President Biden recently had an experience that many of us have gone through lately — a family member tested positive for COVID-19. It was first lady Jill Biden.
And like many of us, Biden faced the question: Should I cancel my own plans and isolate?
Unlike the rest of us, he had a press secretary on hand to answer. This is the exchange between a reporter and White House press secretary Karine Jean-Pierre after the first lady's diagnosis.
Reporter: If President Biden does test positive for COVID in the coming days, we can assume he's not going to travel to India?
Jean-Pierre: I'm just not gonna get into hypotheticals. I'm really not. There's no updates to his schedule. That's where we are right now. He tested negative last night. He tested negative today. That's what matters.
It seems like people all around us are testing positive for COVID, even as few of them become seriously ill.
Now the Food and Drug Administration has approved updated boosters, and on Tuesday, advisers to the Centers for Disease Control and Prevention recommended them for everyone 6 months and older.
So how should we be navigating the coronavirus pandemic right now?
All Things Considered's Ari Shapiro spoke to Dr. Robert Wachter, the chair of the department of medicine at the University of California, San Francisco, about how to assess the risks.
This interview has been lightly edited for length and clarity.
Ari Shapiro: To start with just, like, a headline in a sentence or two, how would you describe where we are in this moment?
Robert Wachter: Worse than we were a month or two [ago] and substantially better than we've been most times in the last three or four years. So it's definitely an uptick, but it still is nowhere near the kinds of surges that slammed us in the past few years.
Shapiro: Just anecdotally for me, it seems like everyone from family members to co-workers is getting a diagnosis and not being debilitated by it. Is that what the science bears out too?
Wachter: Yeah. I got my first case of COVID two months ago. That's a pretty common story.
The science says that the fact that we essentially have 100% population immunity — you cannot find anyone now who has neither been vaccinated nor been infected. And in most people, they've gotten both. So the virus doesn't find any humans anymore that have zero immunity. That's obviously very different than 2020. And what that means is that when it strikes humans — and it still is giving a lot of people COVID — the cases tend to be substantially milder than they were before. There are still people dying of COVID, but the chances of getting super-sick, going to the hospital and dying are much, much lower than they were a couple of years ago.
Shapiro: And so now there's this updated booster. Doctors have been saying for years that getting a COVID vaccine might become an annual routine like a flu shot. Is that where we've landed at this point?
Wachter: I think so. It's complicated because it's a little bit of four-dimensional chess that you've got to play.
The boosters do four different things, and the relevance of those things differ depending on who you are and how old you are and whether you have other medical illnesses.
The first thing they do, quite reliably, is lower the chances you're going to get very sick, go to the hospital and die. And that is most relevant to people who are at risk of those things.
But there are other benefits that to me tilt the scales to favoring the vaccine and the booster in pretty much everybody. It lowers the chances of getting long COVID. It lowers the chances of getting COVID, but only for a couple of months. And if you do get COVID, it reduces the amount of time that you're sick — not by a ton but by a little bit.
So I think about this as a doctor and the benefits versus the risks of everything we do — like treat high blood pressure, cholesterol. It's an easy decision for an older person or someone with medical co-morbidities to get the booster because they are at significant risk of a severe case.
And to me, when I talk to my 3o-ish-year-old healthy kids, I recommend they get the booster. I don't think it's a slam dunk for them, but I consider it really quite, quite safe. I think the benefits outweigh the risks in pretty much everybody.
Shapiro: Do you apply the same kind of risk-protection calculus to some of the practices that were so common a couple of years ago, from mask-wearing to social distancing to outdoor dining? Or is this kind of like cold and flu season where you go out in public, you take your chances and you live your life?
Wachter: The risk assessment is tricky. It's not just the risk to you, but are you living with other vulnerable people? And that has to get factored in too. And then how much COVID is there in the environment? So that's why it's very tricky to sort this out.
But, yeah, I think that's a fair way of thinking about it. The same kind of thinking that goes into the importance of getting boosted also goes into your thinking about how careful to be. So if you are an older person who's vulnerable and there's a spike in COVID cases, as there is now, it is a time where you should be thinking about masking, thinking about forgoing indoor dining, thinking about taking Paxlovid if you get COVID.
So this kind of drives people a little bit crazy because it really is such a multidimensional and challenging decision.