The classic doctor’s admonition in treating patients is “First, do no harm.” These days, it probably should be amended for the rest of us: “First, do yourself no harm.”
That’s because too many of us are doing active harm to ourselves and those we care about (and even those we’ll never know) as we head into a third winter with new Covid variants emerging regularly, influenza making a concerted comeback, and respiratory syncytial virus (RSV) threatening the youngest among us.
At this point, it can be difficult to know what to do. Even Rochelle Walensky, the director of the Centers for Disease Control and Prevention, tested positive for Covid, for goodness sake.
But it’s worth noting that Walensky, unlike too many of us, is up to date on her vaccinations and boosters, and faced only mild symptoms, the agency told the Wall Street Journal. Not nearly enough of the rest of us could say that if we got Covid.
In fact, two months after a new version of the Covid booster shot arrived, the so-called bivalent vaccine that provides protection from the older variants and two fast-spreading new ones, only 5 percent of eligible Americans had gotten the shot.
To put it mildly, people aren’t exactly lining up for this one, even though it provides important additional protections from the fast-evolving Covid virus.
And here at the start of winter, as people have been slow to upgrade, we’re seeing Covid cases tick upward across the United States. This country should be the most protected and ready for another bout with Covid, already the third-largest killer of Americans the past two years. We need to protect ourselves, mostly from ourselves.
Yes, there are those who wonder why they should bother with the bivalent booster when newer, even more infectious variants are surfacing. But that reasoning is like wishing your fort had a higher wall on one side, while leaving the gate open and the bridge down on the other side. You need to close the gate and raise the bridge.
To put it simply, if you’re over 55 years old, or have a suppressed or diminished immune system from other medical conditions, you’re in the danger zone. It would be best to get the latest vaccine as soon as possible here at the start of the winter season.
Beyond what we can each do personally, however, there’s more we can do as a society to deal with Covid’s still looming threats for all of us.
To begin with, we once again need to marshal public awareness, using smart messaging that goes beyond clinical nagging to actually reach people in meaningful, resonant ways.
One compelling example is the recent AstraZeneca-funded ad featuring actor Jeff Bridges. The spot ably conveys an important message through a familiar, trusted voice.
Does AstraZeneca have a substantial business motive to pay for these ads? Absolutely. Not only does it make a widely used vaccine (in concert with Oxford University), it also makes EvusheldTM, the sole antibody drug that remains effective for six months for those who’ve contracted the virus and have been treated.
But the “Up with Antibodies” message and the person giving it matter even more than the company’s profit motive.
Bridges, an Oscar winner whose new Amazon Prime show The Old Man has been a hit, was battling lymphoma in 2020 when Covid attacked his diminished immune system.
“I love being alive, man,” Bridges says in the ad. “And I got very close to losing it all.”
In a subsequent interview, Bridges said Covid “made my cancer look like a piece of cake.”
Steps to Take
But you needn’t be facing cancer to be vulnerable, particularly as we get older. And that means we need to return to tactics that helped protect us even before vaccines were available: wearing masks in enclosed, high-traffic areas; avoiding crowds; getting tested quickly if you feel symptoms, and promptly seeking treatments that dramatically improve outcomes.
It’s also worth noting that one of the best reasons to take up anti-Covid precautions with renewed vigor is to protect us all from other respiratory illnesses that are also spiking.
Flu-related hospitalizations and deaths are rising again, particularly among people of Black, Hispanic and Native-American backgrounds who frequently have less access to preventive medical care and information.
And the flu is nothing to minimize. Before Covid, flu complications killed 30,000 to 60,000 Americans a year. That is, pardon the pun, nothing to sneeze at.
The government (really, just about every country’s government) has struggled to keep up with Covid’s rapid spread. But there’s more it can do too.
We need to provide free or sharply discounted access to Covid, flu and other vaccines, as part of a broader approach to encourage preventive care.
And we can be smarter about making our vaccines easier to get. As it is, every year, 183 million Americans get a flu shot. That’s pretty good. But it also means another 150 million Americans don’t get a flu shot yearly. That’s not so good.
When people come for their flu shot, it’s the perfect time to also get the latest Covid booster. Doubling up is safe, research suggests, though I recommend taking acetaminophen for any minor discomfort as your immune system responds to the vaccine (other pain relievers cause too many secondary drug reactions).
Short of mandates, can we be more imaginative in encouraging people to get vaccinated? In Massachusetts, in the early days of the vaccine’s availability, the person who drove a newly eligible recipient to a vaccination location was also automatically eligible for a shot. We can continue that kind of “bring one, get one” program for vaccines and much else, reducing some of the inertia that keeps many from getting the preventive care that keeps them healthy.
I’m also hopeful new approaches will come out of the recent landmark political deal allowing Medicare to negotiate for bulk discounts on pharmaceuticals. It’s in its early days and will be months before enabling regulations are in place. But it holds promise to reduce costs and save lives in many ways.
Regardless, we have much to do, still, in dealing with the persistent challenges of Covid. Wishing won’t make it go away. We need to focus once again on how we do no more harm to ourselves and those around us.
Dr. Praveen Buddiga, M.D., is a double board-certified immunologist specializing in allergies, skin health and immune-system issues. He also is an assistant clinical professor at the University of California – San Francisco School of Medicine.