worse than previous COVID waves is the rise of a “variant soup,” meaning multiple new strains of the virus surging at once.
In previous fall and winter waves, only one type of the virus (i.e. delta or the original “wild type” strain) has really dominated. Public health experts are also warning of a “twindemic” or even “tripledemic” in which COVID surges along with flu and respiratory syncytial virus (RSV). Most people may have never heard of RSV, but it was first discovered in chimpanzees in 1956, and the virus regularly causes outbreaks in humans.
It’s usually only serious in babies and older people, but it’s still not a fun illness. Even though the fall is just beginning, both flu and RSV are returning with a vengeance after relatively few cases the previous two years. On Friday, the Washington Post reported that this flu season is early and more severe than it has been in 13 years, “with at least 880,000 cases of influenza illness, 6,900 hospitalizations and 360 flu-related deaths nationally.”
Meanwhile, pediatric hospital beds across the U.S. are filling up with RSV cases, many of them completely full for weeks. Symptoms of flu and RSV may overlap (cold-like symptoms like fever, runny nose, coughing), making it somewhat confusing for sick people to know what illness they really have. That underscores the importance of testing for COVID and visiting a doctor when ill, if you have access to medical care. It also serves as a reminder to stay home when sick and mask up when possible.
Masking prevents the spread of all three of these viruses: flu, RSV and COVID. That’s one theory as to why the last two winters have been mostly free of diseases other than COVID, which has dominated due to its novelty and severe contagiousness. But as restrictions loosen, some of these more familiar viruses are coming roaring back. Keeping track of new and old symptoms is really only part of the equation. Masks, vaccines and social distancing continue to be some of the best tools at our disposal.
The evasive BA.5 omicron variant is driving up Covid cases and hospitalizations as it spreads rapidly across the United States—but despite deaths remaining lower compared to earlier waves, experts tell Forbes there are still plenty of reasons to remain cautious and warn Americans against letting their guard down too soon.
While Covid-19 cases and hospitalizations have been on the rise in most states in recent weeks and jumped 20% nationwide over the past fortnight, deaths have risen only modestly and have hovered around 300-400 a day since April. Driving the new wave is BA.5, an omicron offshoot that has a “superpower to cause reinfection” and can evade immunity from vaccination and previous infection, even from other omicron variants, Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco, told Forbes.
The disconnect reflects the fact that vaccines and past infections still provide strong protection against serious illness and death for BA.5 as well as there being more options available to treat early disease like Pfizer’s Paxlovid. Chin-Hong said there are still plenty of reasons to avoid infection, not least because Covid can still cause severe symptoms “even if you don’t end up in the hospital” and symptoms can “last for weeks.”
Infection also carries the risk of “long Covid”—lingering and sometimes debilitating symptoms that can persist for months or years—and early evidence suggests this is more likely the more times you get infected. Avoiding infection also helps safeguard people around you who may have less protection against serious disease like children, the elderly and those with weakened immune systems, Dr. Stuart Turville, a virologist at the University of New South Wales in Australia, told Forbes.
Increasingly transmissible variants of omicron have surged across the U.S. this year. BA.5, the most infectious form of the virus yet, rapidly spread and became the dominant variant in early July. It now accounts for an estimated 78% of cases, according to the Centers for Disease Control and Prevention and community transmission has spiked. Concerns over BA.5, as well as the related BA.4, prompted officials to direct vaccine makers to target the variants in updated shots and the Biden Administration announced new plans to tackle its spread.
Officials and experts say it is especially important to ensure strong protection against serious disease by keeping up-to-date on vaccinations, including booster shots. Despite the appeals of public health officials and being available for many months, booster uptake in the U.S. is poor. Fewer than half of fully vaccinated people have received their first booster dose and fewer than 30% of those who have and are eligible for a second have taken up the offer, according to CDC data.
More variants. It is inevitable that SARS-CoV-2, the virus that causes Covid-19, will evolve and spawn new variants over time. Another omicron offshoot, BA.2.75—inexplicably and successfullydubbed “Centaurus” by the internet—has already caught the eye of virologists. The variant is spreading rapidly in India, has been detected across Europe and North America and shows signs of evading immunity.
