Scott Olson/Getty Images
President Biden recently had an experience that many of us have had lately: a family member tested positive for COVID-19. It was first lady Jill Biden.
And like many of us, Biden asked himself the question: Should I cancel my own plans and self-isolate?
Unlike the rest of us, he had a press officer on hand to respond. This is the exchange between a journalist and the White House press secretary, Karine Jean-Pierre, after the first lady’s diagnosis.
Journalist: If President Biden tests positive for COVID in the coming days, can we assume he will not travel to India?
Jean Pierre: I’m just not going to speculate. I really am not. There are no updates to his schedule. This is where we are right now. He tested negative last night. He tested negative today. That is what matters.
It seems like all around us are testing positive for COVID, even though few are getting seriously ill.
The Food and Drug Administration has now approved the 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 handle the coronavirus pandemic right now?
All things ConsideredAri Shapiro spoke with Dr. Robert Wachter, chair of the Department of Medicine at the University of California, San Francisco, about how to assess risk.
This interview has been lightly edited for length and clarity.
Ari Shapiro: To start with just a title in a sentence or two, how would you describe where we are right now?
Robert Wachter: Worse than we were a month or two ago (a month or two ago) and significantly better than we have been most of the time over the last three or four years. So it’s certainly a slight increase, but it’s still far from the type of surges that have hit us in recent years.
Shapiro: To me, anecdotally, it seems like everyone from family members to co-workers receives a diagnosis and is not debilitated by it. Is this also what science confirms?
Look : Yeah. I had my first case of COVID two months ago. This is a fairly common story.
The science says that because we have essentially 100% immunity in the population, you can’t find anyone right now who hasn’t been vaccinated or infected. And in most people, they have both. The virus therefore no longer finds any human being with zero immunity. That’s obviously very different from 2020. And that means that when it hits humans — and it still gives a lot of people COVID — the cases tend to be significantly milder than before. There are still people dying from COVID, but the chances of getting seriously ill, going to the hospital and dying are much lower than they were a few years ago.
Shapiro: And now there is this updated booster. Doctors have been saying for years that getting the COVID vaccine could become an annual routine, like the flu shot. Is this where we are at this point?
Look : I think so. It’s complicated because it’s a little four-dimensional chess game that you have to play.
Reminders do four different things, and the relevance of these things differs depending on who you are, how old you are, and whether you have other illnesses.
The first thing they do, quite reliably, is reduce the chances that you’ll get very sick, go to the hospital, and die. And this especially applies to people who are at risk.
But there are other benefits that I think tip the scales in favor of the vaccine and the booster for almost everyone. This reduces the risk of contracting long COVID. This reduces the chances of getting COVID, but only for a few months. And if you get COVID, it reduces the amount of time you’re sick – not by a ton but by a little bit.
So I think about it as a doctor and the benefits versus risks of everything we do – like treating high blood pressure and cholesterol. It’s an easy decision for an elderly person or someone with medical comorbidities to receive the booster, as they are at significant risk of developing a severe case.
And for me, when I talk to my healthy 30-year-olds, I recommend that they get the booster. I don’t think it’s child’s play for them, but I consider it very safe indeed. I think the benefits outweigh the risks for almost everyone.
Shapiro: Are you applying the same kind of risk-protection calculus to some of the practices that were so common a few years ago, from mask-wearing to social distancing to outdoor dining? Or is it a bit like cold and flu season where you go out in public, take your chances, and live your life?
Look : Risk assessment is tricky. It’s not just about the risk you are at, but are you living with other vulnerable people? And this must also be taken into account. And then how much COVID is there in the environment? This is why it is very difficult to resolve this problem.
But yeah, I think that’s a fair way to think about it. The same type of thinking that applies to the importance of being boosted also applies to your thinking about how careful you should be. So if you are a vulnerable senior and there is an increase in COVID cases, as there is now, this is the time you should think about masking up, forgoing meals at indoor, to take Paxlovid if you contract COVID.
So it makes people a little crazy, because it really is a multidimensional and difficult decision.