Why it seems nearly everyone has COVID now — and what to do about it, from a UNC doctor

·7 min read

Even with official COVID numbers down (we had nearly 32,000 new cases reported in North Carolina last week, but that was still down more than 33,000 from the week before), it sure seems like lots of people are getting sick lately.

Everyone knows someone, or many someones, with COVID right now.

And in lots of cases, those testing positive are people who managed to defy infection for the past two-and-a-half years.

So what’s going on? Aren’t we supposed to be getting back to “normal”? Do we need to start wearing masks again?

We know what the Centers for Disease Control and Prevention says about the latest variant:

  • The dominant strain of the virus right now is the omicron subvariant of COVID-19, BA.5.

  • BA.5 is the most easily spread strain to date. It’s getting people who have been previously infected with COVID, as well as people who are vaccinated.

  • 62 of North Carolina’s 100 counties are labeled as being “high risk,” including Triangle counties of Chatham, Durham, Harnett and Orange.

But we wanted to hear from a doctor in our community to get answers to questions we have about COVID.

Dr. David Alain Wohl, a professor at the Institute of Global Health and Infectious Diseases at UNC-Chapel Hill, answered questions for us.

Should we still be wearing masks in public, even if we’re vaccinated and boosted?

Yes, we should still be masking in spaces where exposure to the virus remains high, such as indoors with people outside our bubble, to avoid becoming infected,” Wohl said.

“Studies continue to demonstrate the protection from infection provided by masking, including this review of the data that found the probability of contracting COVID-19 to be substantially lower for mask wearers compared to non-mask wearers.”

Wohl said that masking is important because while vaccines continue to provide some protection from infection, this protection is not as strong as it was for the earlier versions of the variant.

But the vaccines’ protection against infection is not zero, he said.

“A study of Israeli healthcare workers shows that a fourth dose of the Pfizer vaccine, that is a second booster, reduced the risk of infection for about 3 months above the protection people already had. That may not sound like a long time, but it can be the duration of a surge. Plus, the protection against severe COVID-19 disease remained high and strong.”

How reliable are home tests? Should we use home tests or should we go somewhere else to get tested?

“I love the home tests,” Wohl said. “They are easy to use and quick. Plus, if obtained from the federal government, completely free.”

Wohl explains that the reliability of the tests depends largely on when you test after exposure/infection, so it’s a good idea to test more than once (over the course of a couple of days).

“A certain minimum level of virus needs to be present for the home tests to result as positive and that level of virus is what Goldilocks would like: not too high and not too low,” he said.

“So, these tests are reliable in that a positive test is almost always a true positive. But, a negative can mean no virus at all present in the sample or a level that is lower than the test can ‘see.’ This is why many of these tests are packaged with two in the box. Since virus levels generally rise in those recently infected, a negative result on the first test can be followed a day later with another test.”

How is this variant different as far as how contagious it is and how quickly we show symptoms?

“SARS-CoV-2, the virus that causes COVID-19, is evolving to become more infectious,” Wohl said. “SARS-CoV-2 viruses that emerge are better able to get into our noses and throats and more efficient at entering our cells and evading our immunity will win out over other SARS-CoV-2 viruses that do not have these advantages.

“Therefore, the fitter virus wins, and we lose by having something like BA.5, which is much more readily spread than other versions of the virus. This is why masking now is very important despite our COVID-19 fatigue.”

Any advice for students and parents as we face back-to-school season?

Wohl gave us some answers that we know many K-12 kids and parents just don’t want to hear: we should be masking in schools. But he’s also a realist about the current views on masks in schools.

“All parents know that kids are lovable vectors of COVID-19 and should be treated accordingly,” Wohl said.

“On paper, objectively, the list of benefits of masking in school outweigh the downsides, at the present levels of virus spread and asymptomatic carriage of the virus. However, many parents are vocally opposed to masking in schools, and they are winning out over the many parents who would prefer to see masking remain the standard for indoor instruction.

“So, my recommendation to parents and kids who want to reduce their risk of COVID-19 is to mask in school and look for opportunities to minimize risk during lunch and sports, where possible. Make sure to also be up-to-date on your COVID-19 shots.”

Here’s Wohl’s message for college students — and their parents.

“For college students, the ball is in your court. You can mask in social gatherings or take your chances on getting infected, re-infected, long COVID, and giving the virus to someone else who may not do as well as you would with COVID-19.

“For the parents of college students, buy home tests and test your kid when they come home before you let down your mask.”

When can we expect more COVID boosters?

It looks like we’ll have a little extra help before the winter virus surge.

“Media reports that as early as September we will see a combination mRNA vaccine booster with a BA.5 directed vaccine mixed with the original vaccine,” Wohl said. “This will likely help tamp down the expected surge in infections that come with the colder weather.

“There is also a new vaccine made by Novavax. This is FDA authorized for initial vaccination and not yet for boosting, but preliminary data suggest it works well in protecting from BA.5 and is a strong and well-tolerated vaccine, overall. It could be we will see this added as a boosting option too.”

Should we just accept the fact that we’re all going to get COVID?

What we actually sent to Wohl was this:

“There seems to be a prevailing attitude of: ‘Look, I’m vaccinated, I can’t do the masks anymore, I’m over it. If I get it, I get it. It’ll be like a bad cold and I won’t die and it’ll be over.’ Should we just go with that?”

Wohl’s response touched on much more than how serious or mild our COVID symptoms might be with this new variant. High numbers of infected people puts a strain on all facets of society.

“It is true, chances are if you catch COVID-19 it will be like a bad cold and you won’t need oxygen and won’t die,” he said.

“But the costs of massive amounts of people getting infected with the virus — hundreds of thousands of people across the country each day — remain very high. The proportion of people out of work due to feeling ill is huge and this is handicapping our industries, supply chains, and economy, not to mention healthcare as clinicians, schedulers, lab technicians, facilities maintainers are out sick in record numbers.

“Can’t get an appointment at the dermatologist for 6 months? Long line at the bank? Someone at a company you called did not call you back? This is likely due in part to staffing issues exacerbated by the amount of illness our nation is having to shoulder every day.”

Plus, Wohl points out, it’s still possible for people to get very sick with this current variant, and long COVID is still very much a thing.

“On average, each person with COVID-19 infects many others (numbers range, but for BA.5 it is likely at least 5 and probably much more). It does not take too many cycles of transmission from you to others before someone in the chain ends up very ill and/or with long COVID,” Wohl said.

“I understand the frustration of having to deal with this pandemic, but we are perpetuating its impacts if we neglect the most basic measures we can take to reduce its spread and simply choose to ignore it and its consequences, which are lessened but still very harmful on an individual, community, and national level.”