Breakthroughs

When I think of this word, my first impression is one of surmounting a problem that previously seemed insolvable. That’s not the case today. This evening, I am reflecting on COVID infections among those who were properly vaccinated and behaving with caution in order to avoid infection. There are four recent incidents in my circle of family and friends. Perhaps you too have some; it would not be a surprise. Such occurrences are much too common.

The first of them is a family member who until recently came into daily contact with dozens of children infected with COVID. These contacts were just part of the job. Having received the two primary vaccinations and a booster, he became infected at work anyway. A few days of respiratory misery later, he was well enough to return to duty before leaving the workplace forever. Some colleagues who contracted the virus later have fared far worse. Alas.

The second was a former workmate and clinical colleague who went on a European vacation with her husband. Having completed their vacation, they tested for COVID before returning to the USA. They were positive. Again, they had been properly vaccinated and received at least one booster. Their vacation was extended to include a period of quarantine before returning home. I really hate it when that happens.

The third was a former medical colleague who went on vacation with his spouse. They had a long flight, and subsequently a long train ride. Then there were a few hours spent on a tour boat in the Arctic. (I am just a tad envious.) Both became ill during this vacation, and they tested positive for COVID. They spent the latter half of their vacation in hotel quarantine. Sigh.

Tonight, I had a call from a lifelong friend who is immunocompromised but also vaccinated and boosted x 2. He had been admitted to the hospital tonight with pneumonia and a positive COVID test. He was on oxygen by nasal cannula and taking steroids and antivirals. We had a nice chat, and there was a lot of catching up and laughter. This means that his oxygen levels were sufficient to permit speaking – a good thing when one has a severe respiratory illness. My friend does not mingle with folks outside his home; the immunocompromising condition overshadows much in his life. It seems that his spouse had recently visited a state where the Omicron BA.5 subvariant is on a rampage, and returned home, asymptomatic, to infect him. Shit.

So, my points in recounting these stories are simple. I hope you find them of use.

• You can protect yourself by getting vaccinated and boosted. It won’t make you invulnerable, but you will be more likely to survive a breakthrough infection.
• Wearing a mask and being meticulous about personal hygiene can reduce your risk, but it has limited effectiveness against being exposed to lots of people in confined spaces even if you wear a good mask.
• No matter how careful you are about protecting yourself, if your intimates are not equally careful, you will be vulnerable to their infection prevention lapses.
• Everything in life is a trade-off, risk vs benefit, make sure that you accept those trades with your eyes wide open.