What does it mean to “learn to live with COVID”?
Some local public health experts say it means residents should get used to virus waves, keep their masks handy, expect more vaccinations and be ready to shift to outdoor settings when positivity rates increase.
“We have to unpack what that means,” said UC Irvine epidemiologist Andrew Noymer. “COVID is absolutely not going away. It’s going to go in cycles and it’s going to go perhaps in regular cycles, but cycles nonetheless. There’s going to be periods when it peaks, and periods where it drops.”
Noymer, who’s been tracking and researching COVID-19 since the pandemic hit two years ago, said tests and masks should be kept handy so people are prepared for when the next wave hits.
“It means having tests available because you don’t want to wait until they’re impossible to find again. It means having masks – n95 masks – having them at home, clean, in a box where they can be used when the wave comes. And it definitely means – in the long run – improving indoor air quality,’ hey said in a phone interview.
Dr. Shruti Gohil, an infectious disease physician who treats COVID patients at UCI Medical Center, said vaccines play a critical role in preventing a high number of deaths – especially with the new, potentially more transmissible Omicron subvariant spreading.
‘It’s here in the U.S., as every prior variant has proven itself to spread. What I think is really the key point is that the severity does not look like it was the first time around – and most likely that has a lot to do with the vaccination in the population,’ Gohil said in a phone interview.
The original Omicron strain fueled the past wave a couple months ago, which saw nearly 1,200 people hospitalized in Orange County.
From December through February this year, the virus has killed 942 residents, according to daily death data from the OC Health Care Agency.
It wasn’t nearly as deadly as the Winter 2020 wave, which saw more than 2,200 people hospitalized at one point – before vaccines were widely available for OC residents.
From December 2020 through February 2021, the virus killed 3,221 people throughout OC.
The virus has now killed a total of 6,864 OC residents over the past two years.
“Vaccines work and it’s a good indication that those who were vaccinated are faring well, even with this latest variant. They may get sick, but they’re not crashing and burning,” Gohil said.
“If you’re not vaccinated, get vaccinated. If you’re vaccinated, get ready for what is likely to be annual vaccines – just like the regular flu,” she said. “It seems like COVID is reaching a phase where it is going to be endemic.”
Roughly 75% of Orange County’s 3.2 million residents are fully vaccinated, according to the OC Health Care Agency.
And a little over 38% have received a booster shot.
“Now that we’re vaccinated, mostly and these variants don’t look like they’re causing ventilator-level demise, I think we’re okay without mandates, but using good common sense,” Gohil said. “We would watch carefully for the moment for a mandate.”
As of Monday, 95 people were hospitalized for the virus in OC, including 20 in intensive care units, according to the county Health Care Agency.
And the positivity rate is hovering at 1.6% – down from nearly 27% in early January.
Some local public health experts are calling on government officials and business leaders to invest in increasing indoor air ventilation to help curb the spread of COVID-19 as pandemic precautions, like masks, have largely faded away throughout Orange County.
“There’s a whole bunch of indoor air quality measures that can be taken … There are techniques to refresh outdoor air more often and in some cases there are techniques to use ultraviolet light to clean air – to disinfect air. There’s a whole host of measures that can be used to improve indoor air quality,” Noymer said.
He likened it to the cholera outbreak of the 1850s, which led to an overhaul in sewage systems.
“Retrofitting the sewage system to keep wastewater and clean water in separate channels was a similarly huge task in the 19th century, but they did it and it worked. And similarly, we’re going to have to do it again, but with air systems,” Noymer said.
Sanghyuk Shin, a UC Irvine epidemiologist and public health expert, also said an overhaul to air ventilation will be beneficial not only to reducing COVID transmission, but the spread of other illnesses as well.
“I absolutely agree with that and I think these kinds of systemic changes and policies are what’s needed – what would be most impactful. So I completely agree with Andrew,” Shin said in a phone interview.
“Although I still think mask mandates should be used in the middle of surges, it’s just one of those things that is so effective and less burdensome compared to some of the other measures that require a great deal of changes. So I think it should be a combination of approaches,” he added.
Gohil, along with her colleagues Noymer and Shin, said although increased ventilation can help, it won’t offer the same protection as masks.
“I don’t believe ventilation will nullify masking,” Gohil said.
“I think what you want to do is within the guidelines of common sense – that’s the only thing we have guiding us. If you have poor ventilation you’re working against yourself, you’re going to have high transmission 100%. So get ventilation indoors,” she said.
Throughout the pandemic, state officials have given school districts millions of dollars across the Golden State to improve air quality and ventilation inside classrooms.
Yet no official accounting of that spending or inventory of upgraded air systems has been conducted.
Secretary of the state’s Health and Human Services Agency, Dr. Mark Ghaly, said a specialized team could soon examine the air systems at schools.
“Trust me, a part of that task force will be focused on schools,” Ghaly told Voice of OC at a late February news conference.
Meanwhile, the phrase “learn to live with COVID” is undermining public health efforts, said Richard Carpiano, a UC Riverside public health scientist and sociologist.
“We have very much moved into the culture of COVID’s going away and it’s not a big deal any more. So there’s a false sense of security, and I worry that there’s a lot of out of sight, out of mind – in the sense that people aren’t really talking about it,” Carpiano said in a phone interview.
“We will likely be living with it the rest of our lives, so we do need to be thinking about COVID,” he said. “Is what we’re seeing now normal or can we be doing better to mitigate the risks even further? So in many respects, it’s a political as well as a social decision.”
Because state officials have set no case or positivity rate thresholds on when mask mandates could make a comeback, Carpiano said the public health response could come too late for the next wave.
“A point of public health is prevention, so you want early warning systems. If you’re starting to see hospitals filling up, you’re already behind the curve. People have made the arguments that cases are less important and Omicron is less harmful to others, we’re still learning about long COVID – so I’m not really sold on those arguments.”
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