Times are tough now, but the end is in sight. If we hunker down, keep our families safe during the holidays and monitor our health at home, life will get better in the spring. Here’s how to get through it.
By Tara Parker-Pope
Illustrations by Vinnie Neuberg
A guide to the last months (we hope) of the pandemic
Everyone is tired of living like this. We miss our families and our friends. We miss having fun. We miss kissing our partners goodbye in the morning and packing school lunches. We miss travel and bars and office gossip and movie theaters and sporting events.
We miss normal life.
It has been a long, difficult year, and there are many tough weeks still ahead. The coronavirus is raging, and the United States is facing a grim winter, on track for 450,000 deaths from Covid-19 by February, maybe more.
But if we can safely soldier through these next few months, then normal life — or at least a new version of normal — will be within reach. New vaccines that are highly protective against coronavirus are being rolled out right now, first to health care workers and the most vulnerable groups, and then to the general population this spring.
“Help is on the way,” says Dr. Anthony S. Fauci, the nation’s top infectious disease expert. “A vaccine is literally on the threshold of being implemented. To me that is more of an incentive to not give up, but to double down and say, ‘We’re going to get through this.’”
The vaccine won’t change life overnight. It will take months to get enough people vaccinated so that the virus has nowhere to go. But the more everyone does their part to slow down the virus now — by wearing a mask and restricting social contacts — the better and faster the vaccine will work to slow the pandemic once we can all start getting vaccinated this spring.
“Why would you want to be one of the people who is the last person to get infected?” says Dr. Fauci. “It’s almost like being the last person to get killed in a war. You want to hang in there and protect yourself, because the end is in sight.”
Hunker Down for a Little Bit Longer
The pandemic is surging, but as bad as things are, the end is in sight. By doubling down on precautions, we can slow the virus and save lives.
A crucial number to watch this winter is the test positivity rate for your state and community. The number represents the percentage of coronavirus tests that are positive compared to the overall number of tests being given, and it’s an important indicator of your risk of coming down with Covid-19. When positive test rates in a community stay at 5 percent or lower for two weeks, you’re less likely to cross paths with an infected person. Since the fall, the national test positivity rate has crept above 10 percent, and it’s been 30 percent or higher in several states.
Rising case counts and rising test positivity rates mean there is more virus out there — and you need to double down on precautions, especially if you have a high-risk person in your orbit. Cut back on trips to the store or start having groceries delivered. Scale back your holiday plans. Don’t invite friends indoors, even for a few minutes. Always keep six feet of distance from people who don’t live in your home. Skip haircuts and manicures until the numbers come down again. Wear a mask.
Close your leaky bubble.
Here’s the harsh reality of virus transmission: If someone in your family gets sick, the infection probably came from you, another family member or someone you know. The main way coronavirus is transmitted is through close contact with an infected person in an enclosed space.
“One of the challenges we have is that familiarity is seen as being a virus protector,” said Michael Osterholm, a member of President-elect Joseph R. Biden Jr.’s coronavirus advisory group and director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “More likely than not, knowing someone is the risk factor for getting infected.”
This summer, 47 percent of Americans said they had formed a “pod” or social “bubble” that includes two or more households committed to strict precautions so the group can safely socialize indoors.But sometimes your bubble is leakier than you realize. Farhad Manjoo, an opinion columnist for The Times, had initially assumed his bubble was pretty small, but it turned out that he was having direct or indirect contact with more than 100 people.
Whether your bubble is just your immediate household — or you’ve formed a bubble with others — take some time to check in with everyone and seal the leaks. This requires everyone to be honest about the precautions they’re taking (or not taking). Dr. Osterholm said that convincing people that their friends might infect them has been one of the biggest challenges of the pandemic. He told the story of a man and a woman who both contracted Covid-19 after attending a wedding.
“He told me, ‘We didn’t fly. I knew everybody there,’” said Dr. Osterholm. “He somehow had the mistaken belief that by knowing the person, you won’t get infected from them. We’ve got to break through that concept.”
Mask up. You’re going to need it for a while.
A study by the Institute for Health Metrics and Evaluation at the University of Washington estimated that 130,000 lives could be saved by February if mask use became universal in the United States immediately.
