Navigating an unprecedented virus pandemic was never easy.
But in the earliest days of the COVID-19 pandemic, when scientists and doctors were still learning about SARS-COV-2, the guidance was the same for everyone -- stay home, or mask up and keep your distance if you have to go out.
Over two years later, we're in a different spot than those first days of quarantine, with vaccines and treatments available in the U.S. and guidance geared towards living with the virus.
But in some ways, that can make it more confusing to calculate your own risk and make the safest decision for you or your loved ones.
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NBCLA spoke with two Southern California doctors who have spent the last two years advising their patients on COVID-19, and treating patients who caught the virus. Here's the advice they have at this point in the pandemic.
What Can I Do to Protect Myself from COVID-19?
For those who have already gotten vaccinated, maxed out on the number of boosters they can receive, and are still cautious and careful about wearing masks in indoor settings and crowds, they've done almost as much as they can do to keep themselves safe.
After that, it's just keeping track of the little things, and being "cautious when they're getting together with other people at small gatherings," said Dr. Douglas Chiriboga, a family medicine doctor with Pomona Valley Hospital Medical Center.
It's when you're inside eating with a mask off, and you may not know the vaccination status of the people you're with, that the risk of getting sick goes up again, he said.
According to Dr. Nicole J. Van Groningen of Cedars-Sinai Medical Center, if you've already taken all those steps, taking care of the rest of your health may be the best thing you can do.
"Health in general is important, like staying healthy," Van Groningen said. "We know that people who get adequate sleep and people who get exercise have stronger immune systems and are better able to fight off viruses across the board."
A healthy diet can also help, though she added that these factors are more an "added layer of protection" than a guarantee.
And after two years, she said, it's important to include your mental health in the risk equation.
“As much as I’m a doctor, mental health is important," she said.
Your personal risk assessment may mean avoiding high-risk, poorly ventilated restaurants or crowded concerts, but that's different than isolating inside at home constantly when it negatively impacts mental health, and that's what can be tricky. If you can find a way to join gatherings at this point, that's something to take into consideration.
"You don’t want to miss weddings and birthdays," she said. "I don’t think that’s healthy."
And if you're confused about what risks make sense for you, or what extra measures you should be taking to protect yourself, that's an excellent time to reach out to your doctor.
"It’s tough, because we’re not getting blanket guidance from any public health agency anymore," she said. With that in mind, going through risks versus benefits "is an excellent use of your primary care doctor!"
For people who have relaxed their precautions -- maybe they're less stringent about masking up indoors, or they haven't gotten around to getting boosted yet -- getting those boosters should be a high priority.
"If you haven’t gotten your first booster, that is the number one thing on my to-do list," said Van Groningen.
"We’re dealing with a variant that was not around when the original vaccine trials were done" with only one Johnson & Johnson vaccine and two Pfizer or Moderna vaccines, she said. The top-up a booster shot gives your immune system will make a real difference.
"Because people are not very diligent with masking and these booster shots, COVID-19 is becoming a smart virus, it's mutating," said Chiriboga. "It's becoming very adept at fighting off the powers of the vaccine"
"My take-home message is, please get vaccinated" with the full series of vaccines available, to give yourself the best shot, he said. "Take care of yourself and others, take care of your loved ones."
What If I Don't Want to Get Vaccinated, or Can't?
Vaccines are still the best-recommended way to protect yourself against COVID-19.
"I would encourage people who don’t want to get vaccinated, don’t wear a mask, to realize that we need to take the political discussion out of the picture," Chiriboga said.
He said he's seen unvaccinated patients end up hospitalized in the ICU, and regret their decision not to get vaccinated.
"We want to prevent that from happening," he said.
Given the health risks involved in choosing not to get vaccinated, Van Groningen said, it's hard to give medical advice that excludes the highly protective vaccines. But avoiding high-risk activities, wearing a mask, and keeping up your sleep, diet and exercise may help provide some protection.
