No question our BA.2 Omicron bit-of-a-surge is happening in the Northeast, and soon other parts of the country. The fact that BA.2 is sooooooo transmissible means Covid is once again playing havoc with our plans and our daily lives.
The good news is we’re not seeing a huge uptick in people who need to be hospitalized — as long as people are vaccinated. Unfortunately, unvaccinated and immunosuppressed people (especially those who haven’t yet gotten Evusheld) still can get super sick, need the ICU, etc.

I became suspicious about a surge last week because each day I received yet another text about a local friend or acquaintance who turned positive. I hadn’t gotten “a text a day” since the early days of Omicron so by mid-week I was starting to pay more attention.

Then earlier this week I felt “The Circle of Covid” start to tighten around my family and I began to worry about our holiday plans. I had so much hoped to finally have our usual Big Huge Easter Dinner!

But on Monday a couple of guests declined because of bad exposures to people who turned out to be unknowingly Covid positive. Two friends had Covid in their extended family. Then one of my invited guests got sick and had a positive Covid home test on Tuesday. Then one on Wednesday. Then another on Thursday. Then another today.
I was actually grocery shopping for the Easter meal when the third call came in. It was from a guest who has never ever called me from work. He called from work. I answered the phone already sick to my stomach. Sure, enough, he told me about his newly positive Covid test. At that point I realized 3/20 sick invitees had just gone over my comfort level and we were going to have to cancel.

One by one I took everything out of my cart and put it back on the shelves. Third Easter in a row, wrecked!
Curses, foiled again by this dang virus.

While I can feel the numbers of sick people increase around my family, it’s happening all over the Northeast, too.
Our absolute “numbers” haven’t gone up all that much but of course there’s so much home testing now, the numbers no longer can tell the whole story. Wastewater positivity is also still rising, although not precipitously.
The other thing happening right now is that we are seeing a late uptick in the flu, particularly Flu A, probably because so many people are unmasked.

I wanted to get a general “beyond-the-numbers” sense of things, so I asked some of my doctor friends what was happening in their Massachusetts clinics and hospitals.

Private practice: We’ve had a big increase in the past two weeks, including several who were symptomatic with negative antigen and positive PCR, which we hadn’t seen much before. Also continuing the pattern of testing antigen negative for the first few days of symptoms and then positive day 3 or 4. Don’t trust the first few days tests if symptomatic. Paxlovid had been easy to get so that is an improvement.

Adolescent medicine: This variant is the most contagious one I’ve seen yet. Mild symptoms – most people think it’s allergies but then test and it’s Covid. I’m seeing people test negative for 2-4 days with very mild symptoms and then positive. I’m grateful for affordable and accessible home tests. I’m also grateful for vaccines that keep most (but not all) from getting serious illness.

Family medicine: Myself, my husband, my 3.5 and 1.5 year old have COVID now. After cancelling Christmas due to exposure, we now have cancelled Easter. Half tested positive Sunday, the other half not until Thursday. Relatively mild symptoms except exhausted (compounded by the 1.5 year old not sleeping!).

Pediatrician: We went a couple of weeks without any patients testing positive but now are starting to see positives again. Three staff members were out with Covid last week. Also lots of Flu A. We think there’s more flu because a lot of people thought numbers would be low like last year and didn’t get flu vaccines. But then….the Great Unmasking!

Emergency medicine: We’re seeing more influenza A than COVID right now, but definitely more COVID than people realize. People think it’s not a thing right now, but it is most definitely a thing — and rising — and everyone should be protecting themselves.

Surgeon: My 85 year old in-laws who only go to the grocery store have it…

Hospitalist: When I worked last weekend, I had more sick/hypoxic (needing oxygen) flu A patients than Covid patients. The Covid patients I’ve seen haven’t been terribly sick for the most part, but there does seem to be an uptick.

Pediatric urgent care: 97% of my day is “fever and cough.” Pretty much everyone has a 103-104 fever! A lot have turned out to be the flu. Occasionally Covid but usually with a known exposure. We are also seeing some combinations (Covid/RSV) and my kid’s school had their first positives in a month.

Pediatrician: Lots of flu A, some Covid. So many kids with 103-104 fevers (some with respiratory symptoms, some not) but who test negative for Flu/covid. This is kids from babies to teenagers. Not sure what it is. Plus some diarrhea/vomiting mixed in.

Private practice: I had Covid last week for the first time. I believe I got it when we were both wearing a surgical mask. I’m still wearing N95 masks for all patient encounters. I took Paxlovid which leaves a horrible metallic after taste in your mouth, but was otherwise fine to take.

Cardiology: My sister is vaccinated and boosted but has had it twice: Jan 4 and April 6. The first time we couldn’t get her Paxlovid and she was miserable for 2-3 weeks. The second time around she got it prescribed from an online doctor and she was only sick for one day.

ER doc: We are amidst Passover, Easter, and school break…for those of us still trying to avoid COVID…hold onto your pants – it’s gonna get rough.

So. Lessons from the ground:
—If you have any exposures, test.
—If you have even the mildest of symptoms, test.
—If you have significant symptoms, get tested for Flu A as well
—And then test again.
—And maybe test again.
—If you’re immunosuppressed, this is a good time for Evusheld.
—If you’re high risk, this may be a good time for a booster.
—If you’re high risk and get Covid, talk to your doctor about Paxlovid (or sometimes the monoclonal called bebtelovimab), both of which are incredibly effective at keeping you out of the hospital (and locally very available)
—If you take Paxlovid, be prepared for a metallic taste in your mouth. Gum and hard candies and bubbly water, especially Coke, can help (apologies, dentists!) and it will go away a couple days after the five-day course. And it will keep you out of the hospital!

But the “Circle of Covid” may tighten around you anyways, no matter what you do. Like the ER doc said, “Hold onto your pants!” (ER docs always have good advice). And be ready to take additional precautions and cancel stuff once again. Here’s hoping for a small surge, a beautiful spring, and a 2023 full of non-cancelled events!