None of this is perfect but here are some rough estimates I make: I generally assume presymptomatic spread is a risk and include that in my personal assessment of a given situation. If I don't know the people present, I assume roughly the same rate of infection as a recent test positivity read out would indicate (could be slightly more or less - sick people often stay home, but we also may not catch all positive cases in testing and it is an underestimate). If I do know the people and know how cautious they are (or not) about getting sick I factor that into how I'm looking at the situation. If someone is as cautious as I am, I'm fine spending an afternoon indoors with them if they haven't traveled recently and local infection rates aren't high. Generally, more people will be presymptomatic as viral rates start to increase in a given area (during the upswing phase of a peak or the first week when kids start to go back to school is another good example). As the local virus rates are dropping in the wastewater fewer people (of course some still are) will be presymptomatic - this is especially true for SARS-CoV-2 which has a long tail of shedding virus particles while the person is no longer infectious.
Thanks so much for sharing your personal protocol and the data backing up your choices.
I really think if we ever get out of science denialism (before the next pandemic), a good public health message will be something like, “take one with you.” I mean just have a couple of masks in your car or purse or whatever. If you find yourself in a higher risk situation, put one on.
Instead, Americans are so attached to binary thinking, they can’t conceive of masks as a health tool like an inhaler - just have one with you even when viruses aren’t running rampant.
I too am still Novid, in large part because of your early guidance and developing those strategies into routines.
As I have CVID, I mask where I’ve always masked—drs offices, crowded stores—high transmission areas. But I too have also relaxed my mask wearing for quick in-and-out stops and small stores, at drive-thrus (yes I was one of those), and with friends who don’t show signs of illness.
But the two thresholds I will not cross — for the REST OF MY LIFE — unmasked are:
Public transportation (including air travel)
And
ANY PUBLIC RESTROOM. (This one I think has been key in keeping me Novid.). E.g., If I eat unmasked at a restaurant and do have to use the restroom, I always put a mask on as I head toward the restroom.
Again thank you for your early and frequent guidance that has helped keep my family safe and limited infections in our family of five to just 3 instances: 0 for my husband; 0 for me; 1 for son in law; 0 for nephew; and 2 for daughter who also has CVID.
Being vaccinated at least once a year (I have been every 6 months until this year), the use of PAXLOVID when our daughter did contract covid, and adaptive mask wearing have all lessened our risk of infection, and severity for the 3 cases we have had “in-house” since 2020.
To your guidance, I added my own personal rule: NEVER use a restroom away from home w/o a mask!
How do you handle the possibility of presymptomatic spread? That’s my primary concern and the reason I haven’t let my guard down
None of this is perfect but here are some rough estimates I make: I generally assume presymptomatic spread is a risk and include that in my personal assessment of a given situation. If I don't know the people present, I assume roughly the same rate of infection as a recent test positivity read out would indicate (could be slightly more or less - sick people often stay home, but we also may not catch all positive cases in testing and it is an underestimate). If I do know the people and know how cautious they are (or not) about getting sick I factor that into how I'm looking at the situation. If someone is as cautious as I am, I'm fine spending an afternoon indoors with them if they haven't traveled recently and local infection rates aren't high. Generally, more people will be presymptomatic as viral rates start to increase in a given area (during the upswing phase of a peak or the first week when kids start to go back to school is another good example). As the local virus rates are dropping in the wastewater fewer people (of course some still are) will be presymptomatic - this is especially true for SARS-CoV-2 which has a long tail of shedding virus particles while the person is no longer infectious.
Thanks so much for sharing your personal protocol and the data backing up your choices.
I really think if we ever get out of science denialism (before the next pandemic), a good public health message will be something like, “take one with you.” I mean just have a couple of masks in your car or purse or whatever. If you find yourself in a higher risk situation, put one on.
Instead, Americans are so attached to binary thinking, they can’t conceive of masks as a health tool like an inhaler - just have one with you even when viruses aren’t running rampant.
I too am still Novid, in large part because of your early guidance and developing those strategies into routines.
As I have CVID, I mask where I’ve always masked—drs offices, crowded stores—high transmission areas. But I too have also relaxed my mask wearing for quick in-and-out stops and small stores, at drive-thrus (yes I was one of those), and with friends who don’t show signs of illness.
But the two thresholds I will not cross — for the REST OF MY LIFE — unmasked are:
Public transportation (including air travel)
And
ANY PUBLIC RESTROOM. (This one I think has been key in keeping me Novid.). E.g., If I eat unmasked at a restaurant and do have to use the restroom, I always put a mask on as I head toward the restroom.
Again thank you for your early and frequent guidance that has helped keep my family safe and limited infections in our family of five to just 3 instances: 0 for my husband; 0 for me; 1 for son in law; 0 for nephew; and 2 for daughter who also has CVID.
Being vaccinated at least once a year (I have been every 6 months until this year), the use of PAXLOVID when our daughter did contract covid, and adaptive mask wearing have all lessened our risk of infection, and severity for the 3 cases we have had “in-house” since 2020.
To your guidance, I added my own personal rule: NEVER use a restroom away from home w/o a mask!
Thank you for all you do for us!!!
(Also: hi Dr Rubin!)