Four Years On: Time to Rethink COVID Approach?

Woman with a mask surrounded by germs illustration

(Illustration by Emily Faith Morgan, University Communications)

With the 2023 holiday season fast approaching - Thanksgiving is Nov. 23 - people are asking when they should start treating the coronavirus as a common illness to navigate, much like the flu or a cold.

"I think we are there now," Dr. William Petri, an expert on infectious diseases at the University of Virginia, said.

The pandemic arrived in the United States in January 2020. Almost four years later, Petri said it's reasonable for families to wonder how to behave. Hospitalizations for the disease in the United States are 15,000 per week, but "at the height of the omicron variant, which was in January 2022, we had 150,000 hospitalizations a week," Petri said.

The current numbers are "nothing to sneeze at," he said. But common sense, coupled with taking advantage of medical advances, are a potent combination.

Experts have been working tirelessly to create and improve coronavirus vaccines year-over-year and this year's shot is potent, Petri said. His advice is to get vaccinated for the coronavirus and the flu ahead of the holiday season.

"If you get vaccinated right now, that's going to protect you at the greatest levels for about four months," he said.

Here are his answers to UVA Today's other questions about staying healthy as large gatherings with family and friends draw near.

Q. Do you have any general guidelines for people to follow as they prepare for the holidays?

A. In addition to getting vaccinated for coronavirus and the flu, be aware that there are very effective medications for COVID, the No. 1 being Paxlovid.

There are some commonsense things you can do to improve ventilation that the Centers for Disease Control and Prevention recommend. If we have nice weather, have that family gathering out on your porch or out in your yard. Or have the windows open. If you have a heat pump, if you have it on the "on" switch and not the "auto" switch, the fan runs all the time so you're going to be exchanging air faster out of your house.

Q. What is the current guidance for people who test positive for the coronavirus?

A. Number one is stay home for the first five days and then wear a mask outside for an additional five days, so you're not going to spread it inadvertently to vulnerable parts of the population.

Q. If you have the flu, what should you do?

A. If you have the flu, of course you can't test yourself at home. The reason to get diagnosed with the flu is we have medications that are very effective for treating flu. It makes sense to go to your primary care provider within the first day, maximum two days of illness, to be tested.

Dr. Bill Petri
Dr. William Petri is an expert on infectious diseases at the University of Virginia. (Photo by Dan Addison, University Communications)

The problem with both flu and COIVD is you are infectious before you know you're sick. There is not a strict, five-day isolation period for viral infections including flu. Staying home until you're feeling better makes really good sense.

Q. What do you recommend for people with a cold?

A. There are many different viruses that cause the cold, four of which are actually other coronaviruses. It's common sense: Stay home until you're feeling better just so you don't make all your colleagues at work or school sick.

Q. Does being vaccinated against coronavirus and the flu lessen symptoms if you get either virus?

A. Yes. It's not 100% protection. It's about 75% protective against keeping you from being intubated or dying. But it's only less than 50% effective preventing you from getting infected. So, what it does is it truly moves the needle sort of to the left, so to speak, away from very, very severe disease to less severe illness.

Q. Do you think COVID has gotten less severe?

A. Yes, it has.

It's hard to judge how much of that is the virus evolving to be less severe. I don't think that that's a major factor, yet. I think it's more that the levels of immunity are helping. If you look at the older-than-65-years age group, who's at greatest risk for dying from COVID, their vaccination rates are above 80%. So, I think either immunity from having vaccination or having had prior infection is very helpful. It's the over-75-years age group and the immunocompromised population who are predominantly the ones who are suffering.

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