How Protected Are You From Covid?

Yet another wave has begun and the virus continues to adapt — we must as well

The United States is facing yet another rise in Covid cases and many public figures have announced they’ve tested positive in recent days, including Jimmy Kimmel and US Health Secretary Xavier Becerra.

Test positivity in the US has climbed to above 11%, indicating that transmission is increasing — and that a lot of infections aren’t being diagnosed. Estimates suggest that the true number of infections is 5–10 times greater than the number of reported cases.

This new wave, driven by the new BA.2.12.1 sub-lineage of Omicron, is reaching some who have been vaccinated before and some who have had Covid before. So who’s at risk of getting infected, reinfected, hospitalized, and deathly ill? How well do vaccination and prior infection protect us now?

How protected are those who’ve already had Covid?

A recent CDC study estimated that as of February 2022, approximately 60% of Americans had antibodies from natural infection. Over a two-month period earlier this year, nearly one quarter of people in the US (80 million) were infected — more than 1 million infections every day!

Although there’s evidence a previous infection can protect against future infection and severe disease, the strength and length of protection varies depending on factors such as disease severity, age and underlying health status. The dose and impact of infection isn’t standardized — in contrast to vaccination.

How protected are those who have been vaccinated?

It’s now clear that protection against infection starts to wane within several months of vaccination, and this protection starts lower and wanes even faster against Omicron. But that’s not the most important point!

This is: Vaccines continue to provide excellent protection against hospitalization and death from Covid. To maintain high levels of protection against these severe outcomes, it’s important to stay up-to-date on your vaccination.

Data continue to show that unvaccinated and under-vaccinated people are much more likely to get infected and die from Covid. It’s crucial that we continue to reach people who received an initial vaccination series but haven’t stayed up-to-date with boosters — especially people aged 65 and older, about 1 in 3 of whom in the US haven’t gotten boosted and therefore are at higher risk of severe illness and death.

Changes in the virus and our behavior

Because BA.2.12.1 appears to be even more infectious than BA.1 and BA.2, there’s a greater chance of becoming infected if you are exposed to Covid. It can also evade existing immunity, so it’s not surprising that so many people with prior immunity are getting infected.

Re-infections are also more likely as things open again. People have gathered more and shed their masks over the past few months — changes in behavior that increase the likelihood of exposure if the virus is spreading widely.

So does this mean we’re all going to get Covid eventually?

There’s a high likelihood many of us will be exposed at some point, as transmission rates of BA.2.12.1 rise and as our behaviors change. But infection is not inevitable, nor is severe illness.

What can we do to protect ourselves? Stay up-to-date with vaccination to reduce the risk of severe disease if you do become infected. There is also emerging evidence that vaccination reduces the risk of long Covid.

People at high risk for severe disease if they get infected (e.g. immunosuppressed, elderly, medically vulnerable) as well as those who live with high-risk people should consider masking up with N95s in public indoor spaces. An N95 mask isn’t fool-proof, especially if it’s not tightly fitting, but it reduces the risk of other people not being masked in your space.

People should also consider masking when community transmission rates are high or rising if they want to avoid infection and prevent further spread to others.

Gathering outdoors and increasing ventilation by opening doors and windows can reduce the likelihood of exposure, and this are easier to do in many parts of the US during the summer months.

It’s not over

Many people have moved on, but the pandemic isn’t over. The virus is adapting to us and has shown its ability to get around some of our protection. And mutations don’t stop — there’s no guarantee we won’t see more dangerous strains of the virus emerge. They may have already.

But we have more layers of defense than ever to fight Covid and drive down its impact, including vaccines, masks, tests, treatments (especially Paxlovid), and early warning systems that are improving. We’re all safer when everyone — no matter where they live — has access to these.

We can stay ahead of Covid and future health threats by working together, improving our ability to track disease, investing in public health, and rebuilding trust. As the growing monkeypox outbreak reminds us, an outbreak anywhere is a threat everywhere, and new threats can emerge at any time.

Microbes outnumber us, but, if we persist and work together, we can outsmart them.