Still have not had COVID? Why experts say infection is not inevitable despite surge – San Francisco Chronicle

In March of this year — about two years after the COVID-19 pandemic took over the U.S. — The Chronicle asked Bay Area experts: Is getting COVID inevitable?

At that time, the response was a qualified “no.” Even though the highly contagious omicron variant of the coronavirus had recently sent cases higher than ever, the experts said that at least in the near future, people who continued to take reasonable precautions against exposure, and who got vaccinated and boosted, could avoid the disease.

Since then, omicron’s subvariants have sent case numbers soaring around the world once again, with even some who had dodged the coronavirus for two years getting infected, and some even getting reinfected.

That prompted a recent follow-up with the same experts, who this time were asked: For those still uninfected, have the chances of avoiding COVID grown even slimmer, or perhaps dwindled to nothing?

With some caveats, their answers remained largely unchanged: While COVID is now harder to avoid, getting it still does not have to be inevitable, at least in the short term.

“I still don’t think infection is inevitable, but the chances of dodging it have gone down since March,” said Dr. Bob Wachter, the chair of medicine at UCSF.

Wachter reported last month that his wife, journalist and author Katie Hafner, had contracted the coronavirus after avoiding it for more than two years, and said last week that she has developed symptoms of long COVID.

However, “I remain uninfected,” Wachter told The Chronicle, “and am still relatively careful (no indoor dining and KN95 in indoor spaces) — I’d give myself a 50-50 shot at staying uninfected through 2022.”

Wachter added that “it’s all math.” He said that much of the population that hasn’t gotten COVID — which, by the U.S. Centers for Disease Control and Prevention’s latest estimate was about 40% of Americans, as of the end of February — continues to be exposed to high levels of virus.

But that virus now, with each new variant, “is better at infecting people and at partly evading the immunity from vaccination,” he said. At the same time, he noted, many who were previously very careful are beginning to let their guard down, “both because they’re tired and because they perceive (correctly) that the risk of a severe acute case (hospitalization/death) has gone down by a lot.”

The risk of long COVID is very real, he said, but isn’t as obvious to people as “acute harm.”

He thinks these two factors — more infectious variants and reduced caution — together will keep cases at a high plateau, which makes the virus harder, though still possible, to avoid.

Dr. Peter Chin-Hong, an infectious disease expert at UCSF, said in March that, biologically, it’s possible that everyone may eventually get COVID. But, he cautioned then, it was not the time to “embrace that philosophy.”

Now, he said, “because of the specter looming of even more transmissible variants … it is not only likely that more people will get infected, but it becomes easier for folks to get reinfected.” He pointed to the Biden administration’s recent estimate that there could be up to 100 million infections from the virus in the fall and winter.

But, he’s hopeful that an upcoming “version 2.0 of the boosters” could be more effective in preventing breakthrough infections, and that other developments, such as vaccines for the youngest children and improved treatments for those most at risk, protect those who do get the virus.

He urged people to get a booster shot, and for those who are over 50, to get a second booster. “The older you are, the more urgent it is to get it to prevent serious disease and deaths,” he said.

The viewpoint expressed by Stanford infectious disease expert Dr. Abraar Karan in March has not changed: Widespread infections are not inevitable, but it’s still critical to try to prevent them, he said. The onus for that prevention, however, can’t fall solely on individuals, he said, and doesn’t come down only to isolation and masks.

“What individual people do will only take them so far,” he said. Community responsibility is also essential.

He noted that with the virus being so transmissible, even the most careful people — himself included — can get the coronavirus from their inner circle of friends and family whom they not be completely careful with all the time.

“In the past, you could N95 your way through a wave,” he said. Now, that’s not the case — while masking is still useful and important, he thinks so much more can be done to improve indoor air quality in both private and public spaces — measures he’s spent much of the pandemic advocating for — that he says would drive community transmission down, no matter the variant, and make public spaces more safe for everyone.

He pointed out that better ventilation and air filtration — which he thinks government and policymakers should push — would not only help prevent the spread of COVID, but would help with any other airborne illness, allergens and even smoke from wildfires.

“There are no downsides to this, only upsides,” he said.

He argued that simply giving up and allowing infections to happen also has profound economic implications, as it can take many people out of work at the same time — as is happening in his own hospital.

“What people aren’t appreciating is that low level infections are a worthy goal even if we cannot eliminate covid. Stopping big surges should be the goal. It can be achieved if we stop superspreading,” he said on Twitter. “There are many ways to do this! We aren’t doing any of them right now.”

Danielle Echeverria is a San Francisco Chronicle staff writer. Email: danielle.echeverria@sfchronicle.com Twitter: @DanielleEchev

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