Little data is available and it’s not clear whether BA.2.75 causes more severe disease. It’s also not clear whether it would be able to take over from BA.5 “as the ruler of the roost,” Chin-Hong explained, as they haven’t had a chance to directly compete with each other as yet.”
A great deal. Data collection and surveillance is poor compared to earlier on in the pandemic. Individual testing is down, genomic surveillance is reduced and evidence suggests cases could be vastly higher than official figures state. Conversely, hospital figures are inflated and reflect routine testing upon admission, which catches many “incidental” infections from people seeking care for other problems.
There is a lot to be understood about the newer omicron variants as well, experts say. BA.5, as well as other more recent omicron offshoots like BA.4 and BA.2.75, are relatively new pathogens that are infecting or reinfecting large numbers of people in the community, Turville explained, which makes it hard to provide absolute and definitive answers. “As with most things with SARS CoV-2, it is a large bag of unknowns,” he added.
Turville told Forbes the decoupling of deaths from cases shows the longer term effects of vaccination and exposure to the virus. It’s a “maturing immunity to SARS-CoV-2 in general” which has taken off the “edge of disease severity,” he added.
While cases are growing—and likely undercounted—it’s worth noting that they are a long way from the earlier omicron peak in January. In July, there were around 100,000-120,000 cases reported on average compared to more than 800,000 in mid January.
I am a senior reporter for the Forbes breaking news team, covering health and science from the London office. Previously I worked as a reporter for a trade publication
So far there is no evidence that this variant causes more serious illness. And infectious disease experts say that even though new infections are on the rise, the impact of BA.5 is unlikely to be on the scale of the surge we saw last winter — in part because the country is better equipped to manage it.
The U.S. is averaging about 300 deaths a day, compared to 3,000 last winter. Dr. Anna Durbin, a professor at the Johns Hopkins University School of Medicine, says the combination of prior infections and vaccinations is still protective, and COVID-19 treatments are better.
“Most people have some underlying immunity that is helpful in fighting the virus,” she explains. “We have antivirals … And I think that because of that … we’re not seeing a rise in deaths. And that’s very reassuring. It tells me that even this virus, even BA.5, is not so divergent that it is escaping all arms of the immune system.”
She adds that new booster shots specifically targeting omicron — which could roll out as soon as this fall — should also be helpful in preventing serious illness and deaths.
There are steps you can take to reduce your exposure to the virus, like masking up in crowded indoor spaces. Here’s how to step up your mask game.
Americans who haven’t had covid-19 are now officially in the minority. A study published this week from the US Centers for Disease Control and Prevention (CDC) found that 58% of randomly selected blood samples from adults contained antibodies indicating that they had previously been infected with the virus; among children, that rate was 75%.
What is different about that minority of people that hasn’t yet gotten infected? Stories abound of close calls, of situations where people are sure they could have (or should have) gotten sick, but somehow dodged infection. Not all the questions are answered yet, but the question of what distinguishes the never-covid cohort is a growing area of research even as the US moves “out of the full-blown” pandemic. Here are the possibilities that scientists are considering to explain why some people haven’t contracted the virus.
They behave differently
We’ve seen it play out time and time again—some people adhere more strictly to protocols known to reduce transmission of the virus, including wearing a mask and getting vaccinated. Some people avoid large public settings and may have even been doing so before the pandemic, says Nicholas Pullen, a biology professor at the University of Northern Colorado. Then again, that doesn’t tell the whole story; as Pullen himself notes: “Ironically, I happen to be one of those ‘never COVIDers’ and I teach in huge classrooms!”
They’ve trained their immune systems
The immune system, as any immunologist or allergist can tell you, is complicated. Though vaccination against covid-19 can make symptoms more mild for some people, it can prevent others from contracting the illness altogether.
Growing evidence suggests that there may be other ways that people are protected against the virus even without specific vaccines against it. Some could have previously been infected with other coronaviruses, which may allow their immune systems to remember and fight similarly shaped viruses. Another study suggests that strong defenses in the innate immune system, barriers and other processes that prevent pathogens from infecting a person’s body, may also prevent infection.
