COVID into the fifth year

Four years ago, here in the US, things were pretty much shut down due to the COVID-19 pandemic. B was working from home. I was the household’s designated shopper and would go, masked, to the grocery store every other week to stock up, although I’d sometimes have to visit more than one store because supply was a problem. We managed to keep ourselves safe, although we were horrified at the death toll in the US and around the world and at the people who became very ill. Over time, we also saw that some people had lasting damage to their lungs or other organs and others had symptoms that debilitated them for months.

Now, things are much better, due to vaccines and other precautions that have cut down on serious illnesses, although the US has slipped on vaccination, even as the virus has mutated in ways that make SARS-CoV-2 more infectious and immune-evasive. There are still way too many people getting sick and suffering long-term damage or death. While there are studies and some treatments on-going, there are still a lot of people suffering from long COVID.

We finally had our first case of COVID in our house last November, when B contracted it at a rare, in-person event for work. He isolated in part of our house and daughter T and I remained infection-free.

I don’t know how much longer we will be able to manage that status.

I was disappointed when the Centers for Disease Control and Prevention changed their guidance about isolating when infected with COVID. The new recommendations are for respiratory viruses in general and say that people can resume normal activities when their symptoms are improving and they have been without fever for 24 hours without being on fever-reducing medication. People are supposed to use masking, distancing, and other strategies to protect others from infection for five days afterward.

While I appreciate CDC’s reasoning, which is based on statistics, I don’t find it personally useful. It is typical that a person with COVID is infectious for ten days. It’s entirely possible to be fever-free and have improving symptoms and still be infectious. I’m afraid that most people won’t hear or won’t follow through on the part of the recommendation for masking and taking precautions to avoid exposing others after they leave isolation. This is especially troubling to me because so many people are not current on their vaccinations and/or are vulnerable due to age or health conditions. It’s great that the immunity level in the population halved the rate of serious illness and death, but that’s cold comfort if you expose a loved one, neighbor, co-worker, etc. and they become seriously I’ll or die.

If/when I contract COVID, I will isolate and mask until I test negative and am reasonably sure I can’t transmit the virus to anyone else. I want to protect my family and my community, especially our elders and those with medical issues, from contracting a virus that could cause them severe symptoms.

Please remember, when you see someone wearing a mask in public, to be kind and understanding. It’s entirely possible that they are trying to protect your health, not just their own.

(COVID Photo by Martin Sanchez on Unsplash)

still positive

Spouse B is still testing positive for COVID on Day 11, although the line on the test kit is fainter so maybe he is getting closer to the two negative tests 48 hours apart to be ready to be unmasked together without worry.

Not sure yet what we will do about Thanksgiving. It will just be the three of us and we were planning to do something other than the traditional turkey dinner. Maybe we will just postpone until we can all eat together in the same room. T and I have been eating in the dining room while B sequesters himself in his office at mealtimes.

We all remain grateful that his symptoms were relatively mild and short-lived but we are anxious to actually spend time together again. We are also grateful that T and I aren’t infected but we want to make sure we remain cautious. B would feel so badly if his case spread to us because we got tired of following protocol. Given the length of time that has passed, we all realize T and I dodged catching it when he was infectious before and in the early hours of the symptomatic phase.

So, at least, three more days of masking in our future.

I might need to order some more KF94 masks…

(COVID Photo by Martin Sanchez on Unsplash)

One-Liner Wednesday: household COVID update

Spouse B seems to be through most of his symptoms on Day 5, but will continue to mask and isolate at home, while daughter T and I are continuing to be symptom free and are masking at home when we are with each other and when we have to go out in public. (COVID Photo by Martin Sanchez on Unsplash)
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This update brought to you as part of Linda’s One-Liner Wednesdays! Join us in these brief (usually fun or inspirational) posts! Find out more here: https://lindaghill.com/2023/11/15/one-liner-wednesday-worried-who-me/

Smoke


B took this photo in front of our house yesterday morning (June 7, 2023) as the early morning sun tried to break through the wildfire smoke coming down from Quebec, several hundred miles away.

Things got worse as the day went on.

The air at ground level smelled like a campfire and an orange-tinged haze reduced visibility so that you couldn’t see the hills or tell where the horizon was. You could see smoke in the air just looking across the street. You needed indoor lighting even with the drapes pulled back on the windows.

We were keeping a watch on the air quality index numbers from airnow.gov. By mid-afternoon, they reached 460, well into the hazardous category. At that level, people should stay indoors with filtered air. If people have to be outdoors briefly, they should wear masks that are good at filtering out particulates, such as N95 or Kf94. Fortunately, many people still have some on hand from our pandemic experience.

