The harsh reality of the next few months is that almost all the population will be exposed to COVID-19. Even worse, with the remarkable infectivity of the Omicron virus, all unvaccinated and a significant percentage of vaccinated will get COVID-19. So, in many ways it’s not a question of if, but when?
Many more people will be tested because of the free kits being offered, so we also will have lots of individuals who are not symptomatic, but who will be identified as infected. This is a new situation.
Managing infections in this environment is therefore different and potentially confusing, given all the recommendations that have come before. In addition, the decision tree for infected people who are vaccinated, with or without booster shots, and those unvaccinated, Is necessarily different. Confounding this, many of the approaches we have used to treat infected individuals in prior outbreaks (monoclonal antibodies) do not work with Omicron.
There are huge implications for everyone on how people react to a positive COVID test since poor decisions could make this wave of infections much worse. On one hand, overwhelming hospitals and doctors with patients having minimal illness could destroy the health care system. However, having individuals who are seriously ill with COVID-19 stay home until it is too late is not an option.
Therefore, let me try to give simple advice to infected people based on pre-existing conditions, vaccination status, and symptoms.
Red-Put on a mask and go to the emergency room
Regardless of vaccination status
- Anyone with serious trouble breathing (can’t walk a few steps, blow out a candle, or take a deep breath)
Yellow-Call the doctor, mask, and quarantine.
(This does not mean you need to be hospitalized, but they need to know you are infected.)
Regardless of vaccination status:
- Anyone over 70 years old or with significant heart or lung disease (defined as requiring a hospital stay at some time).
- Anyone with immune system problems
- Anyone over the age of 50 with significant heart, lung, or immune problems, regardless of symptoms.
- Anyone with significant symptoms even if not having trouble breathing
Green-Quarantine and mask.
- Anyone without symptoms.
- Anyone under 50 years of age with symptoms, but no trouble breathing and no significant heart, lung, or immune problems.
Vaccinated (with or without booster)
- Anyone without symptoms
- Anyone with symptoms, but no trouble breathing.
The current recommendation is 10 days of quarantine for everyone, but NFL is now allowing fully vaxxed people to return to work 24 hours after symptoms resolve. Given the impact this wave may have on critical jobs, this may become universal for fully vaccinated and boosted individuals.
So, if you don’t want to sit in your basement for 10 days, finish your COVID vaccination.