An innate immune system that’s already not functioning as well due to other medical conditions or lifestyle factors such as sleep or diet may put a person at higher risk of getting sick from a pathogen. There’s not single answer here yet, but initial studies are intriguing and may offer avenues for future treatments for covid-19 and other conditions.
They’re genetically different
In the past, studies have found interesting associations between certain genetic variants and people’s susceptibility to communicable diseases such as HIV, tuberculosis, and the flu. Naturally, researchers wondered if such a variant could exist for covid-19. One June 2021 study that was not peer reviewed found an association between a genetic variant and lower risk of contracting covid-19; another large-scale study, focused on couples in which one person got sick while the other didn’t, kicked off in Oct. 2021.
“My speculation is that something will be borne out there, because it has been well observed that resistance embedded in genetic variation is selected in pandemics,” Pullen says. But most experts suspect that even if they are able to identify such a variant with some certainty, it’s likely to be rare. For now, it’s best for those who haven’t gotten covid to assume they’re as susceptible as anyone else. Whatever the reasons some people haven’t yet gotten sick, the best defense remains staying up to date with vaccinations and avoiding contact with the virus.
“Being exposed to the SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why,” study author Rhia Kundu said in a statement, using the scientific name for the coronavirus. “We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection.”
The study, which examined 52 people who lived with someone who contracted the coronavirus, found that those who didn’t get infected had significantly higher levels of T cells from previous common cold coronavirus infections. T cells are part of the immune system and believed to protect the body from infection. “Our study provides the clearest evidence to date that T cells induced by common cold coronaviruses play a protective role against SARS-CoV-2 infection,” study author Ajit Lalvani said in a statement.
Researchers cautioned that the findings should not be relied upon as a protection strategy. “While this is an important discovery, it is only one form of protection, and I would stress that no one should rely on this alone,” Kundu said. “Instead, the best way to protect yourself against COVID-19 is to be fully vaccinated, including getting your booster dose.” And the findings on the subject have been inconsistent, with other studies actually suggesting that previous infection with some coronaviruses have the opposite effect.
A major question that has come from the so-called ‘never COVID’ group is whether genetics plays a role in preventing infection. In fact, the question has spurred a team of international researchers to look for people who are genetically resistant to COVID-19 in the hopes that their findings could improve therapeutics. “What we are doing essentially is that we are testing the hypothesis that some people might not be able to get infected because of their genetic and inborn makeup, meaning that they might be genetically resistant to COVID,” says Spaan, who is a member of the COVID Human Genetic Effort.
The effort has sequenced genetic data from about 700 individuals so far, but enrollment is ongoing and researchers have received thousands of inquiries, according to Spaan. The study has several criteria, including laboratory test confirmation that the person has not had previous COVID-19 infection, intense exposure to the virus without access to personal protective equipment like masks and an unvaccinated status at the time of exposure, among others. So far, the group doesn’t know what the genetic difference could be – or if it even exists at all, though they believe it does.
“We do not know how frequent it is actually occurring,” Spaan says. “Is it like a super rare individual with a very, very rare mutation? Or is that something more common?” But the hypothesis is “embedded in human history,” according to Spaan. “COVID is not quite the first pandemic that we are dealing with,” Spaan says. “Humans have been exposed to viruses and other pathogens across time from the early beginning, and these infections have left an imprint on our genetic makeup.”
Those who haven’t gotten the coronavirus are “very much at risk,” says Murphy of Northwestern University. “I think every unvaccinated person is going to get it before this is over.” Experts stressed that research to determine why some people get COVID-19 while others don’t is still very much underway, and no one should rely on any of the hypotheses for protection. Instead, those who haven’t gotten the coronavirus should continue mitigation measures that have been proven to work, like vaccination and mask-wearing.
“You don’t ever want to have COVID,” Murphy says. “You just don’t know which people are going to get really sick from this and die or who’s going to get long COVID, which is hard to diagnose and difficult to treat and very real.” But with coronavirus cases on the rise and mitigation measures like mask mandates dropping left and right, it’s not an easy task.