Various studies have used machines puffing fine mists to show that high-quality masks can significantly reduce the spread of pathogens between people in conversation. And the common-sense evidence that masks work has become overwhelming. One well-known C.D.C. study showed that, even in a Springfield, Mo., hair salon where two stylists were infected, not one of the 139 customers whose hair they cut over the course of 10 days caught the disease. A city health order had required that both the stylists and the customers be masked.
Choose a mask with two or three layers that fits well and covers your face from the bridge of your nose to under your chin. “Something is better than nothing,” said Linsey Marr, professor of civil and environmental engineering at Virginia Tech and one of the world’s leading aerosol scientists. “Even the simplest cloth mask of one layer of material blocks half or more of aerosols we think are important to transmission.”
Watch the clock, and take the fun outside.
When making decisions about how you’re spending your time this winter, watch the clock. If you’re spending time indoors with people who don’t live with you, wear a mask and keep the visit as short as possible. (Better yet, don’t do it at all.) Layer up, get hand warmers, some blankets, an outdoor heater — and move social events outdoors.
In an enclosed space, like an office, at a birthday party, in a restaurant or in a church, you can still become infected from a person across the room if you share the same air for an extended period of time. There’s no proven time limit that is safest, but based on contact tracing guidelines and the average rate at which we expel viral particles — through breathing, speaking, singing and coughing — it’s best to wear a mask and keep indoor activities, like shopping or haircuts, to about 30 minutes.
Take care of yourself, save a medical worker.
The country’s doctors, nurses and other health care workers are at a breaking point. Long gone are the raucous nightly cheers, loud applause and clanging that bounced off buildings and hospital windows in the United States and abroad — the sounds of public appreciation each night at 7 for those on the pandemic’s front line.
“Nobody’s clapping anymore,” said Dr. Jessica Gold, a psychiatrist at Washington University in St. Louis. “They’re over it.”
In interviews, more than two dozen frontline medical workers described the unrelenting stress that has become an endemic part of the health care crisis nationwide. Jina Saltzman, a physician assistant in Chicago, said she was growing increasingly disillusioned with the nation’s lax approach to penning in the virus. In mid-November, she was astounded to see crowds of unmasked people in a restaurant as she picked up a pizza. “It’s so disheartening. We’re coming here to work every day to keep the public safe,” she said. “But the public isn’t trying to keep the public safe.”
Scale Back Your Holiday Plans
How and when the pandemic ends will depend on the choices we make this winter, particularly around Christmas and New Year’s Eve.
Nobody wants to open presents by Zoom, light holiday candles at home alone or clink virtual champagne glasses to ring in the New Year.
But here we are, in the midst of a surging pandemic, on course to losing nearly a half million souls in less than a year. Despite the promise of a vaccine on the horizon, only a tiny fraction of Americans will be vaccinated by the end of December. Vaccines won’t enter large-scale distribution until spring 2021.
The only way to drive down infection rates for now will be to avoid large indoor gatherings, wear masks, cancel travel and limit your holiday celebrations to just those who live in your home.
Dr. Fauci said he, his wife and three daughters, who live in different parts of the country, all made a family decision not to travel for the holidays. It will be the first Christmas in 30 years that the entire family won’t be together.
“I’m a person in an age group that’s at high risk of serious consequences,” said Dr. Fauci. “That’s the first Thanksgiving since any of my three daughters were born that we have not spent it as a family. That was painful, but it was something that needed to be done. We are going to do the same thing over Christmas for the simple reason that I don’t see anything changing between Thanksgiving and Christmas and Hanukkah. In fact, I see it getting worse.”
If you do travel, get tested.
People who choose to travel over the holiday season despite the warnings should consider taking precautions. First, try to quarantine for at least a week (two weeks if possible) before your trip or visit with another household. The C.D.C. now recommends that domestic air travelers get tested before and after their trip.
Remember, a lot can go wrong between the time you take a test and the moment you hug Grandma. Not only are false negatives possible, you need to consider the risk of catching the virus after taking the test — in an airport, in a plane or from a taxi driver or rental car agent.
For a laboratory test, check the turnaround time in your area and try to schedule it as close as possible to your visit. If you’re using rapid testing, try to take more than one test over the days leading up to your visit, and if possible, get a rapid test on the same day you plan to visit family, friends or a vulnerable person. Test again after you arrive if you can.
Plan a safer holiday gathering.
If you’re determined to have people to your home for the holidays, keep the guest list small and consider these precautions.
