Are we still in a pandemic? Do antivirals work? We ask a California infectious disease expert

Sara Nevis/snevis@sacbee.com

We’re about to enter the fourth year of the coronavirus in the United States, but there’s still uncertainty ahead.

The Sacramento Bee posed several reader questions alongside our own to Dr. Dean Blumberg, chief of pediatric infectious disease at UC Davis Health.

Below, in a video interview edited for brevity and clarity, he answers: Are we still in a pandemic? Will COVID ever end? Is my wedding plan safe enough? What about masking in schools? Some readers gave The Bee permission to publish their names, and others preferred to remain anonymous.

Watch the video here:

Read an edited transcription below:

Is coronavirus still a pandemic?

The Bee asked: Are we still in a pandemic?

Blumberg: “I think we’re right at the cusp of transitioning from the pandemic into an endemic area. I think the pandemic ... we were getting waves that were occurring in the summer, which is not the traditional season where we see coronavirus transmitted, but we saw that, also, in 2009 with influenza H1N1. That’s why that was a pandemic because we have this susceptibility within the population and the abnormal transmission pattern...

“The wave that we already saw this winter — that’s already getting better. That continues to subside. And if we don’t get any new variants of concern, then hopefully the next wave we’ll have will be next fall or winter. But of course, the wildcard is if there’s new variants, that could all change.”

@sacramentobee A behind the scenes look at an interview with Dr. Dean Blumberg at UC Davis #interview #behindthescenes #ucdavis ♬ original sound - The Sacramento Bee

Will we be rid of COVID any time soon?

A reader asked: “Do you think COVID... will ever be over? If so when, considering all the new variants?”

Blumberg: “I think COVID is going to remain with us and become a seasonal virus, kind of like influenza is. We’re going to see waves every winter. We’re going to have a COVID season...

“For example, during the summer — unless we do get some concerning new variants and hopefully with more widespread immunity within our communities due to vaccination and previous infection — it won’t result in an overwhelming number of hospital admissions or deaths anymore.”

Should I get the bivalent vaccine?

Reader Eric Burdick asked: “I am ‘fully’ vaccinated... Should I receive the Omicron vaccine or am I protected against that variant?”

Blumberg: “Everybody should get all vaccine doses for which they’re eligible for, including the bivalent vaccine if they’re eligible for that. The bivalent vaccine protects better against currently circulating strains, including strains that aren’t even in the vaccine like XBB.1.5. And it also results in a wider, more diverse immune response that will likely protect against strains that we haven’t seen yet.”

Can the vaccine worsen my chronic condition?

Reader Steven Kasower asked: “My cousin claims that the Covid vaccine exacerbated his arthritic condition. Has this reaction been observed in some vaccine recipients?”

Blumberg: “Anecdotally, things are going to happen after getting vaccinated for different people. So some conditions might get better and some conditions might worsen. But the vast majority of scientific evidence and all the studies, they don’t show that vaccination results in worsening arthritis or worsening with other chronic conditions.”

How can we prevent the transmission of COVID?

Reader Martin Chow asked: “What preventive measures and drug treatments are already in place to limit and stop the RAPID transmission of this pandemic?”

Blumberg: “We have the same things available that seemed to have worked over the past few years — having people vaccinated (and) up to date with their vaccines and all the doses which they’re eligible is the primary way to prevent infection and then masking continues to do a very good job of preventing infection.

“For those who do get infected, the next step is to see if they’re eligible for antiviral treatment and the most common one is the brand named Paxlovid. That’s the one that has the less side effects, that’s easiest to give — you give it orally — so you can take this at home, you don’t have to be hospitalized for that. I would encourage people, if they do have a breakthrough infection or if they do get infected to call their healthcare provider to see if Paxlovid would be a good treatment for them.”

Can Paxlovid treat new variants?

The Bee asked: Do antivirals work for any variant?

Blumberg: “We have continuing protection with Paxlovid. It continues to work with the current variants. We haven’t seen any drug resistance, any antiviral resistance developed to date. But that is something that’s being monitored and it is a concern.”

Is an indoor event safe?

A reader asked: “I am getting married this April. The ceremony is outside but the reception is inside with open windows. What are the best ways we can mitigate risk for our guests?”

Blumberg: “Any activity that’s outside is going to be safer than activities that are inside, which are going to be more close quarters, you’re going to be closer to people and there’s going to be less air for the virus to diffuse into.

“Masking might still be a good option for some people indoors if they are concerned about getting infected... Some people have been recommending having people test before large gatherings... For that, it seems like it works better if the people who are hosting the event provide the tests to the people who are attending... When you’re indoors, increasing the ventilation is always good, so having the windows open is good. And if the venue has very high ceilings, that means there’s more air volume for the virus to be diluted in...”

How careful do I need to be about COVID?

Reader Lisa Dare: “How careful do I have to be about COVID given that I have multiple but mild autoimmune disorders?...”

Blumberg: “It really depends on the medications that are needed to treat those conditions... Talk with your healthcare provider and ask them if they would consider you ‘severely immunocompromised,’ ‘moderately immunocompromised,’ or really not at all.”

How dangerous is XBB.1.5, dubbed ‘the Kraken’?

The Bee asked: Should we be concerned about the new variant, XBB.1.5 called the “Kraken?”

Blumberg: “That one does have a growth advantage. It multiplies faster than (other variants), and it can evade previous immunity that people have from having been infected with other variants or previous vaccination. But it does not appear to result in more severe illness or more hospitalizations.

“And again, the bivalent vaccine appears to provide better protection against that variant and other upcoming variants, compared to the old monovalent vaccine.”

How is COVID affecting school-aged children?

The Bee asked: What should parents be concerned about in terms of their children going to schools as we near the beginning of the fourth year of coronavirus?

Blumberg: “Most people aren’t masking in schools these days, so going to school is going to be a risk factor for not only getting COVID, but other respiratory viruses... I think that many parents have been used to their children being healthy without these common childhood infections the past few years because of homeschooling.... distance learning... masking that was in place.

“I think what we’re seeing is parents are seeing their kid sick all the time, but that’s a return to normality.”

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