• Coronavirus map: How many COVID cases are in Bay Area and California

There’s no mistaking that the SARS-CoV-2 virus is staging an unwanted comeback in the Bay Area. The uptick in COVID cases evokes memories of summers since 2020. Official figures, though early, back up the anecdotes: The state’s test positivity rate has climbed to 11.8%, its highest level since the beginning of the year, and hospitalizations are up more than 63% in the last month, from a seven-day average of 163 admissions per day in mid-July to 266 per day last week.

Nationally, there were 12,613 new COVID-19 hospitalizations for the week ending Aug. 12, according to data released Monday by the Centers for Disease Control and Prevention. This figure reflects a 21.6% rise compared to the preceding week. Deaths due to COVID-19, a lagging indicator, are also starting to pick up nationwide, with an 8.3% increase over the same period.

While many cases result in mild symptoms, especially for those who’ve been vaccinated or previously battled the virus, COVID’s disruption to work and life is still undeniable. Plus, some evidence suggests that each subsequent bout of the virus may raise the risk of experiencing a persistent state of exhaustion, brain fog, or other symptoms known as long COVID.

Despite the resurgence, a sense of “pandemic fatigue” pervades the population, prompting many people to resume normal activities and overlook the threat, especially if their risk of severe illness is low. Restaurants, movie theaters, concert venues and airplanes are now packed with crowds of almost entirely unmasked people who roll the dice and hope for the best.

But what if you’re not among those willing to wager on chance, either due to underlying health conditions or general concern about adverse outcomes? As the summer swell gains momentum, here is a refresher on the latest expert advice to navigate uncertain times.

When to consider vaccinations and boosters

Throughout 2023, the dominant strains of the coronavirus nationwide and in the Bay Area have been descendants of the omicron family of SARS-CoV-2. The currently available vaccines and boosters were tailored to combat both the original 2020 coronavirus strain and a 2022 omicron derivative, so they offer somewhat diminished protection against the current variants. Yet they still afford greater protection than no vaccination at all. Updated vaccines geared toward more recent variants are set to roll out in late September or early October.

When to consider a booster:

• Higher-risk individuals: People at higher risk of severe illness, including those with health conditions such as obesity or diabetes, individuals age 65 and above, or those with compromised immune systems due to underlying immunological problems or cancer treatments, should get a booster shot every six months. Some vulnerable people might consider a shot now if it’s been more than four months since their last.
• General population: If you are in good health, under 65, and have received a vaccine or battled COVID within the past six months, the best option is likely to wait until the fall for the updated booster. Even if it has been more than six months, you might want to hold out for the new booster because it’s better tuned to fighting off current variants.

Masking calculus

Few topics have sparked more debate than masking, with arguments ranging from its efficacy to ideological objections to mandates. Yet the evidence remains clear: Consistent masking has been shown to be an accessible and effective means to reduce transmission, whether you’re at risk of unknowingly spreading the virus or of contracting it.

For those looking for more protection in the current environment, situations where a tight-fitting quality N95 or KN95 mask can be beneficial include:

• Public transportation.
• Airport waiting lounges and during aircraft boarding and taxiing.
• Crowded indoor spaces where people are singing or shouting.
• Bustling restaurants before and after meals.

Scenarios that may not warrant the same level of precaution include:

• Walking or hiking outdoors.
• Open-air concerts or sporting events.
• Alfresco dining or social interactions.

Navigating social situations and testing

Although there are no definitive rules for safe or unsafe behavior in more intimate social settings, a combination of thoughtfulness and common courtesy can guide most interactions.

• Home test kits, while still able to detect the latest coronavirus strains, are not as reliable as they were in the past. A positive home test remains a clear indication of COVID, and there’s no need to confirm the diagnosis with an official lab test unless it’s required for work absences or other reasons.
• A greater concern is the potential for “false negatives” from home tests during the early stages of infection. If you suspect you may be ill and are worried about meeting other people, multiple tests over successive days should clear up any doubt.
• If you need to have more certainty for some reason, many pharmacies and health providers still provide a polymerase chain reaction, or PCR, laboratory test, which is considered the gold standard. Payment is dependent on insurance carriers, and out-of-pocket testing can cost upward of $100.
• When visiting at-risk friends or family members, wearing a mask requires minimal effort and can safeguard your loved ones. If you have any reason to suspect you may be sick or have been exposed to the virus, taking a home COVID test before meeting affords a quick — if imperfect — screen.
• For hospital or nursing home visits, an over-the-counter test ahead of time and masking can help protect vulnerable populations, as well as yourself.

What should you do if you are exposed or infected?

• In case of exposure: The Centers for Disease Control and Prevention offers a practical risk calculator for determining post-exposure actions following contact with someone who has COVID-19. The first step: Put on a mask to protect others for 10 days, watch for symptoms such as fever, and test yourself on Day 6. If you’re negative, keep masking until Day 10, and then you can stop.
• If you are infected: In the event of a positive test or development of symptoms, the CDC advises immediate isolation. Wear a high-quality mask if you must be around others. The most infectious period usually spans the first five days after testing positive.
• When to seek emergency treatment: If you have trouble breathing, persistent pain or pressure in the chest, feel disoriented, unable to wake or stay awake, or experience a change in skin tone, call 911 or your local emergency department.
• When to end isolation: Those who show no symptoms can end isolation after five days, the CDC says. But if you do have symptoms, you should continue to isolate until you are fever-free for 24 hours without the use of fever-reducing medication.If you had moderate (difficulty breathing) or severe (requiring hospitalization) symptoms, you should isolate through Day 10. Wear a mask until you have two sequential negative test results 48 hours apart.
• Treatments and medications: For those experiencing mild illness, the CDC advises home recovery, with over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Motrin, Advil) to help manage symptoms.A Food and Drug Administration-approved antiviral drug, Paxlovid, can effectively treat mild to moderate COVID-19 in individuals who are at greater risk, but treatment must be started within days of symptom onset. Preliminary research also suggests Paxlovid can reduce the risk of developing long COVID.

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