Right now, the US is in the middle of an infectious disease trifecta. The “tripledemic” of the coronavirus, influenza, and respiratory syncytial virus (RSV) has led New York City and Los Angeles County, among others, to “strongly recommend” masking indoors. Officials in Oakland and Sacramento may follow suit soon. The CDC, which has barely spoken about masking for the past year, now advises wearing one based on Covid-19 community levels — a recommendation that considers hospital admissions, beds available, and the number of case rates.
Look, I’m not trying to freak you out with this objectively scary information. The data simply speaks to how crucial it is to prepare to weather this season. There’s a sense of fatigue especially when it comes to Covid: It’s been almost three years since that particular pandemic started, and the recommendations from officials have remained confusing. It’s overwhelming; I totally get that. But addressing the emotional reality of navigating these illnesses can go a long way toward protecting you and your loved ones.
Covid-19 cases have increased by 26 percent over the two weeks preceding December 19, while hospitalizations and deaths have seen a 14 percent and 63 percent jump, respectively. And this flu season is on trend to be one of the worst in recent years. The CDC estimates that 15 million people have contracted the flu this season. As of December 16, at least 150,000 people have been hospitalized, and 9,300 have died from flu rates higher than average. And even though RSV is beginning to trend downward, infection rates remain high. These high rates of illness are also putting a major strain on hospitals and pharmacies.
So how can we best navigate this icky viral chaos? I asked Elizabeth Stuart, a Johns Hopkins Bloomberg School of Public Health professor, and James Conway, a physician specializing in pediatric infectious disease at the University of Wisconsin. Here’s their advice, edited for length and clarity.
Don’t engage in presenteeism: Stay home if you’re sick
This one feels the most obvious, but for many reasons, it doesn’t always pan out. Some employers have exploitative workplace policies to ensure workers come in even when they don’t feel well. Some employees succumb to the idea that working while sick makes them an ideal employee, someone willing to sacrifice their well-being for the company.
But symptoms of any sort, mild or severe, are a clear sign to stay home. “For far too many years, whether in the workplace or for important social engagements, people took it as a badge of pride that they would tough it out and go to work even if they were sick,” said Conway. “I think people have finally come around to recognizing that’s both impractical and a little disrespectful to others.”
For people who can’t miss a shift — the reality for many in the service industry, especially —other measures like masking, handwashing, and vaccination will be crucial to your well-being and everyone else’s. (The biggest help, of course, would be a universal sick leave policy.)
“The vaccines are a really very good match this year for what’s circulating and are performing well,” said Conway.
Some remain hesitant when it comes to vaccines, some lack access to the vaccines they need, and others don’t think they’re necessary. For Covid boosters, specifically, Conway says people are likely to believe that receiving their primary series, recently contracting the coronavirus, or some combination of both protects them well enough. (If you contract Covid-19 before you get vaccinated or boosted, the CDC does recommend delaying the shot by three months after the start of symptoms or a positive test. You’ll get the most out of your vaccine if you ride out your post-viral immunity.)
“That probably was decent enough back in the delta era,” he said. “But with these rapidly emerging omicron variants, especially this new BQ subvariant that’s replaced the BA.4 and BA.5, you’re basically unprotected unless you’ve had the bivalent booster.”
New Covid subvariants might cause more breakthrough infections. Wear a mask and wash your hands.
Both Stuart and Conway advised keeping a lot of masks around — hang one by your car keys, keep a few in your bag, throw an extra in your coat pocket, and share them with others. The same goes for hand sanitizer or, preferably, washing your hands regularly.
“Some of these viruses do aerosolize and fly through the air, but the majority of respiratory viruses are transmitted by what we call droplets, where people cough and sneeze and they land somewhere,” explained Conway. “And then you touch that space and touch your own face. Wearing a mask is a way of keeping your hands away from your face. Hand hygiene is an extra layer.”
Finding a mask that fits you well is essential, too, added Stuart. If you like your mask, you’ll be more likely to wear it, and you can buy that winner in bulk.
The caveat is that masks can be pricey. Stuart advised checking to see if any organizations in your area are giving them away for free. In Washington, DC, for instance, masks are available to anyone who wants them at local Covid centers. The CDC also has a tool that allows people to find free N95s based on their zip code. A quick search showed CVS, Walgreens, local pharmacies, and several major grocery store chains are a significant part of the program in more rural areas, which still suffer from limited access to vaccines.
If you manage to grab an N95 or KN95, you can use it until it’s visibly dirty, too loose-fitting, or falling apart — knowledge that lets you know it’s cool to stretch that mask for the week. “Masks are disposable but not single-use,” said Stuart. “You don’t need a new mask every single day or for every single interaction.”
Let the outside air come inside and clear out anything icky
If you share a home with someone sick, don’t be afraid to wear a mask inside or crack open a window to help ventilate the space.
“This week, my daughter has been sick, and I’m now wearing a mask inside the house when I’m with her,” said Stuart. “We hopefully have learned from the past couple of years to have more appreciation for ventilation and how to prevent spreads — whether that’s cracking the windows a little bit or wearing masks, especially in large groups.”
You can also circulate air throughout your home by putting a fan in the window, turning on the exhaust fan above the stove or in the bathroom, which helps move air outside the house, or grabbing a HEPA air filter if you can afford it. A humidifier could come in handy, too, since the coronavirus isn’t a fan of damp air.
Set the tone with friends and family
Setting boundaries with your loved ones isn’t always easy, but it benefits everyone to do so during this tripledemic. So don’t feel guilty for declining invitations to crowded parties or not allowing anyone who isn’t vaccinated to attend a gathering you’re hosting.
Besides, requiring vaccination for flu and Covid, or a rapid test prior to arrival, might not be that big of a deal to them anyway.
“I’ve been sort of pleased with some of the invitations I’ve received for social gatherings where people are saying their expectation is that everybody’s vaccinated,” said Conway. “Where that would be considered provocative in the past, I think it is becoming a little bit more normalized.”
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