Moderna’s COVID-19 vaccine may pose a higher risk of heart inflammation in some age groups than Pfizer-BioNTech’s shot, the U.S. Centers for Disease Control and Prevention said on Tuesday, citing recent data. The agency, however, said the findings on myocarditis and pericarditis, types of heart inflammation linked to both the mRNA shots, were not consistent across all of the U.S. vaccine safety monitoring systems.
The CDC’s analysis comes as the U.S. Food and Drug Administration’s advisers meet on Tuesday to discuss the authorization of Moderna’s vaccine for children and teens aged 6-17. Based on data from the Vaccine Safety Datalink (VSD) system, the incidence of heart inflammation was 97.3 cases per million doses for males aged 18-39 following a second dose of Moderna’s shot, versus 81.7 cases per million Pfizer vaccine doses.
Available information suggests that most people with myocarditis after mRNA COVID-19 vaccination recover over time, the CDC said.. Moderna’s two-dose Covid-19 vaccine is associated with a higher risk of heart inflammation than Pfizer’s, but the benefits of both companies’ shots outweigh the risks, according to a Centers for Disease Control and Prevention panel of outside experts.
The CDC’s Advisory Committee on Immunization Practices met Friday to debate the risks of developing myocarditis after receiving Moderna’s or Pfizer’s vaccines. Myocarditis is an inflammation of the heart muscle that can result in serious health problems, according to the National Heart, Lung and Blood Institute. Though myocarditis is most common after a viral infection, the CDC has found a link between heart inflammation and vaccination with Moderna and Pfizer’s shots.
The risk of myocarditis after Covid vaccination is highest in teenage boys and young men following the second dose of mRNA vaccines, the technology used by both Moderna and Pfizer. Symptoms develop within a few days after vaccination, including chest pain, shortness of breath, heart palpitations and fatigue. Though rare, Pfizer and Moderna’s vaccines have both been linked to a risk of myocarditis.
However, the risk was higher following the second dose of Moderna’s vaccine in people ages 18 to 39, according to the CDC’s safety surveillance program, which gathers data from nine health-care organizations in eight states. For every 1 million second doses administered, Moderna vaccine recipients had 10.7 additional cases of myocarditis and pericarditis over people who got Pfizer, according to the study.
The difference was even higher in men, who experienced 21.9 excess myocarditis and pericarditis cases with Moderna’s second shot, while women had 1.6 additional cases. However, there was no difference in the symptoms experienced by people who got either company’s shots. Most patients were in the hospital for a single day and nobody was admitted to intensive care, according to the study.
Public health authorities in Ontario, Canada found that the rate of myocarditis was five times higher for males ages 18-24 following the second dose of Moderna’s vaccine than Pfizer’s. The rate of myocarditis was also higher among people in the same age group who received Pfizer as their first dose and Moderna as their second than in people who got two Pfizer shots.
Dr. Sara Oliver, a CDC official, said more myocarditis cases would be expected following Moderna’s vaccine, but the company’s shots would also prevent more Covid hospitalizations than Pfizer’s vaccine. “The benefits still for the mRNA vaccines far outweigh the potential risk,” Oliver said. Canada, the United Kingdom and several other countries have recommended Pfizer’s vaccine over Moderna’s shot in higher-risk age groups. Dr. Pablo Sanchez, a professor of pediatrics at Ohio State University, said the CDC’s vaccine experts should consider making a similar recommendation.
“It may be that we should at least in the highest risk groups, that younger male, that we should maybe be recommending a preference of Pfizer versus Moderna,” Sanchez told the committee. Researchers are still investigating what triggers myocarditis after Covid vaccination. Canadian public health authorities also found that the rate of myocarditis was higher for both Moderna and Pfizer’s vaccine when the interval between the first and second dose was less than 30 days.
The CDC’s vaccine experts are considering a longer interval of 8 weeks between the first and second doses of both company’s shots to address the risk of myocarditis. Moderna’s vaccine is fully approved for adults 18-years-old and over. Pfizer’s vaccine is fully approved for those 16-years-old and over, and authorized on an emergency bases for children 5 to 15 years of age.