Get tested: If testing is available in your area, consider asking all guests to be tested a few days before the holiday, timing it so they get the results before coming to your home. If rapid testing is available, get tested a few times during the week and on the day of the social event.
Move the event outside: Even if it’s cold outside, try hosting all or part of your holiday celebration outdoors. Look into space heaters and fire pits to warm a porch or patio. Even a partially open space, like a screened-in porch or a garage with the door open, is better than socializing indoors. If you decide to stay indoors, open the windows and turn on exhaust fans to help ventilate your home.
Wear masks: All guests should wear a mask when not eating. If you’re the host, set the example and put your mask on after the meal is over and everyone is enjoying the conversation. Limit the amount of time you spend together indoors.
Socialize outdoors the Scandinavian way.
In the pandemic, rather than feeling depressed that the arrival of cold weather will mean that you’ll be isolated indoors, apart from friends and family, we can take lessons from Scandinavians about how to continue getting together outdoors.
Take Care of Yourself at Home
Covid-19 can be scary, but we’ve learned a lot about how to monitor the illness and home — and when to seek hospital care.
Since the start of the pandemic, we’ve learned a lot about how to care for people infected with Covid-19. Death rates from the disease are dropping as doctors have gotten better at treating it and advising patients when to seek medical care.
Steroids like dexamethasone have lowered the number of deaths among hospitalized patients by about one-third. And although limited in supply, monoclonal antibodies, a treatment given to President Trump when he was ill with coronavirus, can possibly shorten hospital stays when given early in the course of infection.
But the vast majority of patients with Covid-19 will manage the illness at home. Check in with your doctor early in the course of your illness, and make a plan for monitoring your health and checking in again if you start to feel worse.
Get tested if you have symptoms.
Ideally, you should be able to get a coronavirus test whenever you want it. But in the United States, test availability varies around the country, depending on whether supplies are low or labs are overwhelmed. Check with your doctor, an urgent care clinic or your local health department about where to get tested in your area.
If you feel sick, you should be tested for Covid-19. A dry cough, fatigue, headache, fever or loss of sense of smell are some of the common symptoms of Covid-19. After you take your test, stay isolated from others and alert the people you’ve spent time with over the last few days, so they can take precautions while you’re waiting for your result. Many tests will work best if you are in the first week of your symptoms.
Track your symptoms.
Marking your calendar at the first sign of illness, and tracking your symptoms and oxygen levels, are important steps in monitoring a coronavirus infection. Covid-19 has been unpredictable in the range of symptoms it can cause. But when it turns serious, it often follows a consistent pattern.
The Coronavirus Outbreak ›
Words to Know About Testing
Confused by the terms about coronavirus testing? Let us help:
- Antibody: A protein produced by the immune system that can recognize and attach precisely to specific kinds of viruses, bacteria, or other invaders.
- Antibody test/serology test: A test that detects antibodies specific to the coronavirus. Antibodies begin to appear in the blood about a week after the coronavirus has infected the body. Because antibodies take so long to develop, an antibody test can’t reliably diagnose an ongoing infection. But it can identify people who have been exposed to the coronavirus in the past.
- Antigen test: This test detects bits of coronavirus proteins called antigens. Antigen tests are fast, taking as little as five minutes, but are less accurate than tests that detect genetic material from the virus.
- Coronavirus: Any virus that belongs to the Orthocoronavirinae family of viruses. The coronavirus that causes Covid-19 is known as SARS-CoV-2.
- Covid-19: The disease caused by the new coronavirus. The name is short for coronavirus disease 2019.
- Isolation and quarantine: Isolation is the separation of people who know they are sick with a contagious disease from those who are not sick. Quarantine refers to restricting the movement of people who have been exposed to a virus.
- Nasopharyngeal swab: A long, flexible stick, tipped with a soft swab, that is inserted deep into the nose to get samples from the space where the nasal cavity meets the throat. Samples for coronavirus tests can also be collected with swabs that do not go as deep into the nose — sometimes called nasal swabs — or oral or throat swabs.
- Polymerase Chain Reaction (PCR): Scientists use PCR to make millions of copies of genetic material in a sample. Tests that use PCR enable researchers to detect the coronavirus even when it is scarce.
- Viral load: The amount of virus in a person’s body. In people infected by the coronavirus, the viral load may peak before they start to show symptoms, if symptoms appear at all.
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