The time has come for DIY mandates on COVID-19

Here we are on another COVID-19 surge, but most people I see out and about are acting like the pandemic is over. And I live in Los Angeles County, which has arguably one of the most vigilant and proactive health departments in the United States

We all have pandemic fatigue. Even people who should know better have let precautions slip. When you feel a mea culpa on road, I will not disappoint.

I’ll admit I’ve been a lot less cautious over the past few months than I was when I started. I left home without a mask on a trip to the grocery store or pharmacy, and instead of returning to get one, I went in unmasked and told myself I would only be there for a short time.

In June, I took a 12-hour transatlantic flight with virtually no passengers or crew masked. Initially I wore my mask, a tight-fitting KN95. But after dinner I have somehow somehow forgot to put it back on. In July, when COVID was clearly on the rise, I hosted a birthday party for my daughter without asking guests to test themselves before coming indoors.

And there’s more where that came from.

Whether it was luck or boosted immunity, I managed to dodge the virus. But worrying reports of the BA.5 Omicron subvariant — which has been spreading like California wildfire, in part because it can bypass some defenses offered by vaccines and past infections — gave me the headbutt I needed to change my behavior to support.

I did not break any rules in the situations described above because none existed. Public mandates — like masking and requiring people to be vaccinated to enter restaurants, gyms and other indoor venues — have been so bitterly politicized that to return to them now, especially in an election year, would be tantamount to attempting to ban a ghost again to stuff the air bottle. I think many of us are adjusting to a future where keeping the virus in check comes down to personal responsibility.

Most of California is in the high-risk category for COVID-19 transmission, as determined by the Centers for Disease Control and Prevention. But even in pandemic-hit LA County, which is reporting thousands of new infections a day and a double-digit positive test rate stretching well into the danger zone, serious resistance arose when health officials recently discussed — and eventually shelved — a plan to reinstate a mask requirement. Several cities in the county, including Beverly Hills, Long Beach and Pasadena, said they would not enforce it. Business owners openly questioned whether they would ask their employees to impose such a rule on unwilling and sometimes hostile customers.

Kathryn Barger, a member of the county board of supervisors, wrote in an open letter to voters that “masking mandates are polarizing and unenforceable.” A better way, she said, would be “to trust the public to make personal COVID-19 prevention decisions to protect themselves and loved ones, to promote vaccine and booster shot effectiveness, and to engage in equitable access to COVID-19 to invest in treatments.”

Let’s face it: the virus will be with us for the foreseeable future, and we can only speculate about other variants that might catch us later, or how many times we can risk reinfection without risking permanent health damage. Faced with this inconvenient truth, now is an excellent time to adopt everyday habits that reduce our risk of contracting it — and not just from COVID-19.

“There will be cases of COVID-19 for decades and centuries to come, just as there was with influenza,” says Dr. Saahir Khan, an infectious disease specialist at USC’s Keck Medicine. In many Asian countries, he notes, there is a culture “where people wear masks in public places every winter when these viruses are circulating at high levels. And I think that has to become part of the culture here.”

The pandemic complacency that has gripped so many of us is largely a credit to vaccines and treatments that have greatly reduced the severity of illness from infection. But current vaccines have proven to be far less protective against the infection itself, particularly when confronted with BA.5’s evasion mechanisms.

Shira Shafir, associate professor of epidemiology at UCLA’s Fielding School of Public Health, experienced this disturbing reality firsthand. When I called to interview her for this column, she was at home with COVID-19. Shafir’s 70-year-old mother had planned a visit from Arizona, so she and her husband decided to test themselves and their young son. Their son tested positive and they told their mother not to come.

“My son had no symptoms,” says Shafir. “We only tested it because my mother was visiting – and thank God we did, otherwise my mother would have been exposed and would certainly have contracted it.”

The next day, Shafir tested positive, and the next day her husband did too. Both she and her husband are boosted, and their son, who participated in a Pfizer vaccine trial for children under 5, has received three shots.

A starting point for developing your defense strategy is to determine how much transmission is occurring in your community. If you’re in an area of ​​high prevalence, as was the case in more than 45% of US counties at the end of July, extra caution is advised. An easy way to find out is to consult this CDC webpage, which will show you which category your county belongs to. You can also follow your local health department on social media.

Another good measure is purely anecdotal: “If you currently know a lot of people who have COVID, that means there’s a lot of COVID,” says Shafir.

I know at least 10 people, both friends and professional contacts, who have become infected in the last few weeks and have all been vaccinated and refreshed. And that rang the alarm bells I needed to re-learn basic safety precautions.

Below: Wear a mask in indoor public spaces and in crowded outdoor areas. If you’re at high risk of serious illness, avoid these places and find alternatives like curbside pickup and home delivery.

If you plan to host a dinner party, ask guests to take a quick test at home before they come over. If you take a plane, put on a mask as soon as you enter the airport and leave it on at least until the plane is airborne, and then again when you land.

If you test positive, follow these guidelines: Isolate from people for at least five days after your first symptoms or a positive test result. You can end isolation after the fifth day if you test negative, do not have a fever and your symptoms are improving.

If you’re one of those people who doesn’t worry about COVID-19 because you don’t think it will make you terribly ill, remember: the course of the disease can still be highly unpredictable and includes some chance, to end with long COVID that can leave you with brain fog, shortness of breath and heart damage.

If all of this doesn’t convince you, then at least show some consideration for neighbors, co-workers, and relatives who may be older and more ill than you.

“That worries me,” says USC’s Khan. “I want to make sure society is doing its best to protect these people.”

This story was produced by KHN (Kaiser Health News), one of the three major operating programs of the KFF (Kaiser Family Foundation).