B came home from work early because the smoky air began penetrating the stairwells in his building. It became quite windy. I was hoping that there were some rain clouds up above the smoke but no precipitation fell.

We aren’t alone in this phenomenon. Much of the Northeast and Mid-Atlantic regions of the US are having significant smoke impacts, sometimes even worse than areas in Canada that are much closer to the fires, due to a stationary low pressure system that is circulating in such a way that it draws smoke in our direction. It’s been a dry spring, so there are hundreds of wildfires in Canada right now, with over two hundreds that are considered out of control.

That’s a lot of smoke.

We need rain to help quell the flames and to prevent even more fires from erupting. Also, the plants and animals need more water. We are getting to what should be peak strawberry season here but the crop is expected to be low due to lack of rain, although a late freeze in May didn’t help matters.

As frequent readers may recall, I’ve been active around environmental issues for a number of years, particularly around climate change. I know that the extra carbon people have put into the air through fossil fuel extraction and use, deforestation, unwise agricultural practices, etc. has increased the risk of all kinds of extreme weather events. It makes the likelihood of heat waves, droughts, and wildfires higher and the changes in the air, land, and ocean temperatures make severe storms and stalled weather systems more likely.

We can see it with our own eyes.

I’m frustrated that corporations, politicians, and world governments did not make this a priority years ago. We might have averted some of the impacts we are experiencing now and reduced our future risk. I’m grateful that some action is coming on line now, but we need to make changes more quickly and more universally to reduce the severity of hurricanes/typhoons, wildfires, droughts, floods, sea level rise, biodiversity loss, heat waves, coral bleaching, etc.

In my little corner of the word along the New York/Pennsylvania border, we have a bit of improvement today. For the last few hours, our air quality is rated as “unhealthy for sensitive groups” rather than hazardous for everyone, although I know that, in the New York City area, airports have had to suspend service due to lack of visibility from the smoke. Washington, DC is having a purple alert for air quality, which is one level higher than red alert. The upper level winds have shifted enough that we aren’t in the worst sector today, but others are suffering higher levels than yesterday.

My fear is that a report that I heard today will come true – that this pattern will repeat itself throughout the summer.

It’s hard to predict.

A moment ago, I saw a bit of sunlight break through. I looked out the window and can see the sky with some clouds.

I haven’t seen the sky for a couple of days because of the smoke.

The clouds don’t look like rain is imminent, but I will try to have hope.

How low can you go?

This month, my county (Broome in New York) has finally made it into the low community risk level for COVID-19, using the current US Center for Disease Control tracking method. Our community transmission rate is still in the medium category, the second lowest of four categories. Both of these are the lowest levels that I recall seeing since this tracking model went into effect.

In recognition of this, I’ve begun to back off from masking in indoor public spaces. For example, I went to church on Easter and this weekend unmasked. On Friday night, I ate and sang unmasked with Madrigal Choir at a retirement dinner in honor of a Binghamton University professor who is a long-time choir member.

It feels a bit strange after masking for so many months.

I know there is still risk. A friend came down with COVID a few days ago. I had not seen her recently, so I wasn’t exposed, but it’s definitely a reminder that I may not be able to stay COVID-free forever. The number of people I know in the never-been-infected category is tiny at this point.

I don’t want to get sick and I especially don’t want to transmit COVID to someone else but I’m feeling that, with the community risk level at low and major personal events like my two cataract surgeries and visit from our UK branch of the family completed, I can let down my guard a bit. I’ll still be tracking our local statistics so I can put more precautions back in place as warranted.

Madrigal Choir is going into a busy week, getting ready for our final concert of the season next Sunday, so fingers crossed…

still masked

Last Friday, the US Centers for Disease Control and Prevention (CDC) changed their methods of assessing COVID risk to include the strain on the health care system, resulting in about 70% of the population now being classified as being in low or medium risk areas, meaning that indoor masking in public places and distancing measures can be rolled back.

However, Broome County, New York, where I live, is still in the high risk category. In the even more granular Covid Act Now tracker, our risk level is rated as very high, the fourth of five levels, with 26 daily new cases per 100,000 residents as of today, February 27.

The problem is that, when New York State rescinded its mask mandate, our local government also rescinded theirs. Our local conditions don’t warrant that, but, without a rule in place, the vast majority of people will not be masking in public, which will likely delay further progress in getting our case numbers down. Another thing that would help would be increasing our vaccine booster rate, which has crept up to 34% but is still low for our state, as is the 63% full vaccinated rate.

