COVID Now
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/ Categories: WELLNESS, 2022

COVID Now

As the effects of the COVID-19 pandemic on society recede, we must recognize that health risks remain, particularly for older individuals and those with compromising health conditions. Fortunately, the mortality and rate of severe illness have declined with the use of vaccines and treatments. Here is the latest.

  • COVID-19 hospitalizations in the U.S. are rising, similar to last year at this time
  • One difference is that hospitalizations are primarily limited to people above 65 this season due in part to population immunity from vaccination and prior infection(s)
  • Models forecast continued growth in hospitalizations through January
  • An increase in illness from other respiratory viruses has put a severe strain on hospitals
  • New variants are not causing worse disease thus far

Mitigation and prevention

  • Doctors and epidemiologists continue to recommend risk assessment in considering mitigation measures such as masking and avoiding crowds
  • Someone above the age of 65 or who has an underlying medical condition may choose to wear an N95 mask whenever in public, whereas a healthy, young person may choose to mask only when in crowded areas or not at all
  • In addition to age and underlying health, a risk assessment includes one's tolerance for becoming ill
  • No one, whether they are at risk for severe disease or not, wants to be ill while on vacation or during another significant event and thus may choose to mask for several days prior

Risk

  • Risk can be a difficult concept
  • Take, for example, a situation in which there is a 5% chance you will be exposed, perhaps attending a crowded, indoor venue
  • Many healthy people may elect to take that chance
  • However, there is a cumulative effect when the activity is repeated
  • If the individual attends the same venue 15 times, that 5% chance increases to a greater than 50% chance of exposure

Vaccine

  • There are demonstrable benefits to the individual and the community in remaining up to date with COVID-19 vaccine recommendations
  • Those who are up to date with the vaccine and become infected have a
    • Shorter duration of illness, and
    • Reduced severity of disease
  • They are also less likely to experience long-term sequelae from the disease
  • The COVID-19 vaccine schedule continues to be modified and will likely become an annual series

Trey Dobson, MD, is the chief medical officer at Southwestern Vermont Medical Center, part of Southwestern Vermont Health Care, in Bennington. 

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How to Become a Mask Wearer

Long before COVID-19, online chat groups for people with pulmonary fibrosis (PF) were filled with posts about how uncomfortable it is to wear a mask in public: not physically uncomfortable, a fact that was barely mentioned, but psychologically uncomfortable. For people with this condition or the lung transplant used to cure it, catching a cold or the flu could be deadly. They need to wear masks in public to help protect themselves from getting ill.

The participants discussed how awkward it is riding the bus in a mask, going to the grocery store in a mask, or boarding a plane while wearing one. They were mostly self-conscious that others would think they were ill or weak. Many would rather suffer the risk of getting fatally sick than put a mask on in a department store.

Now, we've all been directed to wear masks in public. Both Bennington and Wilmington's Select Boards have passed local mandates requiring masks in public places. This—along with distancing and handwashing—are crucial parts of returning to a more normal way of life. Suddenly, we are all feeling the psychological discomfort PF patients have felt for many years.

People usually have an interest in blending in. And, just like doing anything out of the ordinary, wearing a mask for the first time definitely feels like putting yourself out there. If we want to return to a somewhat normal way of life, masks are crucially important, along with frequent, thorough handwashing and keeping a distance from others.

Here are a few tips for making the leap from being someone nervous about wearing a mask to being a person who wears one regularly.

Do it for others. We know that people can spread COVID-19 as many as a few days before they get sick. Even if you feel fine, you could have COVID-19 right now without knowing it. At the same time, masks are far better at keeping sick people from spreading germs than they are at keeping people from getting sick. So wearing a mask isn't a sign of weakness; it's a sign of altruism. It's like saying, "I am not certain that I am not sick, so I want to pay those around me the consideration of limiting the likelihood I will infect them." Think of it as a badge of kindness.

Get a mask that fits. We know that masks are not completely comfortable physically. Getting the right fit makes a big difference in their "wearability." Cloth masks are readily available online and from local groups. The Green Mountain Mask Makers have excellent information and resources. If you can, purchase a few types in a few sizes to see which you like best. Buy enough of that type to allow washing between trips out in public.

Get a mask that you like. Once you have found a mask source and as long as you have a choice, pick one that you like. You can choose colors that match your wardrobe or that represent your interests, like camouflage. There are even masks that look like fashionable scarves when they hang around your neck. The sooner we start thinking of masks as part of our outfits, as essential and unremarkable as shoes or a belt, the healthier we will all be.

Try to quit caring about what others think. This one is hard. But one wise PF patient wrote, "I just don't give a darn!" Essentially, he shared that if people want to judge him for wearing a mask, so be it. Their opinions don't have a single thing to do with him. Many in the chat group applauded his confidence and vowed to adopt his attitude.

If we all do our best, soon the cultural scale will tip. Wearing a mask or not wearing one will cease to be a political statement. It will be normal. And thankfully, if wearing a mask in public, handwashing and sanitizing, and keeping our distance are all normal, going out into public again can be safe and normal too.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center.

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