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5 Steps to Weather Another COVID Winter

A little planning — and a quick call to your doctor — could go a long way as temperatures drop

We need to take steps to protect ourselves from COVID again this winter.
Innocenti / Getty Images

Much of the country is on the cusp of the cold-weather season, when respiratory illnesses rage. And this winter — our third living with COVID-19 — health experts are urging caution, citing the potential for yet another surge, plus a flu season that could be worse than last.

However, there are five simple steps you can take to help improve your odds of staying healthy in the coming weeks and staying out of the hospital if you do come down with COVID. Here’s what’s on the list.

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1. Get your booster

There’s a new COVID-19 booster available — what’s known as a bivalent booster — and this latest version targets the original coronavirus and the omicron subvariant that is currently driving the majority of COVID-19 cases in the U.S. 

“And based on everything we know about immunology and science and vaccines, these updated vaccines should provide a much higher level of protection against infection, against transmission and certainly against serious illness and hospitalizations and deaths,” Ashish Jha, M.D., the White House COVID-19 response coordinator said in an Oct. 11 news briefing.

As of Oct. 12, everyone 5 and up is eligible to get the still-free shot, but so far, few adults have rolled up their sleeves — about 4 percent. However a recent report from the Commonwealth Fund finds that if that percentage bumps up to 80 by the end of the year, more than 936,700 hospitalizations could be avoided and nearly 90,000 lives could be saved.

“If you’re eligible for this bivalent booster, then you should go get it. That’s number one, by far the most important thing,” says Mark Rupp, M.D., chief of infectious diseases in the Department of Internal Medicine at the University of Nebraska Medical Center.

When’s The Best Time to Boost?

White House COVID-19 Response Coordinator Ashish Jha recommends getting the updated booster before Halloween. “Why Halloween? Because it takes a couple of weeks for your immune system to generate the benefit from that vaccine. And that means you will be ready by Thanksgiving and certainly by the holidays,” he explained. “If you miss Halloween, is it too late? It’s not too late. Again, it takes a couple of weeks for the immune system to benefit from the vaccine, so there is no time period where the window is out and you’re no longer going to benefit; you will always benefit.” The Centers for Disease Control and Prevention (CDC) also recommends getting the annual flu shot before the end of October.

2. Think ahead about treatments

Don’t wait until you come down with COVID-19 to figure out how you plan to treat it. Discussing the options with your doctor ahead of time can help to ensure that you have access to treatments in the first place, and that you get the right one for your situation.

Recent studies show that the antiviral Paxlovid, which was authorized by the U.S. Food and Drug Administration nearly a year ago, can significantly reduce the risk of hospitalization and death from COVID-19. One pre-print study from researchers out of Kaiser Permanente Southern California found that when taken in the first five days of symptom onset, the prescription pill cut the risk of hospitalization by 88 percent, even among a highly vaccinated population. Another study published in the New England Journal of Medicine found that the drug was especially effective in people 65 and older during the recent omicron surge.

Yet health experts say many adults who are eligible for Paxlovid, including older adults who are at higher risk for complications from COVID-19, aren’t receiving it even though it’s widely available. All the while hospitalizations and deaths among Americans 65-plus spiked during the summer months, more than doubling between April and July, an analysis from the Kaiser Family Foundation found.

“The data are overwhelmingly clear that our older Americans are once again bearing the highest burden of severe outcomes from COVID-19,” Tom Tsai, M.D., senior policy advisor for the White House COVID-19 Response Team, told AARP.

Tsai points to a few different factors that could be contributing to the low utilization rates, and potential drug interactions is one of them. Paxlovid doesn’t mix with a number of prescription medications, including some common blood thinners, statins and blood pressure meds.

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“And I think that providers have been kind of scared away from its use because of the long list of interactions and the fact that you do have to spend some time and take care in really knowing what the patient’s taking, and sometimes adjust their medicines,” Rupp adds.

Finding out from your doctor ahead of time if you’re eligible for Paxlovid based on your own prescription regimen — and also where you can get the prescription filled if you need it — is key, Tsai says. “Patients need to be their own advocate, especially around treatments, because time is of the essence,” he adds. In fact, Paxlovid works best if it’s started in the first five days of symptom onset.

Rupp suspects another possible reason for the lag in the prescription’s use is due to individuals delaying treatment until it’s too late. COVID symptoms may start out as mild, “and then by the time they really start getting in trouble, it’s probably past peak efficacy,” Rupp says.

Reports of Paxlovid rebound — or testing positive for COVID-19 right after Paxlovid treatment — could also be to blame. However, Tsai says emerging research suggests that rebound may not be due to treatments, but instead is “more of a phenomenon of the COVID-19 itself.”

If you are not eligible for Paxlovid, there are other treatment options. While less effective than Paxlovid, the antiviral molnupiravir (brand name Lagevrio) is available as a prescription pill, and it has fewer drug interactions, Tsai says. Your doctor may also recommend an infusion of monoclonal antibodies or remdesivir.

“Part of the treatment strategy is to not rely only on one treatment option, but to ensure that Americans have access to a range of therapeutic options to keep them safe this fall and winter,” Tsai says. 

3. Symptoms? Take a test

Suffering from the sniffles? Have a sore throat, or feel a cough coming on? With vaccines, boosters and a constantly evolving virus, it’s harder than ever to distinguish symptoms of COVID-19 from that of a cold, or even the flu. And that’s why it’s important to test.

If your symptoms are due to COVID-19 and you’re eligible for a treatment, you’ll want to get started on it right away. You’ll also want to steer clear of others while you’re sick to avoid spreading the virus.

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If you’re negative for COVID-19, your doctor may want to test you for flu, which is also more dangerous and deadly for older adults. There are also treatments for flu, and they work best when taken soon after symptoms start.

“Think about it this way: Testing leads to diagnosis, diagnosis leads to treatment and treatment leads to recovery,” Tsai says. And getting early access to these treatments “can truly minimize the number of deaths associated with COVID-19,” he adds.

Beneficiaries with Medicare Part B can get up to eight over-the-counter COVID-19 tests free each month. Many private health plans are also reimbursing enrollees for at-home tests.

4. Know your risk — and keep your mask handy

After two-plus years of the pandemic, COVID fatigue has set in. Fewer people are wearing masks, more people are packing into planes, and large indoor gatherings have mostly resumed.

And while you may feel more relaxed in some situations — say, a family event or a friend’s dinner party — that doesn’t mean you need to ditch all prevention efforts going forward. It’s important to consider your risk before deciding on plans, and also to pay attention to transmission rates in your area.

“Show a little prudence, be a little careful,” Rupp says. “Continue to avoid those higher-risk situations where you can and where it just doesn’t make sense for you to put yourself in that risk. And if you can’t avoid them, don’t feel shy about popping on a mask.”

5. Get your flu shot

Just like the COVID-19 vaccines can reduce your risk of severe illness from a coronavirus infection, the flu shot can lower the likelihood that you’ll wind up seriously sick from influenza. This year, adults 65 and older should ask for one of the higher-dose options, the CDC says.

“Prevention is the best thing you can do, so get your flu shot and get your COVID booster right now,” Rupp says. (And yes, you can get both the COVID-19 booster and your flu shot at the same time.)

Tsai adds, “Really for the first time in the pandemic we have full access to all the tools, from updated vaccines to widely available supplies and treatments. And we just need to make sure that we use these tools to protect ourselves and our loved ones.”