Your Covid questions, answered!

Emily Landon is in the house.

Hellloooooo and happy Friday! We have, once again, made it to another weekend!!!!! 

Many of you already know Dr. Emily Landon. She’s an epidemiologist at the University of Chicago, and she was a frequent guest on Nerdette over the course of the pandemic. She’s great at providing clarity during VERY CONFUSING TIMES.

I was part of the recent wave of COVID-19 illnesses, and found myself wishing for guidance about how long to isolate and whether to get Paxlovid. Some of you also sent in questions around long Covid and how to plan when to get the next vaccine booster. So Emily is here, today, with answers!!!! 

Emily and me!!!

Before we get into it, a couple of quick announcements: 

• We are ON for September book club! We’re reading Danzy Senna’s Colored Television, and we’ll discuss it via Zoom on Sunday, Sept. 29 at noon Central time. Email me at greta m johnsen at gmail dot com for the Zoom link, and I’ll add you to the calendar invite! 

• Speaking of books! I’m thrilled to report that I have two copies of Sally Rooney’s HIGHLY anticipated new book, Intermezzo, to give away, one in audiobook form and one physical book. Y’all probably know the drill by now, but just in case -- this newsletter is totally paywall-free, but I still rely on paid subscribers to help support the work I do here. If you’re able to become a paid subscriber, you’ll automatically be entered into every giveaway I do, AND you’re helping me scheme up the next steps in my new freelance career! All donation levels are very much appreciated!!!

• I’m curating a series of events with the Chicago Humanities Festival this fall, and I especially can’t wait to hang out with my friend Shannon Downey on Monday, Nov. 4 at 7 pm at Chop Shop. WHAT ELSE WOULD YOU RATHER DO THE NIGHT BEFORE THE ELECTION? I mean, really! We’ll talk about her new book, Let’s Move the Needle, and a ticket to the event also gets you into the crafty happy hour afterwards. (BYO craft or pick up a kit at the event!) Here’s a link to tickets. 

Dr. Emily Landon answers your questions about COVID-19

As I mentioned, Dr. Emily Landon is an infectious disease expert at the University of Chicago. She told me that there was a significant Covid wave this summer, which seems to have peaked a couple of weeks ago. I say “seems to” because Emily says that federal requirements around reporting cases have changed a lot since 2020, which makes it much more difficult for people like her to make predictions about variants and waves. 

That means if it feels like more and more people you know are getting sick, you’re not crazy! So here’s some hopefully helpful guidance about how to keep you and your community safe. 

Greta: My first question is about Paxlovid. Last time we talked, you said that you thought that pretty much everyone who has Covid should be taking it. Is that still the case? 

Emily: Yeah, I would still say that. The official recommendations are about people that are at high risk for a bad outcome, but I would not hesitate to give anybody Paxlovid. 

My doctor said that since I’m not considered super high risk and my case was mild enough, I didn’t neeeeed Paxlovid. I was mostly curious about getting it because I’ve heard it can help lessen the likelihood of getting long Covid, but my doctor said the jury is still out on that. 

It is a little bit out on that. Earlier on [in the pandemic], the data was stronger because more people were getting long Covid. But some people still do get it, and you just need larger groups, like larger trials, in order to show that. So I would say, while the jury is out, the downsides of Paxlovid are nearly none.

It may prevent long Covid. It's definitely going to prevent other complications of COVID-19. So why would you not? 

That makes sense. So for people who get Covid, what is your guidance around isolating these days?

Okay, the rules are: When you have respiratory symptoms and If you have a fever [whether or not you test positive for Covid], you should stay home until you're fever-free without taking fever-reducing medicines for 24 hours.

After that, you should wear a mask around people for at least a total of seven days from when you started getting sick.

I think as long as you wear a mask around other people, it's probably okay. The evidence shows [masks] work really, really well for source control. So if you're wearing a mask around other people, then there's really no reason why you couldn't be out and about. Now, if you're not feeling well enough to go back to work yet, that's another issue.

That’s good to hear. What's your guidance on when we should do a booster situation if we’ve had Covid recently? 

Everybody needs to get a booster every year, just like they get the flu shot. They're both out now. 

I would say, if you recently had Covid, you want to push that a little bit. You want to be a little closer to winter. So since I had Covid this summer, I would certainly want to spread my protection out a little bit, and I will get mine around November.

Okay. So what’s your advice for people who haven't had Covid recently? 

Get the vaccine now, if you want, and it might help prevent you from getting Covid in this wave, but then you won't really have as much protection [later this winter]. The vaccine really provides the biggest benefit in the first two to three months after you get the booster. 

Yeah, I gamed it out a little last year. I knew we were traveling to Mexico in January, so I waited until closer to Halloween to get the booster to make sure I’d be more protected for that trip. 

Yeah, I think that's what people should do. And I think you should do the same with your flu shot.  I would say, if you want to have the maximum protection when we usually see the most flu, then you probably don't need to get your flu shot until October. I usually get my flu shots in October or early November.

That makes sense. Do you have a preference between the three different brands of boosters?

Nope.

So, yeah, a GRETAGRAM reader told me they had read an article that said that exercising too soon after having Covid could cause long Covid. Is that true?

There’s evidence that too much exercise can be detrimental. My best advice to anybody that has Covid is rest, rest, rest, rest, rest, rest, rest, rest, rest, rest, rest, rest.

It's very clear that for many people, when they do have long Covid, extra exercise makes it worse, and there is a small subset who get better with exercise. But that's not the routine. Most people get worse. 

If you have to get back to working, take it easy! Do not exercise and do not over exercise. You need to really give it time.

Your body is doing more to fight off Covid, even after you feel better, even after you no longer have a positive respiratory test. Tour body's still working on repairing the damage. So just take it easy! 

Soooooo you're telling me not to go to Orangetheory tomorrow.

No, no, not yet! Go for a walk, or ride your bike a little bit. You have to get yourself into it slowly, and you really do need to get plenty of rest for many days. I would say, for at least a couple of weeks. You want to be taking it pretty easy.

Okay, you’ve convinced me! Something we've talked about in the past that I found really helpful was about assessing risk in your community, that a very useful metric is to pay attention when more people you know are getting sick. Do you still feel that way? 

I think anecdotally, when you start hearing about people getting sick and testing positive for Covid, then you should start watching out. If it's affecting your friend group, or when you start hearing about a new variant, it usually means there's going to be a wave afterwards.

I think those are good predictors that your risk is higher.

That makes sense. And then what's your advice at that point? I’m guessing it’s to mask as much as possible?

Yes. Adjust your masking to the risk that you want to take on.

My last question is, can you believe it's been 4 and a half years?

It feels like a million years! I feel like pre-Covid was like a different lifetime for me.

It was!

But then, at the same time, it feels like that wasn’t that long ago, and it's hard because you feel like you could go back. You want to feel like that's within reach, and you could just go back to that. But the fact of the matter is, we're not going to go back to that. I mean, Covid doesn't play as big a part in our everyday lives as it did in 2020…

Thank God!

… but It's just something we have to incorporate into our future now.

Fair enough. Well, Emily, thank you once again for being the best and taking the time! I appreciate you.

Thank you! Happy to do it.

Ok, that’s it for this week. I hope it was helpful to hear from Emily again, and that y’all are taking care!

Talk to you next week

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