TREATING COVID BY THE NUMBERS

These days, being both fully vaccinated and contracting COVID-19 is a “viral topic” among our friends of similar age. While the virus no longer comes with the severe medical complications and death for our age group, people are becoming infected with the virus when they least expect it.  Now we are learning that no vaccine is 100% effective and that breakthrough infection of new COVID variants is to be expected.

Over the course of 2022, my wife and I resumed all of our normal activities and again began traveling overseas. In late October, we spent two weeks in Italy with two dozen strangers on a tour bus. We remained infection free after mingling with large crowds in Sorrento, Rome. Florence and Venice. At home, our masks hung unused from the car steering wheel, unless entering a nursing home or physician’s office.  

In early February, two days after returning from a trip to New York City, my phone began “blowing up” every morning. The message blurted out that we were exposed to the virus while in the city. The “COVID Alert NY” app works by using secure Bluetooth technology to detect when another phone with the same app is near. If the two apps sense that they have been in within six feet of each other for longer than 10 minutes – they will exchange random codes.

Little did we know that the phone warnings were prophetic of incoming COVID. Our year of dodging the bullet, following attendance at dozens of events with large numbers of unmasked people, was over.  My wife was the first to experience symptoms after returning home. On February 7, she went to an area dealership to pick up a vehicle we had purchased. She sat inside the car for 30 minutes with the salesperson going over all the bells and whistles. (Of course, this poor fellow came down with COVID.) She had a fever that evening and other tell-tale symptoms developed. Two home tests for the virus were negative.

Finally, our physician tested her in the parking lot of her office. On February 9, she was confirmed positive. Paxlovid, the oral anti-viral drug for COVID was administered. We learned that the home test kits, which are rapid Antigen tests that produce results in 15-30 minutes, are less reliable than laboratory based tests.  Negative antigen test results do not rule out infection and should be repeated if symptoms persist.  

By February 12, her symptoms were already resolving. Three days later, with the physician’s approval, my wife and a girlfriend, both masked the entire time, attended the Yo-Yo Ma concert at Heinz Hall.

My COVID experience that followed was both rapid and predictable.  When my spouse received her laboratory test, she learned that COVID-19 tests only detect the presence of the virus – they do not determine the variant.  What is known is that the variants now circulating are so contagious that even if we are diligent with masks, up to date on vaccines or have been infected before, many of us will continue to be susceptible to catching the virus. Thankfully, the vaccines are holding up well against serious disease, and we are not back in the dark days of 2020.

It was not until after my wife tested positive that we began to occupy separate living spaces. By then, the “COVID Rule of Fives” had guaranteed I would contract the virus despite our best efforts. These rules include: (1) If fully vaccinate, get tested 5 days after exposure, (2) If there are no  symptoms, continue to wear a mask for another 5 days, (3) Stay home for 5 days after symptoms appear and until fever free, (4) Wear a mask for an additional 5 days after no longer isolating.

Exactly 5 days after my wife learned she was infected, I tested positive with a home test. I had multiple symptoms but never contracted a fever. Because of another medication I was taking, Paxlovid was not prescribed. During the video conference with my physician, we were given the only good news of the week. We would both have excellent renewed immunity for our planned trip to Portugal on March 1.

Keeping up on the science of the virus fell off the radar when our lives were COVID-free. Since our infections, we have learned from findings published in The New England Journal of Medicine that protection against infection from the virus plateaued about four weeks after our fourth shot was administered.  Among those who did not get the second booster, the infection rate was about twice as high.

More encouraging was the second booster's lasting effectiveness against severe COVID-19. A month after getting the fourth shot, the rate of severe disease was 3.5 times lower in that group than in those who had only received three shots. The boosters have shown the ability to provide needed protection for people who are immunocompromised, including those with cancer, who are often given immunosuppressive treatments that weaken their innate immune defenses. 

COVID-19 is a resilient disease that can be controlled with yearly boosters. The greatest danger may now be contracting “long COVID.’’ Thankfully, modifiable lifestyle factors that help prevent other diseases also appear to fend off chronic post COVID conditions. These include, never smoking, moderate alcohol consumption, a high-quality diet, good sleep habits and moderate physical activity.  The pandemic is over but long-term COVID prevention still requires vigilance.