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.