The overwhelming majority of people who had myocarditis after Covid vaccination fully recovered and most reported no impact on their quality of life, according to a CDC survey of cardiologists and other health-care providers. The survey found that 81% of their patients who developed myocarditis after vaccination completely or probably recovered within 37 weeks after their diagnosis. Another 15% had improved, while 1% had not gotten better.
Most of the patients, 83%, had restrictions on their physical activity after their myocarditis diagnosis. However, 39% still had restrictions at the time of the survey. Physicians recommend that people who develop myocarditis avoid vigorous physical activity for a few months to make sure their heart fully recovers. There were no known deaths from myocarditis following vaccination in the group, according to the data.
People face a much higher risk of developing myocarditis from Covid infection than the vaccines, according to the Department of Health and Human Services. The risk of myocarditis from Covid is 100 times higher than developing the condition after Covid vaccination, according to a recent paper in Nature Reviews Cardiology. “There’s a little bit of danger in focusing on vaccine and myocarditis when the elephant in the room is really true disease, true infection from COVID-19 and the potentially devastating even life threatening myocarditis,” said Dr. Camille Kotton, an expert on infectious disease and people with compromised immune systems, at Massachusetts General Hospital in Boston.
CDC and its partners are actively monitoring reports of myocarditis and pericarditis after COVID-19 vaccination. Active monitoring includes reviewing data and medical records and evaluating the relationship to COVID-19 vaccination.
Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. In both cases, the body’s immune system causes inflammation in response to an infection or some other trigger. Learn more about myocarditis and pericarditis.external iconSeek medical care if you or your child have symptoms of these conditions after COVID-19 vaccination. Myocarditis and pericarditis have rarely been reported, especially in adolescents and young adult males within several days after COVID-19 vaccination.
After mRNA COVID-19 vaccination (Pfizer-BioNTech or Moderna), especially in male adolescents and young adults
More often after the second dose
Usually within a week of vaccination
Most patients with myocarditis or pericarditis who received care responded well to medicine and rest and felt better quickly.
Patients can usually return to their normal daily activities after their symptoms improve. Those who have been diagnosed with myocarditis should consult with their cardiologist (heart doctor) about return to exercise or sports. More information will be shared as it becomes available.
Both myocarditis and pericarditis have the following symptoms:
Chest pain
Shortness of breath
Feelings of having a fast-beating, fluttering, or pounding heart
Seek medical care if you or your child have any of the specific or general symptoms of myocarditis or pericarditis especially if it’s within a week after COVID-19 vaccination. If you have any health problems after vaccination, report them to VAERSexternal icon. Healthcare Providers: For additional recommendations and clinical guidance, visit Clinical Considerations: Myocarditis after mRNA COVID-19 Vaccines | CDC.
Dr. Anthony Fauci declared last month that the U.S. is transitioning “out of the pandemic phase,” following mask mandates lifting across the country. However, that doesn’t mean COVID-19 is behind us. Surges continue in different parts of the U.S., while an estimated 300 people die every day because of the virus.
So it’s understandable that some people — at least the ones who have been trying to protect themselves and others from the highly-contagious virus for the past two years — are feeling a bit confused about what exactly they should be doing at this stage of the pandemic to stay healthy and safe.
Dr. Joseph Khabbaza, a critical care medicine specialist and pulmonologist at the Cleveland Clinic, tells Yahoo Life, “A lot of people have been given a sense that this is probably over for most of us. The answer isn’t going to be the same for every two people.”
Khabbaza says that’s because every person has to assess their own individual risk factors when it comes to getting COVID. Dr. Prathit Kulkarni, an assistant professor of medicine in infectious diseases at Baylor College of Medicine, agrees, telling Yahoo Life: “Safety precautions at this stage in the pandemic are related to one’s personal risk of having a bad outcome from COVID-19, vaccination status and one’s personal risk tolerance. All situations are slightly unique and require an individual and situational risk assessment.”
