Look at what I wrote in May: Cases are fantastically lower in many parts of the US. I mean, theres still 37,000 cases a day which is horrible but it sure is better than the 237,000 after Christmas.”

Today: “Cases are definitely lower in many parts of the US. I mean, there’s still 75,000 cases a day which is horrible but it sure is better than the 150,000 during the summer peak.”

Also today: “Hospitalizations are down, too; now 50,000 — down by half from the summer peak of 100K. (And 135K at our very worst.)”

So yeah, it’s better. But good heavens: these are still horrible numbers and it’s definitely not over.

Our New Normal: SafeR Behavior

We can’t yet walk around like everything’s normal: it’s not. Vaccines and boosters are helping us move towards more normalcy, less limits and fewer fears. But what we’re approaching now is a “New Normal” which involves modifying our behaviors to stay “safeR.”

This is going to be my new mantra for a while: being safeR.” While acknowledging we can’t be completely safe — there’s too much of the wildly contagious Delta around and too many unvaccinated people — we can for sure be “safeR.”

How can we be “safeR”? More of the same. We need to keep being extra careful around unvaccinated people. Vaccinated people are a magnitude of order less risky to hang out with: not 1000% safe, but safeR.

We need to make decisions based on how many cases there are around us. We need to be careful with being indoors and we need to think about masking indoors where there’s a lot of cases in our community. We need to consciously work at making decisions that keep us safeR.

Okay Booster:

The scientists did their part the last few weeks to get us still safeR. They studied all the available booster data and they issued some guidelines. First the FDA’s independent panel looked at effectiveness and safety data, then the CDC’s panel looked at it and more, and then the CDC head Dr Rochelle Walensky reviewed it all and released initial guidelines saying yes to Moderna boosters, J&J boosters and mixing boosters.

First, though, a repeat reminder that even though the science advances every week, we are still “flying the plane while we build it.”

The guidance for boosters is mostly based on lab results and the lab results are mostly based on antibody studies and antibodies are only one part of the immune system.

So, far, there hasn’t been time to accumulate “real world evidence” about boosters and there hasn’t been time to do more complex tracking of the boosters’ impact on the other parts of the immune system. Plus all of the booster studies are pretty small — nothing like the big vaccine trials. So things may change some.

But for now we have some basic ideas:

  • Everybody over 65 SHOULD get a booster
  • Everybody over 50 at risk to get serious Covid SHOULD get a booster
  • Everybody over 18 who had J&J SHOULD get a booster
  • Everybody over 18 at high risk to get Covid can get a booster — eg front-line workers, health care workers, teachers, retail workers, etc
  • Mixing of vaccines appears to be safe and effective
  • (This is my guess): Pretty soon, everybody will get a booster. Just like we do with hepatitis, MMR, etc where three shots are often the recommendation, my bet is that’s how this will end up, too.

More guidelines regarding mixing will be released by the CDC soon. But here’s a couple of basics:

  • If you had J&J you should get boosted >2 months out
  • If you had Pfizer/Moderna mRNA vaccines, you should get boosted after 6 months
  • You can get a flu shot and a Covid booster at the same time (and please do!)
  • You can get a Shingrix shot and a Covid booster at the same time
  • As above, exact recommendations re mixing will evolve

So yes, there’s still stuff we don’t yet know about How To Be Perfect About Boosters. But there is no doubt boosters will make us safeR and there is no doubt that step by step the “Good News” Covid column keeps lengthening.

Among other things:

  • The vaccines are unbelievably powerful in preventing serious illness and death — they have saved thousands and thousands and thousands of lives
  • The vaccines still do not show any major risk of a significant chance of bad side effects — and after 400,000,000 shots in this country alone, I think we can be pretty sure this is clear.
  • The vaccines are not showing any impact on fertility and pregnancy.
  • The number of hospitalizations (now the most important number to me) continues to decline.
  • Vaccinated people are not very infectious for very long, decreasing their “at risk” time period.
  • Home testing is becoming more available and reliable in showing when you’re infectious (just in time for Thanksgiving!)
  • There is no particularly frightening variant at the current time.
  • The CDC says kids can trick-or-treat! But of course they also need to be safeR: stay outside, wear masks and don’t expose vulnerable people to potential cooties.

Having so many additions to the “Good News” column means many of us can start approaching our lives as a trying-to-be-safeR New Normal by:

  • Masking when indoors and other risky situations
  • Being pro-active about asking friends about risk (“Is everybody at the wedding going to be vaccinated?”)
  • Staying creative about social interactions (“Let’s go for a walk” or “Let’s open the windows.”)
  • Assessing travel, dining, gyms, etc in terms of who might be there, the level of infections and vaccines in our town, and what our own medical risks are.
  • Starting to think about at-home testing more often (eg Thanksgiving!)

This isn’t over, but step by step we are getting SafeR. It’s happening.