Earlier this month when New York dropped its mask mandate, I posted that I would continue to wear an N95 in public and to avoid crowds in an effort to stay COVID free. As a participant in the Pfizer/BioNTech vaccine trial, I am supposed to be following CDC protocols. With our county still being at high risk according to the current CDC map, I am still in compliance with my obligations to the trial.

The next decision point for me will be when Broome County finally gets into a lower risk category. In discussions with my personal physicians, they have advised attempting to avoid infection entirely for as long as possible. I share in this viewpoint. Many public health commentators have gone to the less stringent goal of trying to keep out of the hospital or dying from COVID and to prevent strain on the health care system. I, however, want to protect myself, my family and friends, and my community from being infected at all, so they won’t have to deal with the threat of severe illness, long COVID, and long-term cardiovascular, pulmonary, or neurological damage that can follow infection, even in those who didn’t have serious enough symptoms to warrant hospitalization.

The CDC does say in their guidance that “People may choose to mask at any time.” That will probably be me for quite some time yet, unless our county improves dramatically soon.

Lent is about to start. I’m trying to be hopeful that our situation will improve enough that I can safely drop my crowd avoidance in time to participate in some of the Lenten and Holy Week liturgies. We’ll see.

politics and/or science

Over the course of the pandemic, I’ve posted frequently about it, the Pfizer/BioNTech vaccine trial in which B, T, and I are participating, the evolving science on the SARS-CoV-2 virus and its variants, the similarly evolving public health recommendations, and how these are being implemented here in my home state of New York and elsewhere in the United States. I do sometimes comment on the pandemic in the UK and globally, but I know best what happens close to home.

Throughout the pandemic, New York had been in the vanguard of following the recommendations of public health experts, avoiding the tendency we have seen in so many other states to ignore the benefits of masking, distancing, limiting crowds, getting vaccinated, isolating if infected, etc.

That ended this week.

Governor Hochul bowed to public and political pressure and lifted the mask mandate for businesses. While it is true that statewide the peak of the Omicron wave has passed and the vaccination rate is decent, my county’s risk is still rated as very high, with 44.7 per 100,000 daily cases. Technically, New York as a state is also in the very high category with 31.2/100,000 today (February 11), but it is counties like mine that are keeping the state in that risk category rather than dropping into the (merely) high category. Medium and low risk are a long way off at this point.

Meanwhile, the national Centers for Disease Control and Prevention are recommending not only that everyone age two and over wear a mask while in public but also that those masks be N95 or similarly protective types because Omicron is so highly contagious. Alarmingly, an even more contagious omicron sub-variant has reached the US, making protective masks that much more important.

Does this sound like the proper time to end mask mandates for businesses in New York State?

Certainly not, if one is truly following the science.

The problem is that many people are tired of having to deal with the pandemic and are complaining very loudly. The politicians who had been following the science hear them and loosen the rules that had been helping to get their residents through the current wave with as little hospitalization and death as possible. This could extend the current omicron wave and increase the likelihood of yet another new variant that has the potential to be even more transmissible or evade current vaccines and treatments or cause more severe disease.

Regardless of New York State rules, I am continuing to follow medical advice, to avoid crowds, and wear an N95 when in public. Because I am vaccinated and boosted, I will still visit with people who are similarly protected without a mask. I had hoped to return to church services this weekend but have decided that I can’t do so with the daily case rate still being so high; being stationary in a room with that many people for over an hour is too much risk for me, even masked.

Sigh.

At some point, the pandemic will end and I will follow medical and scientific advice on what my “new normal” will be. I had hoped that our state policies would be an aid in this, as they had been through most of these past months, but that remains to be seen.

I’m just hoping that this latest relaxation of protections doesn’t cause even more cases than we have already suffered.

Update: Almost immediately after publishing this post, I saw reports of this study from the CDC, which shows that booster effectiveness wanes significantly after four months. Given that B, T, and I all had our boosters on the early side due to our participation in the Pfizer/BioNTech vaccine trial, I’m all the more resolute in my vigilance regarding masking, distancing, etc. While we are all still likely to avoid severe disease or hospitalization due to our longer-than-four-months-ago boosters, I prefer to try to avoid infection entirely.

over COVID?

Over the last few weeks, many people here in the United States have said publicly that they are “over COVID” or “through with the pandemic” and are going to “go back to normal” which means living like they did before SARS-CoV-2 appeared.

