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As seasonal COVID-19 cases spike in North Carolina, the burden is on high-risk people

Mary D'Rozario and her cat.
Mary D'Rozario
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Mary D'Rozario and her cat.

Mary D'Rozario is in the high-risk health classification. Among other diagnoses, she has a heart condition and chronic fatigue. Her body responded well to the COVID-19 vaccine. Still, she hasn’t caught the virus and hopes to not put the vaccine to the test. But she knows the life changes for her are permanent.

"I avoid being around people where it's not necessary and it doesn't bring anything to my life," D'Rozario says. "I don't go to the grocery store; I get my groceries delivered. Because it's not worth it."

Heading into the fourth year of the pandemic, many people face lower risks now than even just one year ago. But for immunocompromised people, the health risks are still higher.

"You're around people who are emotionally engaged with you — friends, family. And you expect this level of care, but you're not necessarily getting it," she says.

D'Rozario says she's often the only person in a room wearing a mask. But she resists the urge to direct her frustration at individuals. Instead, she says public health leaders need to give better information, and spaces in society need to shift the paradigm. She says she witnessed this in action at a recent visit to an optometrist.

"Every single person in the optometrist was wearing a mask. A lady walked in the front door who was not wearing a mask, looked around, saw everybody else was, looked a little embarrassed and went up to the desk and asked for a mask," D'Rozario says. "So, when there's an environment that supports that decision, more people are willing to make that decision."

With the holidays over, North Carolina is now seeing the predictable uptick in cases of COVID-19.

Fortunately, the big spike in flu and RSV cases that the state also saw in the last few weeks has receded. Dr. David Wohl — an infectious disease specialist at UNC Health — says vaccines are still effective against the dominant COVID strain right now.

"The good news, if there is any, is that the surge isn't as big as it was, or course, last year, which was catastrophic," he says.

That's in part because the newest booster vaccine is tailored specifically against omicron. And the new XBB subvariant is still part of the omicron family.

"And we do see especially the bivalent vaccine that we have out right now since September; that vaccine is looking like it does provide better protection than natural infection against getting really sick," Wohl says.

In North Carolina, however, only 20% of people with the original vaccine have gotten the latest booster.

Dr. David Montefiori — a human immunologist with Duke Health — says there's both vaccine and booster fatigue.

"The immunity that was built up in the population is going to be declining over time," Montefiori says. "And that's going to allow the virus to cause serious illness and deaths in more people."

COVID-19 immunity levels are high in most North Carolina counties, including Durham where officials at Duke University are encouraging students with flu-like symptoms to wear a mask indoors and in gatherings with others.

Health experts have predicted there would be seasonal upticks in cases, which will come with increases in hospitalizations and deaths. Montefiori says that's going to continue with this coronavirus.

"This virus probably has not exhausted its ability to change and continue to evade the immunity that has built up in the population from vaccination or infection or a combination of both," he says.

Montefiori says vaccines are still largely protective against getting very sick. And even if young, healthy people are not likely to experience the worst symptoms, older people or those with weaker immune systems could still face higher risks.

Jason deBruyn is the WUNC health reporter, a beat he took in 2020. He has been in the WUNC newsroom since 2016.
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