With the exception of people who are immunocompromised or elderly, though, “if you’re fully vaccinated and up-to-date on boosters, your personal odds of getting severe illness are very low, even if you come across the virus,” says Khabbaza. “Whereas for people who have not been vaccinated they may not factor in that they are at high risk for severe illness. But that’s something some people have chosen.”
How can you protect yourself in general?
In a nutshell, getting vaccinated and boosted if eligible is still the right call — especially if you’re more vulnerable to severe illness from COVID — and offers “the best protection,” says Kulkarni.
He adds: “Folks who are at higher risk for a worse outcome from COVID-19 may wish to enhance their protection from contracting COVID-19. The best way to do this is with a well-fitting mask. N95 respirator-type masks afford the greatest individual protection.”
Kulkarni says that “the folks who are potentially at the highest risk at this point in the pandemic include unvaccinated individuals, especially older persons, folks who are at higher risk but have not yet been boosted such as older persons or people living in nursing homes and people with significant immunocompromising conditions.”
Both Kulkarni and Khabbaza say it’s also important to know what the COVID rates are in your area or where you’re traveling to. “Following CDC’s tracker of COVID activity around the country can also be helpful to get a gauge for how things are going in a particular geographic area,” says Kulkarni.
Planning on going back to the office, hitting the gym or attending a wedding? Keep these precautions in mind to stay COVID safe and healthy.
Flying on a plane
With multiple U.S. domestic airlines including Delta, American and United dropping mask requirements on flights, you may be wondering how to stay safe while traveling on packed planes. The CDC states that it continues to recommend that people wear masks in indoor public transportation settings at this time. But depending on your own personal risk factors and risk tolerance, while at the airport, “if you’re able to space apart from people and avoid close sustained contact, then a mask is not going to be needed,” says Khabbaza. But when you’re in prolonged close proximity to others, it’s a good idea to mask up.
For example, Khabbaza shares that he doesn’t wear a mask while walking around the airport because he’s in motion and able to distance himself from others. However, he puts on a mask while in the security line “because of close contact.” He then takes it off walking to the gate and while sitting at the gate “because I’m away from other people.” Once on the plane, Khabbaza puts his mask back on. “Ventilation in airplanes seems to be good, but to me, it’s easy enough to minimize my risk in a setting with others by wearing a mask,” he says. “That’s where you’ll get more value for masking.”
Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health, told CNN that wearing a mask in the highest-risk settings while traveling is key. “That includes during boarding and deplaning when the ventilation systems on airplanes are often not running,” she says. “Don’t drink or eat at those times.”
Although airlines often hand out sanitizing wipes as you board, Khabbaza explains that, from a COVID transmission standpoint, “I don’t think that would have much of a barrier.” That’s because “contact with surfaces is not as big of a mode of transmission as initially thought, if at all,” he says. That said, it doesn’t hurt to wipe down the seat and tray table for hygiene’s sake.
Kulkarni agrees, saying, “In general, wiping down surfaces via routine cleaning can be generally helpful for avoidance of transmission of several different infectious organisms.”
Eating at a restaurant
In general, it’s safer to dine outdoors when feasible. “Similar to the initial stages of the pandemic, outdoor transmission of COVID is very limited compared to indoor transmission,” points out Kulkarni.
Khabbaza says to keep in mind that “if you are choosing to dine in a restaurant, most of your risk is when you’re sitting down and eating, which is much of the time.” Putting on a mask while walking for “a few seconds to your seat” or wearing one on the way to the restroom may not change the fact that there’s a “slightly higher risk of indoor dining right now,” he says. “Theoretically, it could lower it a little bit, but you’re drinking, eating, talking and laughing when seated and not moving around — that’s where the risks are.”
Khabbaza says the safest way to dine indoors is by choosing restaurants with big open windows to further lower the risk of transmission or going to restaurants during off-hours “when they’re not full.”
Working in an office
If you’re alone in your own office or in a private cubicle, a mask likely isn’t needed. “It will be hard to transmit if far away from others and there’s a barrier with cubicles,” Khabbaza says.
