North Carolina has seen a dramatic increase in COVID-19 cases in recent weeks and, increasingly, in the more highly contagious omicron variant. Hospitals and the healthcare workforce are strained. As weary as we all are of the restrictions and inconvenience COVID has caused us, we hope you will not let down your guard.

Case rates have not been updated on the NC Health Department site due to the holiday weekend but continue to be at record levels. Case positively (only the reported cases, not in-home tests) is still about 31%. Although the omicron variant is seemingly less severe, particularly in fully vaccinated individuals, this astounding number of cases (with a small percentage still getting very ill) has filled up the hospitals (hospitalizations are still climbing) and a high percentage of all ICU beds. A bright spot is that a smaller percentage of all COVID-hospitalized people currently need ICU admission.

Vaccines are your best protection against serious COVID disease, hospitalization, and death. They also reduce the likelihood that you will transmit the virus to others. They are available in most pharmacies and in community clinics, free of charge, for those 5 years of age and older. Boosters are available, also free of charge, for those 12 years of age and older; the latest guidance recommends a booster 5 months or more after completion of the initial vaccine series. Immunocompromised children ages 5-11 may now be eligible for boosters as well. We urge vaccination and boosters for all those who are eligible. You can obtain your flu shot at the same time! Please do your part to keep our community healthy and to keep our healthcare systems from becoming overwhelmed.

Breakthrough infections are possible, even in vaccinated people. Some of these cases can even result in hospitalization. We urge the use of masks and social distancing indoors whenever you are exposed to those who are unvaccinated or those of unknown vaccination status, whether in private or public settings. Double masks are more effective than a single mask; N95 and KN95 masks appear to offer the best protection. Eating and singing together indoors are particularly high-risk activities. For vaccinated people who gather indoors, particularly if they will be unmasking to eat, testing for the COVID antigen immediately before gathering may add some measure of assurance that someone is not unknowingly infected with COVID and thus capable of spreading the virus. When a gathering includes high-risk individuals—elderly, pregnant, immunocompromised, or unvaccinated people (eg, children under age 5) or partially vaccinated people—testing for COVID before gathering becomes more important. It will be necessary to make appointments well in advance if you plan to use a pharmacy for PCR testing (the most sensitive) prior to an event. Home antigen test kits are available in some pharmacies and big box stores (eg, Abbott’s BinaxNow), to keep on hand for the times they are needed; however, these are currently in short supply. Starting Wednesday January 19 test kits can be ordered through covidtests.gov Please note that antigen tests typically do not become positive until 3-5 days after exposure and may miss some contagious individuals that a PCR test would identify in this early period; however, a negative antigen test 6 days after the most recent exposure is more reassuring. A positive antigen test, on the other hand, likely means someone has a contagious COVID infection, while PCR tests can remain positive after infection, even beyond the contagious period.

The next meeting of our COVID Medical Advisory Group will be on February 1 at 1 p.m. Please contact Kat Rice, Jennifer Schaal, or Janie Foy if you have any questions for the group or requests for COVID-related guidance related to proposed activities.