COVID is here to stay, folks

There’s an expression, “You may be done with COVID, but COVID isn’t done with you.”

It’s true. COVID-19 is still very much with us even though we would like to put it totally behind us and resume our normal lives.

The Centers for Disease Control and Prevention reports nearly 1.2 million cumulative COVID U.S. deaths. And it’s not over folks. We need to continue to protect ourselves, our families, our friends, and our communities.

The situation has greatly improved with the societal immunity gained through natural infection and vaccination, and COVID antiviral medications. The federal public health emergency designation has elapsed. There are no longer the huge numbers of severe cases, hospitalizations, deaths, and widespread disruptions to our lives.

Unless something unforeseen develops like a new terribly virulent infectious strain, we are not returning to those dark days when the pandemic raged with lockdowns, business and school closures, required masking, social distancing, and other mitigation measures. The apprehension of leaving our homes or attending gatherings is largely over.

Also, virulent viruses aren’t dumb. There is no advantage in killing their hosts. COVID-19 progressively evolved to be less virulent while becoming more infectious to boost spread, replication, and mutation to evade the immune system.

Ending the emergency designation doesn’t mean that the COVID threat is gone and that our situation is benign without consequences. Serious disease continues and people are still dying of COVID. The CDC reports that for most of 2024, between 1,000 and 2,500 people died weekly. Surges will undoubtedly continue with the seasons and with new variants that emerge.

Also remember that COVID is an unusual virus which causes “long COVID” especially in the unvaccinated or in those with repeated infections. The long-term debilitating symptoms include cardiopulmonary complications, fatigue, migraines, and cognitive deficits. The CDC reported in March 2024 that 17.6 percent of Americans have ever experienced long COVID; 6.8 percent currently.

So, how should you proceed?

Use mitigation strategies prudently. Consider masking in crowded indoor places, public transportation and airplanes, and large gatherings, especially when COVID cases have escalated.

Keep current on COVID vaccinations. The new 2023-2024 booster formulation introduced last fall is CDC-recommended now if you never received COVID vaccinations or this booster. If you are 65 and older or immunocompromised, even if boosted last fall, receive an additional booster now. A new booster formulation recommended for most people is anticipated for the fall.

Vaccination greatly reduces the risk of severe disease and long COVID. The politicalization of COVID compounded with vaccine disinformation, vaccine hesitancy, complacency, and resistance are unfortunate. The Kaiser Family Foundation reports that only 20 percent of adults have received the 2023-2024 booster. Societal immunity can wane, giving the virus the opportunity to thrive.

If you are sick, at least follow the newest CDC recommendations and stay home until afebrile for 24 hours and symptoms improving. Then, mask for at least five days and limit close contact with others. The CDC dropped specific isolation periods and testing recommendations in an attempt to treat COVID like other viral respiratory viruses as a group uniformly.

I believe the new recommendations, although easier to follow and more understandable, are flawed. People will go out while still infectious, including those infected but never displaying symptoms. COVID is much more dangerous than other respiratory viruses, lacks seasonality, is still evolving, and can produce disabling persistent long COVID symptoms.

COVID is here to stay for the foreseeable future. Be reasonably cautious.

Richard D. Feldman, M.D. is an Indianapolis family physician and former Indiana State Health Commissioner who served in the administration of Governor Frank O’Bannon.