It feels like there’s a lot of chaos and confusion out there when it comes to understanding where things stand concerning Covid. In China and Hong Kong, for example, a new wave of the Omicron BA.2 variant is raging and in some areas, extreme measures are back in place to try to contain the spread. Omicron BA.2 is now the dominant variant in the world and it’s thought to be 30-50% more contagious than the original Omicron variant that we dealt with in prior months. Even in the US, this new variant accounts for nearly 55% of all new Covid Infections. Yet at the same time in the US, in the past several weeks, Covid cases have dropped by 35%. States are relaxing mask and vaccination mandates, and all over, many are acting as though the pandemic is finally behind us. But is that so? Will the US experience a similar BA.2 surge? As one expert replies, “We’re in a gray area right now.”

As the New Yorker reminded us in a recent article, the US is at a grim Covid milestone: we are close to reaching a death count of 1 million people due to Covid and many of us are confused about where things stand at this point. Moreover, understandably, so many of us are fatigued from the requirements and restrictions that have contorted our daily lives for so many months and we’re all too ready to resume a type of “normalcy” as the spring and summer approach. In fact, with so many pandemic restrictions falling by the wayside, we’re now, as New Yorker writer Dhruv Khullar reminds us, “reverting to the Wild West phase.” But we’re not, in fact, back to the early days of the pandemic, when we knew little about how to keep ourselves safe and feared every interaction with another person. We know what we need to do should BA.2 become a serious threat to us. As The New York Times recently outlined (in response to newly rising rates of BA.2 in the Northeast US), there are many practical steps we can (and should) take and prepare beyond getting vaccinated. Among the practical suggestions? Pay attention to infection rates in your area (check this map to determine where rates are rising). If rates begin to rise, start using high-quality masks (which you should stock up on) in public places and rethink indoor gatherings where you don’t know the vaccination status of attendees (and rethink travel and social plans as well).  And speaking of stocking up: make sure to have several home-Covid tests on hand, a pulse oximeter if you don’t already have one, and even consider locating some anti-viral Covid medications, which you need to take within 5 days of symptom appearance for them to be effective. As the article so importantly reminds us, “Being prepared for the unexpected will allow you to keep living your life as normally as possible.” For more advice on how to dial back or ramp up your precautions, stand back a bit and read here.

Of course, a lot of the downturn in Covid infections across the US is due to rates of vaccination. We do know that in the US, parts of the country with the lowest vaccinations rates (some “red” states) have Covid deaths 3x the rate of those with the highest vaccinations rates (some “blue” states). We know that overall in the US, 77% of the population has received at least one dose of the vaccines, and 65% have received two doses, while only 29% have received an additional booster. That leaves millions of Americans at risk of becoming infected with the Omicron BA.2 variant. And now a second booster has been authorized (but not necessarily recommended) for American adults 50 and over, and for those younger with compromised immune systems. If you have not yet received your first booster, experts recommend you do so.

The question is, should everyone who is eligible go out and get a second booster shot? The expert advice on this is somewhat murkier. The CDC and FDA stopped short of actually recommending this second booster and it appears there’s not a lot of scientific evidence to support it, except for some limited data coming out of Israel (there is also data out of Israel that immunity from a second booster may wane quickly).  It’s thought that those over 65 or those over 50 with underlying medical conditions that put them at risk for more severe disease (think heart disease, obesity, diabetes, for example) would likely benefit most from a second booster. Weighing the pros and cons in an article in The Atlantic, writer Rachel Gutman points out that there’s little downside to getting a second booster (perhaps a day or 2 of fatigue and fever if you reacted to your first booster, or the cost of the booster if you lack insurance) though the upside of getting the booster is not certain either. But as NPR points out, the older you are, the more likely you will benefit from a second boost, as the majority of Covid-related deaths have been in people over 65. Your Covid risks rise with age as well as with chronic health conditions. And we do have evidence of waning immunity from the first booster shots. So if in your personal judgment (perhaps in consultation with your health care provider) you feel you’d like to boost your immunity, there’s little downside and potential upside to seeking out a second booster. 

One final point: If you’ve gone all Moderna to date or stuck with Pfizer for your first 3 shots, does it make sense to mix things up now? More and more experts suggest that mixing and matching vaccine types probably gives you an additional immunity advantage (though if a different vaccine is not available, it doesn’t make sense to wait). To find out more, roll up that sleeve and read here.