On the other hand, "for people who truly cannot get vaccinated, for a legit medical reason, if they truly have an allergic reaction to one of the vaccines," there is a monoclonal antibody treatment that can help produce an immune response, she said.
Both doctors also emphasized the importance of staying at home if you feel sick, and taking an at-home test before large events where you might spread COVID to other people, regardless of vaccination status and comfort level.
How Many Boosters Are We Going to Get, and Why Should I Keep Getting Them?
For those frustrated by increasing numbers of recommended boosters, it can help to think of the boosters like system maintenance on a car, Dr. Chiriboga said.
"Just because you bought a brand new car doesn’t mean you’ll never need an oil change," he explained.
The initial two-series vaccine "activates your antibodies, but it’s not life long," so you need to top things off, he said. The boosters help remind your immune system what fighting COVID is like, as that defense system fades and the virus mutates.
He recommends following the recommended schedule for vaccinations and boosters.
For Van Groningen, "the more complicated question is, in the current environment, when should I get my booster?"
For her, the first booster dose is "a 'do-it-yesterday' kind of thing," she said.
But her guidance on when to get the second booster dose, for those who are eligible, depends on the individual. It may be able to wait until there are higher case loads, to provide maximum protection when there's more risk, if it's a particularly healthy person over age 50.
In the future, we're likely to see more boosters recommended for everyone, included expanded recommendations for that second dose, both doctors predicted.
That may come in the form of a second booster dose recommended for everyone regardless of age, a future "pan-coronavirus" vaccine that protects against the flu and adds to your COVID protection, or a seasonal COVID vaccine the way we receive seasonal flu vaccines now.
When Will My Child Younger Than 5 Years Old Be Able to Get Vaccinated Safely?
After those meetings, if the FDA approves the vaccines and the CDC approves that decision, young children between the ages of 6 months and 5 years old will be able to get vaccinated.
Both doctors -- along with others NBC4 has spoken to -- agreed that, if and when the vaccines are approved, they will be safe for small children to get immediately.
"I would put a lot of trust in the FDA’s seal of approval," Van Groningen said. "The FDA looks at trials in kids very rigorously," and if she had children that age, she would have no issue getting them vaccinated.
"The risks are far exceeded by the benefits," she said.
"These vaccines for younger kids are just a small fraction of the regular dose that we use for adults," Chiriboga said. "You’re protecting the child."
Does Wearing a Mask Help Even if No One Around Me Wears One?
Wearing a mask is better than not wearing one, even if no one else does, according to Van Groningen.
"What we actually have found in studies of mask use, is that it does provide at least some level of individual protection," she said. "So yes, it's very important to wear."
And unless you're testing yourself for COVID every time you go out in public, you may be carrying the virus without realizing, and masks help keep that virus from spreading to others in the air.
"You may be a carrier," Chiriboga said. "If you’re not wearing the mask, it’s easy to spread it to someone else."
Are There Treatments For COVID Yet?
If you do get sick with COVID, but your case is mild, "the general approach is treating it like any other flu," Van Groningen said. Take Tylenol for any aches or fever, and take a decongestant or cough suppressant if you're congested or coughing.
"Stay really hydrated," she said, and "try to be somewhat mobile," rather than lying in bed all day. "Get some light walking in, if you're able to, even if it's just around your house or around your room, so that you keep your blood flowing and you keep your lungs actually working."
Paxlovid is probably the best-known antiviral medication available to treat COVID-19 if you do get sick, but there are other options as well, she said.
Your primary care doctor can help walk you through the various options, Chiriboga said. For Pomona Valley Hospital Medical Center, where he works, there are telehealth options, or, "if you need to come in, we can see you, we just gown up."
And if you have shortness of breath, chest paint, severe diarrhea, abdominal pain or you get winded walking a short distance like across the street, you should "definitely go to the emergency room," he said.
"If you’re really feeling short of breath, I think chest pain and shortness of breath are two key symptoms that we say 'don’t mess around, go to the hospital,'" Van Groningen said.