We want to be done with Covid. But the virus isn’t done with us.
While cases are not as high as they were at the end of this summer, newer variants are spreading, and experts predict that the patterns often seen over the last three years of the pandemic — the temperature drops, people cluster indoors, cases rise — will play out again this fall. That means it might be time to take stock (yes, again) of how you can minimize your risk.
“It continues to be a moving target, and I think that continues to be hard for people,” said Dr. Peter Chin-Hong, an infectious disease expert at the University of California, San Francisco.
As the holiday season approaches, here is a quick refresher on how to navigate the pandemic.
What precautions should I be taking at this point?
You’ve heard it before, you’ll hear it again: Masks can help you protect yourself and others from becoming sick. So can washing your hands thoroughly and not touching your face with unwashed hands, said Dr. Joseph Khabbaza, a pulmonary and critical care doctor at Cleveland Clinic.
The updated Covid vaccines can also reduce your chances of being infected, and especially cut down on your risk of serious illness, said Dr. Ziyad Al-Aly, the chief of research and development at the V.A. St. Louis Healthcare System.
Rapid tests are also a vital tool. (You can order four free tests per household from the federal government.) Testing when you have symptoms, or after a confirmed exposure, can help determine if you have the virus. Keep in mind that you should take two tests, 48 hours apart, for a more complete picture. If you do have Covid, you may qualify for Paxlovid, which significantly reduces the risk of severe disease and death — but you need to take the medication within five days of symptoms starting.
What are the riskiest activities?
Risk largely boils down to how crowded a place is and how long you spend there. If you’re popping into a convenience store, for example, your risk is probably minimal; if you’re lingering unmasked for hours in a full concert hall, it’s higher.
“Any time you’re indoors with a lot of people, the risk is still there,” said Dr. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago. It’s a good idea to wear a mask on the subway or bus. Planes are likely less risky because of their ventilation, but you still may want to mask, especially when boarding and deplaning.
For any indoor activity, like going to a bar, there are degrees of risk, said Dr. Chin-Hong. How busy is the place? Can you sit by an open window? Newer buildings tend to have better ventilation, and the bigger a place, the more spaced out you can be from other people, which lowers your chance of infection. And anything becomes riskier when cases are rising. It’s tricky to find clear data on Covid-19 cases, but you can check local hospitalization rates and wastewater data to get a better sense of your risk.
If I’m exposed to Covid, when am I in the clear?
As the coronavirus has evolved, the amount of time between being exposed and developing symptoms has shortened, Dr. Chin-Hong said. Most people now tend to test positive three days after they have been exposed to the virus, he said. But for many people, it takes a full week to test positive on a rapid test. (Molecular tests are more sensitive but harder to find outside of a doctor’s office.) Once you’re past the one-week mark, though, you’re likely in the clear.
I’m sick but not sure if it’s Covid. Should I cancel my plans?
It depends on how risk-averse you and the people around you are. It also depends on who you are spending time with — if you’re visiting an older relative, for example, you may want to reschedule.
And you may want to tell those you’re spending time with that you are not feeling well.
“Just like you inform people when you’re coming late, you inform them with the symptoms you have, and you negotiate with them,” Dr. Chin-Hong said. You might move a dinner party outside, for example, or shift plans to another night. Testing is often the only way to determine whether sniffles are due to a cold, the flu or Covid.
If you have a fever, stay home, Dr. Chin-Hong said. That’s a sign you’re likely infectious.
I just had Covid. Do I still need to be careful?
If you caught the coronavirus in the past three months, you’re fairly well protected against it. You can still become reinfected within that window, but it’s far less likely, because the variants circulating are similar.
I’m going home for the holidays. Should I quarantine before my trip?
Consider taking extra precautions, like limiting the time you spend around others unmasked in the five days before a big gathering. Be vigilant about your symptoms, Dr. Khabbaza said. You may also want to test beforehand.
“It’s hard to eliminate risk completely,” Dr. Al-Aly said. “But you can reduce one’s risk.”