These developments are happening as more people continue to travel and do other activities before the pandemic. How should people think about the risk they face from Covid-19 right now? If they are vaccinated and boosted, are they safe? What about those who have recently had Covid-19? What kind of precautions should people take if they still want to avoid Covid-19? And if someone tests positive for the coronavirus, should that person be isolated? To help with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington Milken Institute School of Public Health. He is also the author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.” CNN: Do current Covid-19 trends indicate another spike in cases in the United States? Dr. Leana Wen: I’m not sure this would be called another increase because the numbers didn’t really go down from the previous increase. In the winter, from December 2021 to around February 2022, we saw a huge increase in cases from the original Omicron sub-variant, BA.1. There was a slight lull. Then BA.2 came along with this increase in cases. Now, BA.4 and BA.5 are displacing the earlier Omicron subvariants and causing most of the infections in the US. Many places are seeing an increase in infections from a high baseline level of cases. We must also take into account that the number of reported cases is much lower than the actual number of cases. I think we could have five to ten times more cases than are being reported, considering how many cases are diagnosed with home antigen tests and not reported to public health authorities. The good news is that these recent increases have not been accompanied by a flood of hospitals, which shows the powerful effect of vaccines in decoupling infection from serious disease. CNN: With these numbers, how should people think about the risk of Covid-19? Does this mean people should cancel travel and re-introduce restrictions? Wen: I don’t think most people should change their daily activities, but I do think people should be aware of the 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 disease. However, we also know that immunity wanes over time, and there seems to be some immunity (escape) with BA.4 and BA.5 in particular. This means that people who are vaccinated and boosted are unlikely to get seriously ill if they contract Covid-19, but they could be infected. The question people must ask is this: How much do they want to continue to avoid contamination? There is so much virus around us and the variants are so contagious. This means that avoiding contamination requires extra care. Many people may no longer want to plan their lives around Covid-19 precautions, especially if they are generally healthy and well protected against serious illness. On the other hand, many people may still prioritize not contracting Covid-19 because of the risk of spreading symptoms over long distances. They may also have underlying medical conditions that predispose them to more severe outcomes themselves, or they may live with others who are more vulnerable and want to reduce the risk to those around them. CNN: For those who want to be careful, what do you recommend? Wen: For people who want to prioritize reducing their risk of getting infected with Covid-19, I would advise first to follow CDC guidelines and stay current on their boosters. Everyone aged 5 and over can get a first souvenir. Those over 50 can get a second booster for a total of four shots. Some people (who are moderately or severely immunocompromised) may receive five shots. (These people should also find out if they are eligible for Evusheld, the preventive antibody that can further help reduce progression to serious disease.) I would also recommend that they wear a high quality N95 mask or equivalent in crowded indoor areas. Lifting mask orders doesn’t mean people shouldn’t wear masks. Many people do not find masks to be 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 encourage wearing a mask in higher-risk settings — for example, when you’re in a crowded airport security line and during boarding and deplaning. Of course, remember that outdoor gatherings still carry far less risk than indoors. People who want to be extra cautious should try to go to outdoor gatherings if possible and then only go to indoor gatherings if others test 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? Wen: I definitely understand that feeling. It is very difficult for society to impose restrictions on individuals and ask people to forever put gatherings like weddings and birthday parties on hold or to give up activities they love like indoor restaurants and gyms. My best advice here is to recognize that if you go indoors, you could contract Covid-19. Be aware of your risk and take precautions accordingly. For example, you may be able to continue living your life the way you want, but before visiting Grandma in a nursing home, take a quick test that day. If you go to a crowded indoor wedding, get tested a few days later to make sure you haven’t contracted the coronavirus. And if you have symptoms at any point, get tested right away and don’t expose others around you. CNN: Are you safe if you’ve recently had Covid-19? Wen: Recent infection produces some protection that probably lasts about three months. Re-infection can certainly happen, however, and some studies suggest that getting the original Omicron BA.1 does not protect against the newer variants. Vaccination in addition to recent recovery provides better protection, so make sure you’re up to date with your shots and boosters, even if you’ve had Covid-19. CNN: And what if you test positive — do you still have to self-isolate? Wen: Yes, because you don’t want to spread Covid-19 to others. CDC guidance is that you self-isolate for five days and then wear a mask around others for another five days after that if symptoms improve. I think a testing policy is even better than this because people stay infected for different lengths of time. I would encourage people to test at home daily from day four and end isolation when the rapid antigen test at home is negative. Now is the time to make sure you have plenty of tests at home!
