How to stay healthy for the holidays

• The updated Omicron COVID booster, also known as the bivalent booster, targets the Omicron variant, as well as the original 2020 virus. The Omicron boosters are available for everyone six months and older. These improved vaccines are the best protection against severe symptoms of COVID and hospitalization.
• Earlier in the pandemic, COVID vaccination rates in the Bay Area were high, shielding some communities from the worst outcomes. This vaccine protection has decreased over time, but an Omicron COVID booster can rebuild it. In most parts of the Bay Area, less than half of eligible people have received the updated Omicron COVID booster.
• More people in the Bay Area are getting the flu this year than earlier in the pandemic. Flu is not the same as the common cold and can lead to sudden, severe illness in the very young, seniors, and those with underlying medical conditions.
• Get your flu shot as soon as possible. Your doctor can give you the flu shot and the Omicron COVID booster in the same visit. COVID shots are free and other recommended immunizations are widely available at low or no cost.
• There is no vaccine for RSV, but simple measures like regular hand washing and covering coughs can help.

Stay home if you are sick

• No matter which virus you have, if you are feeling sick the best way to keep from spreading it to others is to stay home until you have recovered. If you think it might be COVID, get tested.
• You can decrease risk of RSV and other respiratory viruses by washing your hands, covering coughs, and, most importantly, staying home when you are sick.

Wear a mask in indoor public places

• Masks can prevent transmission of COVID, flu, RSV, and other respiratory viruses all at once.
• Wearing a high-quality mask, such as a KN94, KN95 or N95, can prevent you from getting sick and missing out on life, work, school, and holiday parties. Wearing a mask is strongly recommended indoors in public settings to prevent the spread of viruses and reduce the risk of illness. Masks also lower the likelihood that you pass on an infection if you are already sick, even if your symptoms are mild. This helps protect people around you, especially those at higher risk of serious illness.
• Improve ventilation indoors by turning on heating, ventilation and air-conditioning, filtering the air with a portable HEPA filter, pointing fans out open windows, or opening doors and windows when possible. These can all help viruses from spreading indoors.

Get tested before an indoor gathering or if you feel sick.

• Reduce the chances of infecting someone else with COVID by finding out if you have the virus before gathering with others. COVID symptoms may be mild or absent. Make sure to stock up on home test kits. They are now free from the federal government, and can be sent to your home by visiting www.covid.gov or call 800-232-0233.

Get treatment if needed

• Free treatments are available if you test positive for COVID. Free medication prevents hospitalization and is available to most adults and some teens with even mild symptoms.
• Talk to your doctor about treatment options or visit https://covid19.ca.gov/treatment/ or find a test to treat location near you: aspr.hhs.gov/TestToTreat. Treatments work best when started right after symptoms begin, and within 5 days of symptoms starting.

One treatment is the use of the antiviral drug Paxlovid, which was associated with a reduction of the risk of COVID-19 hospitalization or death by 44% among highly vaccinated Americans aged 50 and older, according to the results of a large study published last Wednesday in the Annals of Internal Medicine. Researchers from Brigham and Women’s Hospital studied the risk of hospitalization and death among nearly 45,000 non-hospitalized COVID-19 patients who were prescribed Paxlovid — a combination of the drugs nirmatrelvir and ritonavir — during the omicron BA.2 surge from January to July, to factor the risk reduction.

“These data have been helpful as we prepare for a winter surge,” corresponding author Scott Dryden-Peterson, MD, medical director of Mass General Brigham’s COVID outpatient therapy, said in a news release. “Our findings suggest that Paxlovid can save lives, and it can have a real impact on keeping hospital beds available for the treatment of other conditions. The opportunity to prevent COVID-19 hospitalizations is not there unless people know that they’re positive, so we have ongoing efforts to do outreach, make testing available, and communicate to the highest-risk patients that they may benefit from Paxlovid or another antiviral treatment option.”

Of the steps outlined here, which are people least likely to do and why? Will Harper, the public information officer for the county health department, said, “I don’t think we can answer this with any certainty. We are just trying to educate people about the best ways they can avoid getting sick or infecting others with respiratory viruses in circulation now,” in response to which steps people are least likely to take and why. “It’s up to individuals to decide whether to follow our advice. Of course, we hope they do because it will help keep people healthy at a time these viruses are spreading more. “

He said that “we can offer people credible, evidence-based information to help them make their decisions.”

He said the most important thing residents can do is getting their flu shot and staying up to date on your COVID vaccinations. “Even though these vaccines may not prevent infection, they provide excellent protection against severe disease and keep you out of the hospital,” Harper said.

As for which is more dangerous to the public —COVID or the flu— he said “The flu season in California and the U.S. started early this year and is likely why we are seeing a strain on hospital capacity in the county right now.”

COVID hospitalizations are rising as well, but the current rate (there are 94 people hospitalized with COVID in Contra Costa right now) is far from the more than 330 COVID hospitalizations the county saw during the peak of the original Omicron wave in January.

“We’ll have to see what January brings us in 2023 as it pertains to COVID,” he said.

Infectious disease specialists nationwide reportedly have said there are still people who don’t believe COVID vaccines work.

Harper countered with: “There’s ample scientific evidence and data showing that the COVID vaccines protect against hospitalization and death. But if someone is dead set against getting vaccinated, there are other tools at their disposal to protect themselves and others e.g. high-quality masks, staying home when you’re sick, and talking to your healthcare provider about treatment options if you become infected.”

The Paxlovid therapy for those who become infected with COVID is “free, effective and widely available, but under-utlilized,” Harper said, paraphrasing the state’s health officer Dr. Tomás J. Aragón.

People who test positive for COVID-19 should immediately contact a health care provider because treatments must start within the first five to seven days after symptoms begin, Aragon said in a press release. Most treatments are pills that can be taken at home, such as Paxlovid, which can reduce the risk of hospitalization or death by up to 50% and 88%.

Harper also said the county does not keep local data to track ‘long COVID’. But its symptoms include:

• Tiredness or fatigue that interferes with daily life;
• Symptoms that get worse after physical or mental effort (also known as “post-exertional malaise”), fever, difficulty breathing or shortness of breath, cough, chest pain, fast-beating or pounding heart (also known as heart palpitations), difficulty thinking or concentrating (sometimes referred to as “brain fog”), headache, sleep problems, dizziness when you stand up (lightheadedness), pins-and-needles feelings, change in smell or taste;
• Depression or anxiety, diarrhea, stomach pain, joint or muscle pain, rash, changes in menstrual cycles.