Growing herd immunity, the effectiveness of vaccines, and the end of mask mandates in many settings are making decisions about how to handle the ever-evolving pandemic more individual and more complicated, say Duke University virus experts.
“I think at some point, everybody probably will want to get a second booster, but, you know, how long, that is really unclear now. And that’s because of waning immunity," said David Montefiore, director of the Laboratory for AIDS Vaccine Research and Development at Duke University Medical Center.
Montefiore, who studies emerging strains of COVID-19, said that decision should take into account long-known risk factors like age or health issues.
“If you're unavoidably going to have a higher exposure, potentially, then this may be the right time to boost,'" said Dr. Cameron Wolfe, an infectious disease specialist at Duke Health and an associate professor at the School of Medicine.
“Similarly, if maybe their own health status is okay, but they don't want to be the vector to inadvertently bring COVID into a family situation with elderly grandparents or, you know, transplant patients, then there may be their boost at this stage is the right time.”
Wolfe, who also studies infectious diseases and biological and emergency preparedness for hospital systems, tells patients to assume the risk on public transport is real.
“I do think we have to acknowledge it increases the risk of transmission events, if the person beside you no longer has any layer of protection that shields viral spread,” he said.
Encouraging people to make individual decisions about health risks is appropriate at this point in the pandemic, but Wolfe says one reason it’s tricky is that it doesn’t affect everyone equally.
“I can make an individual choice to go to a restaurant, for example, if that restaurant is unmasked and non-mitigated, but many people don't have the choice to take public transport to work,” Wolfe said. “And I think in situations in particular, that's often disproportionately affecting lower socioeconomic families, families who come from racial backgrounds, where COVID has had a more substantive impact.”
Montefiore said the latest types of COVID-19, including the currently dominant sub-variant, have each made the virus more easy to transmit, but thanks to growing herd immunity from infections and to the effects of the vaccines, don’t seem to be making serious cases more common.
And, he said, the vaccines seem likely to remain effective in preventing severe cases, even as more variants emerge.
According to the N.C. Department of Health and Human Services, new reported cases have jumped more than 50% since last week to 7,279. Hospitalizations increased by 36 patients.
WUNC's Joe Jurney contributed to this story.