Guess what? Pandemics don’t disappear just because we are tired or frustrated or in denial. There were 3,622 COVID deaths reported in the US yesterday, adding to the almost 900,000 deaths in the US since the start of the pandemic and 5.7 million deaths worldwide. These staggering totals are almost certainly undercounted, as some regions don’t have the will or capacity to track and report. Also, some deaths result from lasting heart, lung, or neurological damage from COVID rather than from the active infection itself and so may not be identified as COVID related.

Some people are saying we just have to live with COVID, as we do with flu and other viruses. Thus, they are saying that it is now endemic, but here is the problem. There is a specific definition of pandemic, “(of a disease) prevalent over a whole country or the world” (Oxford Languages). Looking at case numbers in the US and around the world, it’s obvious this is still a pandemic. We will get to a point where it is endemic, someday, through a mix of vaccination and immunity from having been infected, although no one yet knows how long immunity acquired through either route will last. Dictionary.com has a handy non-epidemiologist explainer of pandemic, epidemic, and endemic.

The subtext of being “over COVID” seems to be more along the lines of I’m tired of masking and distancing and avoiding crowds, so I’m just going to get back out there because a) I’m vaccinated/boosted so I don’t think I’ll get sick or at least not seriously so; b) I am young/strong/take vitamins/exercise so I’m not going to get sick; c) I don’t believe there is such a thing as this virus; d) you can’t tell me what to do; or e) we have to ease up on restrictions now so that we can re-institute them when the next variant or spike in cases occurs.

The thing is that a virus doesn’t care about your age or status or location. It’s only mission is to live and replicate and it will adapt to make that happen as easily and widely as possible. Exhibit A: the Omicron variant, which is wildly contagious and somewhat able to cause breakthrough infections in the vaccinated.

As regular readers here may recall, spouse B, daughter T, and I are all part of the Pfizer/BioNTech phase three vaccine trial. We are all vaccinated and boosted, although we were boosted on the early side of the curve, B and T as part of the trial that is contributing efficacy data that we see reported out in the news, and I who received a booster through the trial as soon as it was authorized for public use but before most people in my age range were eligible. I am also contributing data for the study, but I’m not on the leading edge like B and T. Therefore, while many of the boosted can get comfort from knowing that their immunity is likely still strong because the data from the trials is showing that, I don’t know if B and T might be showing a decline because there hasn’t been enough time to collect and analyze that data. I’m sure we would all love to know that booster immunity lasts a year or longer but it’s only been about seven months so far, so we can’t know. Likewise, we don’t know how long immunity lasts after infection.

I know that I am unlikely to become seriously ill, to be hospitalized, or to die if I contract COVID, but that doesn’t mean that I’m ready to be cavalier about it. I don’t want to be sick if I can prevent it by continuing with masking, distancing, and avoiding crowds. Even mild cases of COVID can result in months of symptoms, which is termed “long COVID.” As someone who has lived with a person suffering from FM/ME, which causes similar symptoms, I find the prospect of long COVID frightening.

What frightens me even more is the danger of spreading COVID to someone else. I have many friends who are older than I and at higher risk, as well as friends who are immunocompromised. Young children still are not eligible for immunization, although Pfizer/BioNTech has just applied for emergency use authorization for children 6 months-4 years of age, so perhaps that will begin in the coming weeks. I’m sure I also happen upon unvaccinated people because the fully vaccinated rate in my county is 62% and the boosted rate is only 33%. Some of the fully vaccinated are not yet booster eligible but we know that boosted people have the best chance against Omicron, so, if I am out in public, chances are that only 1 in 3 people I encounter will be a similar status to me.

Those are not great odds, especially with a variant as contagious as Omicron accounting for 99% of US cases. I have recently upped my mask protection to N95s, as I wrote about here. I’m learning how to deal with them as someone who needs progressive lenses in her glasses. The tighter fit of the N95 masks makes it difficult for my glasses to be in the correct position, so I can get a headache from eyestrain if I try to do close work for any length of time. Still, I’m trying to wear the N95s when I have to go out with a surgical mask/good quality cloth mask combo if I have to take the N95 off.

I used this site, https://covidactnow.org/us/new_york-ny/county/broome_county/?s=28791756, to find today’s Broome County statistics. (You can use it to find statistics in your area in the US. International data may be found here: https://coronavirus.jhu.edu/.) It rates our risk level as “Extremely High.” While other may be “over COVID,” I am not ready to take that much risk for myself, my family, and my community.

