COVID-19 UPDATE
November 20th, 2023, Happy Thanksgiving!
It’s the busiest travel time of the year and someone out there is bound to get COVID-19. Here I will review some of the current numbers and directional trends, updated vaccine (likely) efficacy, and some action items for a safe and health holiday.
COVID-19 infections typically trend higher after the Fourth of July and Thanksgiving Holidays and I expect this year to be the same. We are currently where a historical low point forms roughly between the 4th and Turkey day as seen in CDC hospitalization data shown below. Note: arrows are a rough approximation of pre-thanksgiving week.
Although all COVID-19 metrics tracked by the CDC are starting to trend upwards (graph below), the good news is that going into this holiday season fewer people are hospitalized with COVID-19. Let’s hope this means that as cases inevitably increase into the winter months our hospital systems will not be strained beyond capacity.
In terms of variants HV.1 is currently dominant among the variant alphabet soup (CDC Variant Proportions, below) . the good news is that the top three variants have very similar receptor binding domain profiles to XBB.1.5 and in vitro studies have shown that antibodies raised against XBB.1.5 are capable of neutralizing other variants in preliminary studies.
In support of those earlier findings today (Nov. 20th, 2023) Lancet Infectious Diseases published a correspondence (Stankov, et al.) showing development of high levels of neutralizing antibodies for multiple variants post XBB.1. vaccination. These studies are not “gold standard'“ real world infection data, however in the past in vitro neutralizing antibody studies from serum have served as a decent approximation for vaccine efficacy.
Caveats always remain, a wild-card variant could emerge and rapidly run roughshod over our hope for what is setting up to be a relatively peaceful respiratory virus winter. If that happens I will keep you posted.
That all said COVID-19 infection is still causing long-haul (PASC), landing people in the hospital and causing deaths, daily. Here are some ways to make the Holidays memorable for all of the right reasons.
Self-quarantine/avoid infection for at least 4-5 days before: I mentioned this in a TikTok post and it’s a bit late now, but better late than never! This will give you a chance to ensure that if you are sick the symptoms will start to show / a test will be more accurate before you infect loved ones. If you have to be out and about, be sure to wear a high-quality well fitting (no gaps) N95, KN95, or KF94 mask.
Rapid antigen test the day of the gathering: We know rapid antigen tests aren’t perfectly accurate, but if everyone takes two that may catch a positive and infectious case of COVID-19 and stop everyone else from getting sick.
Ventilation, ventilation, ventilation! Good airflow and HEPA filtration reduces infection. If you live in a warmer area consider having windows and or doors open with a fan on. If you live in colder areas consider having additional HEPA filtration and cracking a window if you can.
Mask wearing: If a vulnerable family member chooses to wear a mask to protect their health please remember to support and encourage this. Wearing a mask enables vulnerable loved ones to safely participate and be present, this should be celebrated. We have lost over 1 million American family members to COVID already, let’s keep your loved ones safe.
Mask wearing while traveling: I have traveled extensively and have not yet gotten COVID-19. From outside of the departure airport to outside of the arrival airport I keep my mask on. I know it sounds extreme but I am happy to have stayed healthy. If you must remove your mask to eat or drink in the airport, do your best to do it in an open air area away from other people. If you must remove it to eat or drink on the plane, try to do it when others are not eating/drinking /coughing and ensure the air is on ‘full blast’ above you. This air is filtered.
If you or a loved one is unlucky enough to get infected be sure to call your primary care provider as soon as possible to start an anti-viral such as Paxlovid or Molnupiravir. Paxlovid has superior efficacy but may not be appropriate if you have diminished kidney function.
As always, great to see you here and wishing you all safe travels and a happy holiday. And if you haven’t gotten vaccinated yet, you turkey, it’s not too late!