But he stresses that it’s important to know your company’s policy on vaccinations and whether employees need to show proof of vaccination to better assess the risk. “If vaccination is mandatory that certainly makes things a lot safer,” Khabbaza says. “But if you’re in close sustained contact all day at work, masking is probably not a bad idea, especially in times of high cases.”
Wearing a mask can also help put co-workers and employers who are more vulnerable at ease. “If you’re working with people you know are immunocompromised or elderly, it’s OK to try to protect them with masking,” he says.
Along with distancing and good ventilation, Wen told CNN that “testing that’s done at least once a week can help catch early, asymptomatic COVID-19 cases and serve as an additional layer of protection.”
Visiting a public pool
The good news is that the virus doesn’t transmit through water, per the World Health Organization. There’s also the protective benefit of being outdoors while at a public pool. However, Khabbaza points out that “close sustained contact with someone in a pool might have some of that risk.”
If the pool isn’t crowded, it’s easy to avoid people and space apart. “But if it’s a crowded pool party, there’s a risk and masks aren’t feasible,” he says.
When going indoors, such as to the locker room, it’s a good idea to put on a mask if there are several people close by. The CDC recommends bringing extra masks and storing them in a plastic bag in case one gets wet.
Going to the supermarket
In general, supermarkets are “lower risk from a COVID standpoint because you’re not really in close sustained contact — a lot of it is walking by people,” says Khabbaza, “and you can space out in a line at the cashier.”
But if you’re concerned or immunocompromised, he says, “just wear the mask, and then you have a barrier over your nose and mouth.”
Working out at the gym
The size, crowd and ventilation matter when it comes to gyms. Small boutique gyms that rely on fans to circulate the air are going to be “a little [riskier] if crowded because there’s not much ventilation,” says Khabbaza. “In the really big gyms, spacing can be done” so you can distance yourself from others. Large gyms are also more likely to have an HVAC system for better air filtration.
“If you can space out, it’s going to be relatively safer compared to smaller gyms where spacing isn’t much of an option,” says Khabbaza.
While wiping down gym equipment isn’t essential from a COVID transmission standpoint — “it would be very hard to get it, especially if you’re not touching your face,” Khabbaza says — it’s a standard recommendation to do so before and after using gym equipment in general.
Attending an indoor party or wedding
If you’re at a high risk of severe illness, “it might be reasonable to avoid weddings at times of [COVID] surges,” says Khabbaza, who recommends wearing a well-fitting N95 mask at group events, particularly if you’re more vulnerable. “If you’re anxious about the possibility of getting it, weddings may not be best for you during times of surges.”
That said, most weddings take place at “big venues where you can space out a bit,” he says. “If you’re spaced out and in a mask, you should be very good about minimizing your risk.” But Khabbaza says that the best protection is being up-to-date on COVID-19 vaccines and boosters, which makes the odds of severe illness “extremely low, assuming you have a normal immune system,” he says.
You can also go one step further to assess the risk of attending a larger social gathering: Dr. Preeti Malani, chief health officer at the Division of Infectious Diseases and Geriatric Medicine at the University of Michigan, told NPR that before a big event, “ask if people must be vaccinated and/or tested to attend and if they have to show proof or are on the honor system.”
Staying at a hotel
While you don’t need to wear a mask when you’re in your own hotel room, you might want to put one on while riding the elevator if it’s crowded or if you’re staying at a big hotel with longer elevator rides that stop at multiple floors. “A short elevator ride will be on the lower end [of the risk spectrum], but not impossible,” says Khabbaza. “But transmissibility becomes higher when in close contact.”
A 2021 study found that in elevators without proper ventilation, an infected person coughing can transmit viral particles “all across the elevator enclosure.”
Another option to stay safe: If you don’t want to mask, wait for the next empty — or mostly empty — elevator if it’s feasible, or take the stairs, suggests Khabbaza.
Monkeypox virus evades antiviral CD4+ and CD8+ T cell responses by suppressing cognate T cell activation (PNAS) | https://www.pnas.org/doi/10.1073/pnas…
Sick Woman Lying In Bed With Tissues (Getty Images/Obradovic)
