How to navigate COVID-19 with kids and as a family
With COVID variant BA.5 sweeping through the region and nation, what makes this viral wave so different from the rest?
Two UW medical specialists, Pavitra Roychoudhury, Assistant Laboratory Medicine and Pathology Instructor, and Dr. Helen Chu, Associate Professor of Medicine, Division of Allergy and Infectious Diseases, School of Medicine, answer these and other COVID-19 questions. They also mention the steps they are taking to protect themselves and their families.
What simple rules should you follow to protect yourself from COVID?
Helen Chu: I would assume it circulates and is everywhere. That’s how I’m acting right now.
Regarding airborne virus particles, the amount of airflow seems to minimize the risk. If you’re at an outdoor concert and there are a lot of people screaming, yes, mask, or in a crowded situation, coughing, sneezing, or speaking loudly, it makes sense to take precautions. In relation to a hiking trail and walking past someone, I see no value in masking.
What tip do you have for eating out?
Chu: I mask indoors, especially for children who are still going through the vaccination series. I wear KN95 and my kids wear KF94. We don’t eat inside. We dine outdoors. There is so much BA.5. We are quite careful about our interactions with others. When we meet with others, we do so outdoors. And we have a supply of home antigen (rapid) tests.
Would you personally stop eating indoors?
Pavitra Roychoudhury: I personally avoid eating indoors as much as possible as it usually means I’m in a poorly ventilated space and many people aren’t wearing masks. I want to support our local restaurants, so I try to look for restaurants with outdoor seating or to get takeout.
What is one of the most common misconceptions about COVID and BA.5?
Chu: I think people assume that if you get it and you’re protected, you won’t get it back, and that’s not true. What we now know is that one infection does not protect you from the next infection. With every infection, people get sick and it’s quite disturbing when you’re isolated and have to quarantine your family. Once you get it, it doesn’t mean it’s over for your family.
How quickly can people possibly be reinfected?
Chu: People can become infected again within four to six weeks. It depends on how different the previous exposure is from what you are facing now.
What is your advice for students returning to school?
Roychoudhury: If there is a high level of community transmission, I recommend masking indoors with a KF94 or similar mask. My child continues to wear a mask at their school, although it is optional.
Chu: In general, children will do what you tell them to do. You know how to mask. For what it’s worth, my kids continue to masquerade. I’m concerned enough about the risk of indoor transmission.
What distinguishes BA.5 from previous variants?
Roychoudhury: BA.5 is a highly transmissible subvariant, meaning more people get infected. It’s also better at escaping the immunity we’ve gained from vaccinations or previous infections, meaning we’re seeing more reinfections.
What are you seeing and what do you expect to see in terms of variant trends over the next few weeks?
Roychoudhury: Of the 3,000 to 4,000 PCR tests we do every day in the lab, about one in five is positive. We’ve been seeing this 20% level for over two months now, suggesting there’s a lot of community carryover. While this number is lower than what we saw at the peak of BA.1 in January 2022 (35%), many people use home testing, so we probably don’t have the full picture.
As more people get infected, I’m hoping that eventually we’ll see a drop in cases, but I’m worried about what will happen in the fall with colder temperatures as people move indoors.
A subset of positive tests is classified by variant type. What are these results?
Roychoudhury: About 70% of all specimens are BA.5, the dominant subvariant in much of the United States
What do you see nationally and even globally with COVID and BA.5 that seems to be changing?
Chu: Transferability increases over time. If a virus can develop a mutation, it is more easily transmitted. Each variant seems to be becoming more and more transferrable.
Roychoudhury: Every case is an opportunity for mutation. As it makes copies of itself inside an infected person, errors accumulate.
Some of these mistakes can make the virus more transmissible, make the immune system better at evading it, or make people sicker.
The sheer number of infections worldwide is one of the main reasons variants are emerging. In addition, the virus can replicate over a long period of time in immunocompromised people, and this long period of replication provides additional opportunities for mutation accumulation.
If we want to prevent the virus from developing, the best way is not to give it an opportunity, that is, to minimize the amount of transmission and provide treatment to reduce replication in those infected.
Since childhood vaccines are relatively new, what do we know about their effectiveness?
Chu: A study on the effectiveness of vaccines in children is currently underway. We specifically focus on children aged six months to 18 years. We are enrolling 3,500 families who will follow us for four years and with those results we will have more information.
There are many interesting questions in children: how long does immunity last? How many reinfections and health complications occur? How many household transmissions are there from children to adults and from adults to children? These questions in children are not as well studied as they are in adults with COVID. What is known from existing data is that vaccinating children offers some protection against infection and is likely to protect them from serious infection.
How can people learn more about this, especially if they are interested in participating in the study?
Chu: The website www.kpchr.org/cascadia/home provides an overview and a video.
What do you see coming with the COVID trends?
Roychoudhury: Since people move indoors and with this variant – and there could be another variant – my concern would be how it looks in autumn and winter.
What about boosters?
Roychoudhury: There will be another round of boosters that anyone can take. Ideally, they are designed according to BA.5. If this is made available and produced in large enough quantities, that could protect us during the crash wave, combined with some people having some immunity to BA.5 infection.
Personally, I would take any booster that becomes available over the next few months to increase antibody levels as we approach fall and winter.
What message about COVID would you most like to share?
Chu: I think people are fed up with everything. We want this to end. We will continue to see COVID and it will become something that comes back year after year. It will get better with time. It will take time. I feel like the message is hope that we will get more vaccines that are more specific to the variants and we as a population will build more and more immunity.
Written by Sharon Salyer