As conditions change, I will re-evaluate and adjust my behavior as I see fit. Until then, I hope that those I meet will respect my viewpoint.

I’m not “over COVID” yet.

N95s

With the immensely transmissible Omicron variant so prevalent, I’ve decided to try to get N95 masks to wear when I have to go out in public. I have been double-masking with a surgical mask under a very good quality cloth mask made by medicalwear producer Jaanuu but thought that I should probably go to an N95 mask which is designed to fit more closely and filter out 95% of particles under NIOSH standards. (NIOSH is the US National Institute for Occupational Safety and Health.)

It’s somewhat difficult to find N95 masks in stores here. We did get a few from a home improvement store which stocks them because they are protective against dust and other particles for people doing construction or renovating. The problem is that they only carry one size which is too large for my petite face. I was able to find N95s in a size small online and a second fold-flat style that people complained about in the comments as running small, so I have ordered some. They won’t arrive until late this week or early next but I think I’ll be safe with my current mask set-up until then.

Or safe enough…

Masking is just one piece of our strategy. The three doses of Pfizer/BioNTech vaccine is my primary protection. The masks, avoiding crowds, distancing, etc. are additional measures to stay as safe as possible but, especially with Omicron, there are no guarantees.
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Vaccinated and (mostly) unmasked

Shortly after I wrote this post, the US Centers for Disease Control and Prevention published new guidance regarding mask wearing/distancing among fully vaccinated people in response to newly published research findings.

The good news is that fully vaccinated people can stop wearing masks indoors with extremely low risk of contracting or spreading coronavirus. Mask wearing is still recommended in medical settings such as hospitals. Requirements to mask on public transport remain in effect, as do any mandates or policies put in place by state/local governments and businesses.

The bad news is that people who are not fully vaccinated might also stop wearing masks – and wouldn’t stand out because others would just assume if they weren’t wearing a mask that they were vaccinated – and so could be exposing themselves and their contacts to coronavirus, which would drive up infection rates. This is not helped by states that have already dropped their mask mandates or never had them in the first place.

Some governors immediately dropped their mask mandates while others, such as Governor Cuomo of New York where I live, are reviewing the situation before making any changes.

Personally, I expect that I, though vaccinated, will not be making many changes in my mask behavior immediately. The few stores that I frequent are likely to keep their mask policies in place for now. Visiting my father in the health care building of his senior community will probably still require masking because, although they are vaccinated, the residents are still vulnerable due to their age and underlying health problems. If the state does drop the mask mandate, small businesses, such as hair salons and restaurants, may decide to let vaccinated customers unmask and could easily ask for proof of vaccination to give peace of mind to their employees and customers.

I am frustrated by the media commentary surrounding this CDC announcement. For weeks, commentators have been complaining that the CDC was too slow in changing its recommendations for vaccinated people and that it was a disincentive to get vaccinated. The CDC was waiting for additional scientific findings to be published before making changes, but, now that they have, the commentators are complaining that it happened too fast.

They are also complaining that the CDC guidance is confusing. It’s not. It is meant for use on an individual level and it’s very clear about what activities fully vaccinated individuals can do without masking/distancing and what activities unvaccinated people can do without masking/distancing. The CDC and the federal government are not the ones with authority to require masks in stores, churches, etc. State and local governments and businesses do that.

So, please, everyone, stop whining, learn about the recommendations from the CDC and the policies in place in your local area, and behave accordingly for the safety of yourself and others.

If you are eligible for vaccination but haven’t done it yet, make arrangements to do so as soon as possible so you don’t become seriously ill or pass the virus on to someone else.

Remember to be kind and respectful to others. Some vaccinated people will choose to continue wearing masks because they are immunocompromised and more susceptible. I know people with allergies who are continuing to mask outdoors to protect themselves from high pollen counts. Some parents of children who are too young to be vaccinated wear their masks to be a good example for their children. It is not your business to criticize someone else’s decision and masking is never a wrong choice when it comes to public health. In some countries, masks have been common for years, especially during flu season or when there are air quality problems.

The CDC recommendations rely on public trust. Unvaccinated people need to demonstrate that they are worthy of trust by following the public health guidance. Overall infection and death rates are down, but they will spike again if people don’t continue to vaccinate and mask/distance until they complete the vaccine process. A spike might not happen until colder weather drives more people indoors, but it won’t happen at all if we can get the vast majority of teens and adults vaccinated by fall.

The prospect of the epidemic phase of COVID-19 being over by fall is within reach, but only if people follow this guidance and get vaccinated.

Let’s do it!