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Coronavirus FAQ: I'm a NOVID and don't want to catch COVID. Can you guide me?
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Okay, so it seems like everyone I know has come down with COVID this summer — even the people known as NOVIDs (never had COVID before). I’ve been lucky so far. What do I need to know to protect myself during the current surge?
You probably know all the strategies to stay safe. But maybe you’re suffering from COVID amnesia — perhaps the trauma of the early years of the pandemic has wiped out your memory of basic precautions like mask-wearing and hand-washing.
Meanwhile, others have become COVID-indifferent, says Dr. William Schaffner, a professor in the division of infectious diseases at the Vanderbilt University School of Medicine.
They’re living in a bubble, thinking yeah, well, whatever, que sera sera — but it won’t happen to me.
Then came the strong summer surge of 2024 in the U.S. and many other places. “New waves of infection have been registered in the Americas, Europe and the western Pacific,” the U.N. reported this month.
And, adds Schaffner, while getting the virus is a mere annoyance for many, for others, especially older adults and people with underlying health conditions, the consequences can be dire. COVID can still make them pretty sick, land them in the hospital and result in long COVID. And the virus can prove fatal. This summer in the U.S., there have been 400 to 600 deaths a week linked to COVID-19.
Perhaps that is why, for the first time in the history of our Coronavirus FAQ series, doctors have been emailing us and asking us to remind people of the ways to ward off the virus that launched a pandemic now in its fourth year. So think of this edition of as your COVID refresher course.
Vaccines. Yes, an updated vaccine that addresses the currently circulating variants is on the way. Approval came on Thursday. Here’s our story.
Masks. A well-made mask — an N-95 or KN-95 — will still protect you even if others around you are not masked. And it’ll protect others if you might be contagious — say you’ve found out you were with someone who since tested positive but don’t know your status, says Schaffner.
During a COVID surge, you’re less likely to contract the virus if you mask up in crowded spaces like airports, airplanes and busy stores where exhaled pathogens may be in the air.
When making a mask decision, keep in mind that outdoor air is effective at dispersing those pathogens.
Dr. Schaffner says he currently puts on a mask whenever he’s around other people because he has a vulnerable family member and wants to reduce the risk of bringing COVID home.
If you’re out of mask practice, Schaffner gives a gentle but firm reminder that your mask has to fit over your nose and cover your chin and cheeks to protect your mouth properly. If you take mask breaks for a deep breath or a sip of water, Schaffner recommends making it a short break -- outdoors if possible or in a space where you’re not around others.
And oh yeah, you’re probably going to have to pay for the masks. We'll see if government giveaways for masks come back for the expected winter surge, but you probably won't see free masks at your local library right now.
Keep your distance. Putting some space between yourself and others is still a good strategy — even though earlier this summer it was reported that the six-foot rule from the early days of the pandemic was not based on data. A 6-foot distance is not a magic number that will prevent infection since we now know that exhaled pathogens can travel hundreds of feet. But as transmission expert Linsey Marr explains, “As you get farther away from the infected person, aerosols become more diluted, so the chance of inhaling [particles] usually goes down with distance.”
As an analogy, Marr suggests you think about cigarette smoke. Smaller COVID particles “behave like cigarette smoke. If you’re close to someone who exhaled a big puff of smoke, you’re exposed to more than if you’re farther away. The farther away you get, the better.”
What if my housemate catches it? Am I next? Another question to ponder in the wake of rising case counts: If my partner or housemate gets COVID do I automatically get it? Not necessarily, as infectious disease specialist Dr. Abraar Karan wrote in a story for NPR this year. If you’re fortunate, your roomie might have a short window of contagiousness and might not be a superspreader — some people just don’t exhale a lot of pathogens. Open windows and an indoor air filter can help reduce your risk. As do masks, of course.
Testing, testing. And here’s another COVID reminder: be prepared to test if you’re experiencing COVID-like symptoms.
Currently, the federal government is not distributing free tests. A test costs about $7.50 each online and in stores. If you have any in your COVID supply stash, check this FDA website to see if the expiration date has been extended.
But this fall will bring a return of government-supplied freebies. The federal government has just announced that by the end of September people will be able to order up to four free COVID tests from the website COVIDtest.gov.
You might also check expiration dates on items you bought in bulk during the pandemic, such as acetaminophen to reduce COVID fevers and hand sanitizer, which though it lasts for three to five years, might be close to or past the expiration date if you bought it when the world started shutting down in 2020. Expired hand sanitizer isn’t dangerous, per the FDA, it just may be less effective at fighting germs.
The timing of a test is critical. Since most of us have at least some immunity to the virus from prior bouts and vaccines which could initially suppress your load of virus, testing early on might not produce an accurate result. So it can take a few days for a test to register the virus.
And do test, says Dr. Harish Moorjani, an infectious disease specialist at Phelps Hospital in Sleepy Hollow, N.Y.
Symptoms you think might be COVID-19 could be fall allergies or flu or RSV. For proper treatment, advises Moorjani, it’s good to know what you do – or don’t have.
If you do get COVID. Americans who test positive for the coronavirus are no longer advised by the CDC to stay home from work and school for five days.
1. Stay home and away from others if you have respiratory virus symptoms such as fever, chills, fatigue, cough, runny nose and headache.
2. You can go back to your normal activities when, for at least 24 hours, your symptoms are diminishing overall, and you have not had a fever and are not using fever-reducing medication.
3. Take added precautions for the next five days after a decision to stop isolating: for example, frequent hand washing, wearing a mask and physical distance from others if you can.
So the overall takeaway is: You can end your isolation sooner but a) you could still possibly be a little contagious and b) keep in mind that some people will be less cautious about isolation, which increases the risk of COVID exposure for the general public (see: masks, above).
A note about vaccine timing. We should note that if you’ve caught COVID within the past few days or weeks you “may” wait three months from a positive test or the start of symptoms, per the CDC, to make sure that your body mounts a robust response to the vaccine. Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, says that wait should be at least three months. That’s because if you have antibodies to the virus in your system because of a recent infection, the immune response to a vaccine can be weak.
New costs of COVID. People who are uninsured or have high deductibles may have to pay for vaccines and medication at the end of August when CDC ends its “bridge access” program which helped provide free coverage for some COVID-related expenses for such individuals.
COVID vaccines are free for people with health insurance including Medicare and Medicaid, but Dr. Robert Hopkins, chief medical officer of the National Foundation for Infectious Diseases, reminds people that to avoid copays or the full cost — about $120 for the updated COVID vaccine, you have to be vaccinated at an in-network provider.
A large pharmacy chain shouldn’t be a problem but if you have concerns, particularly about an independent pharmacy you can check with them to see if they are in your insurer’s network.
No insurance or having a hard time finding an in-network provider? Call 211 for state health department information and 311 for local health department information to find out about community health clinics and health department drives that offer the vaccine for free.
And if your doctor prescribes Paxlovid to reduce severity of symptoms, which Dr. Schaffner hopes is the case if you are older or have underlying health conditions that increase your risk for severe disease if you get COVID-19, your health insurer may charge a copay. Previously the federal government provided the drug for free regardless of insurance status.
If you need assistance to afford Paxlovid, you might want to contact Pfizer’s assistance program or call Pfizer at 877-219-7225.
One more thing: The summer surge will end of course but remember all this advice because … a winter surge is likely!
If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Coronavirus Questions." See an archive of our FAQs here.
Fran Kritz is a health policy reporter based in Washington, D.C., and a regular contributor to NPR. She also reports for the Washington Post and Verywell Health. Find her on X: @fkritz
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