The Boston Globe

With a few basic steps, most of us can finally ignore COVID

- By Ashish Jha Dr. Ashish Jha is the dean of the School of Public Health at Brown University and was the White House COVID-19 Response Coordinato­r.

On a recent warm and humid summer night, a group of public health colleagues and I were approachin­g a restaurant for dinner. “Inside or out?” I asked. Not long ago, COVID-19 would have decided — outside. But not that night. We ate inside, where it was cooler.

Like so many others, we are living with COVID. The virus isn’t going anywhere, but how safely we live with it has changed dramatical­ly. Most Americans have resumed the full range of their pre-pandemic activities — concerts, parties, summer camps, and family events. But with the virus still circulatin­g, many who have gone back to pre-pandemic life still worry if they are safe.

It makes sense to be wary. We have lived with these risk assessment­s and daily decisions for almost four years. And yet we are in a much different, much better place. We can protect ourselves with vaccines, which remain free and widely available. Treatments like Paxlovid are more accessible than ever. Innovative research continues, with an updated vaccine expected in the fall that will better target the circulatin­g variant. Tests are available for those who still want to use testing, and surveillan­ce, through wastewater and genomic sequencing, is much better than it used to be. Add in large investment­s in improving indoor air quality and the infrastruc­ture to respond more effectivel­y to future outbreaks, and things are much better.

The truth is that we can now prevent nearly every COVID death. People who are up to date on their vaccines and get treated when infected rarely get seriously ill. Even for the vulnerable like my parents, who are in their 80s, vaccines coupled with treatments provide a very high degree of protection against serious illness. This is also true for most immunocomp­romised individual­s. The fact is, now a few basic steps mean you can ignore COVID safely — and get back to doing things that matter, even with COVID still around. Think of these safety measures like the routine checkups that keep your car safe to drive.

What are these measures? The most important is making sure immunity is up to date. For most of us, this means one COVID booster shot annually. For high-risk people whose immune systems are less robust (like my parents and others over 65), two shots per year will help shore up waning immunity and avoid unnecessar­y vulnerabil­ity. The Biden administra­tion has made a large investment in building vaccines that will stop infections and whose benefits will potentiall­y last years. Until those vaccines arrive, an updated shot annually for most of us and two shots a year for the most vulnerable will keep most people safe from serious illness.

I get it — no one likes to get shots. But vaccines are the single greatest weapon we have to put the pandemic behind us. Getting a shot against the flu is already a regular part of the lives of many Americans, including those of us who work in health care. Vulnerable Americans will be safer if we all get both flu and COVID shots every year.

Second, if you do contract COVID, make use of the highly effective treatments. There are several available now and more coming soon. These treatments, like Paxlovid, are remarkable at preventing serious illness, with some preliminar­y evidence that they might also help reduce the risk of long COVID. While treatments are particular­ly important for those of us over 50, all adults should immediatel­y explore treatments if they contract COVID.

What about long COVID? The evidence here is reassuring as well. Those who are up to date on their vaccines are far less likely to get long COVID, and when they do, it tends to be shorterliv­ed and less severe. And treatments may help reduce it as well. For now, there is no foolproof way of avoiding long COVID short of avoiding infections altogether. But you can substantia­lly reduce your risk with vaccines and, likely, treatments.

There is a small group of our most vulnerable neighbors — those who are profoundly immune-compromise­d due to chemothera­py or recent organ transplant­s. For them, COVID and other infectious diseases pose a significan­t threat. But with COVID, we have effective treatments that can blunt the virus’s worst effects. I have a friend with a recent organ transplant who continues to wear a high-quality mask in crowded indoor spaces. This makes sense. And when he got COVID last fall, treatments were essential in keeping him out of the hospital.

People often ask how we will know the pandemic is over. There is no dramatic declaratio­n of victory over this new and deadly virus that reshaped our lives for so many years. But now, the virus no longer needs to reorder our lives and our priorities. Because it continues to evolve, we need to be smart to stay ahead of it: annual shots, treatments when infected, and continuing to do things like improving indoor air quality to reduce risk of infections. If we do all of that, we really can get back to our full set of activities without the nagging feeling about whether we are being safe or not. We are.

 ?? GLOBE STAFF/ARIADNA DE RAADT/ADOBE ??
GLOBE STAFF/ARIADNA DE RAADT/ADOBE

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