On Pace

Fall COVID-19 Outlook

Cases are increasing, but so are ways you can protect yourself.

Written by John Ferrari

COVID-19 has been with us for almost three years; living with the pandemic is almost the new normal. But it isn’t. COVID-19 remains a potentially serious disease for many: the elderly, individuals with underlying medical conditions and those who have not yet gotten vaccinated against the disease.

The pandemic remains a source of stress and uncertainty. As we enter the fall and winter seasons, which could bring a renewed COVID-19 surge (or not), knowledge can help you keep your cool—and stay healthy.

“From the beginning of April to now, we’ve seen an increase in community cases,” says Torrance Memorial infectious disease specialist David Rand, MD. “But we’re not seeing very sick patients. We are seeing a little stress on hospitals, mainly because as we’re testing patients who come in to the hospital, we’re finding asymptomatic COVID-19 cases.”

He predicts the community spread of COVID-19 will continue at significant levels through the fall and with the emergence of new Omicron subvariants. He adds, however, that those new variants are likely to spread more rapidly but cause less serious illness.

To counter COVID-19 there are now four safe and effective vaccines: Pfizer-BioNTech (also known as Comirnaty), Moderna, Novavax and Johnson & Johnson-Janssen. The CDC now recommends the Johnson & Johnson-Janssen vaccine be administered only to certain individuals, including those who have had a severe reaction after an mRNA vaccine dose. Consult with your primary care physician or other health care professional.

Dr. Rand notes that Novavax, the most recently approved COVID-19 vaccine, uses the same decades-old technology used to produce the hepatitis B vaccine, which may encourage unvaccinated individuals wary of the newer (but proven safe) techniques used in the Pfizer and Moderna vaccines to get vaccinated themselves.

Since June, children between the ages of 6 months and 5 years old have been cleared to receive the Pfizer and Moderna vaccines—the last age group to get the vaccination go-ahead. That’s important, Dr. Rand says, because “although kids of that age are exceedingly unlikely to become seriously ill from COVID-19, they can spread it to others.”

David Rand, MD, is an infectious disease specialist and comedical director of infection control at Torrance Memorial.

The vaccination schedule for children in that age group is three Pfizer shots over 11 weeks or two Moderna shots over four weeks. For older individuals, meanwhile, booster shots have become normal. Those 50 and older or who are immuno-compromised should get a booster shot three months after their last booster. For most people, that second booster will be their fourth COVID-19 vaccination shot.

Additionally, both Pfizer and Moderna may release a new COVID-19 vaccine this fall, targeting the Omicron variant specifically. That’s good news, Dr. Rand says, because an Omicron-specific vaccine would reduce breakthrough cases of the disease among those who have already been vaccinated.

The bottom line for vaccines? “Come the fall, you’re going to have to get a booster, whether a new or existing formulation,” Dr. Rand says. “My best guidance is to stick with the vaccine you’ve already gotten.”

There’s good news on the treatment front too. In studies of unvaccinated individuals who caught COVID-19, Paxlovid—an antiviral therapy and currently the first-line treatment for the disease— reduced hospitalization and mortality by 89%. Remdesivir—a broad-spectrum antiviral medication also known as Veklury—also reduces the likelihood of developing a serious case of COVID-19 among individuals who contract the illness.

Immuno-compromised individuals have a different option: AstraZeneca’s Evusheld. A monoclonal antibody administered as two shots, Evusheld can be given to patients whose immune system isn’t robust enough to respond adequately to a COVID-19 infection even after vaccination, and to those who can’t be vaccinated due to an adverse reaction. Evusheld is given before exposure to the disease and may provide up to six months of protection.

For most people, vaccination remains the best defense against COVID-19. Not only does it lower the risk of catching the disease, vaccinated individuals who do contract a breakthrough case are much less likely to suffer serious illness than those who are unvaccinated. And there is, Dr. Rand reminds us, another effective measure against COVID-19 and other illnesses such as the flu: masking. “Masking really does help prevent the spread of COVID-19. If you don’t want to get COVID-19, masking is the way to go.” •