42 Practical Strategies to Live with Covid

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42 practical, safe strategies to live a semi-normal life with Covid. The virus is here to stay for many years into the future. While treatments are improving, this article outlines the 10 most dangerous places where you might be infected.

During interviews with virus experts, Ferozan Mast in March 2022 reported: "…This is going to go endemic and it's going to be a lot like a seasonal flu. But we're going to have a couple of drugs that are going to be good at treating it. I think the immunity that we have with the vaccines… we'll be getting boosters like once a year like we do for flu, and it's just going to become part of the background landscape that we live with," said Dr. Thomas Unnasch, a Distinguished USF Health professor.

We had hoped that the new vaccines, masking, and social distancing would cripple or end the virus spread, with Herd Immunity taking place where 80-90% of the population was vaccinated and/or had been infected. But this national immunity to diminish or end the virus in the US hasn’t occurred nor does it appear on the horizon! Before we discuss the 42 suggestions on how to live a semi-normal life with Covid, let’s examine where we are today as a nation and the future. As we enter our third year under the shadow of the COVID-19 pandemic, people are tired, frustrated, depressed, sad, and angry. In fact, medical doctors we interviewed said that mental health issues are soaring not only in their practices but nationwide as well. Other individuals are worn out with Covid and have simply given up protecting themselves and others. Mast went on to report “Covid fatigue is real, but it's also dangerous and could lead to people ignoring public health guidance. People are tired of the public health interventions," reported Andrew Badley, M.D., Chair of the Mayo Clinic's COVID-19 Research Task Force. He stated that “Some people are doing that less and less, and I think that contributes to the spread… we will be seeing patients with severe COVID disease for years to come." The World Health Organization has documented 6 million individual deaths worldwide—friends, neighbors, family, and public figures alike—from the effects of the novel coronavirus. The Centers for Disease Control and Prevention (CDC) reports that while the US has the best healthcare facilities and professionals in the world, more than 950,000+ American deaths have occurred and that 1,000,000+ will die in the United States by May 2022! Many more people have been sickened by the virus, some to the point of hospitalization or disability, and their absence from the workplace has rippled through the American economy. Supply chain issues, skyrocketing inflation, and an unpredictable stock market with rising interest rates have added even more to the discouragement that many are feeling right now! Most everyone wants to know: “When will this pandemic end?” Moderna’s CEO reported on 2/15/2022 that he believes that there is an 80% chance we are entering the endemic or seeing fewer less serious cases of Covid. However, he also stated that there is a 20% possibility a new variant could surface that is more infectious and virulent than Omicron! And scientists are concerned about Covid’s re-emergence in the winter of 2022!

One of the most difficult aspects of the pandemic has been the uncertainty: every time that we think we’re safe, a new variant suddenly appears, placing us in danger again! A new Omicron mutation has surfaced that is 30% more transmittable than the original Omicron version! That is part of the nature of viruses, including COVID-19—they mutate overtime to survive. As humans gain immunity to certain strains of the virus through vaccines, the virus is forced to mutate or change in an attempt to bypass that protection. Researchers have had years to map genetic sequences of many common viruses, such as measles and influenza (and even then, many more years of study are needed). But because COVID-19 is a “novel,” or new, coronavirus, scientists have mostly been forced to learn about it in “real time” along with the rest of us. And it is mysterious how certain members of a family will be infected while others escape the virus. Scientists are currently studying why some people are more resistant to Covid than others.

Even infectious disease specialists who have studied countless other viruses for decades experienced serious difficulties determining how COVID-19 will evolve and spread. Part of the reason it is so unpredictable, according to a January 2022 article by Sarah Zhang of The Atlantic, is that “The virus’s genome (or genetic code) is 30,000 letters long, which means that the number of possible mutation combinations is mind-bogglingly huge!” The latest COVID-19 infects people very quickly (taking 3 days or less to surface in one person with symptoms and for that individual to infect others; in contrast, measles takes 10-12 days) and has been able to spread rapidly because of its novel status (humans had no existing immunity to it). Each time COVID-19 infects a person, the virus copies itself billions of times; each replication is a chance for the virus to mutate in a way that allows it to bypass the immunity we have built up to it through vaccination and previous infections. While the vast majority of mutations that the coronavirus makes either have no impact on its chances of successfully infecting people or make it less likely, a few will make it to a vicious level. When these mutations survive and thrive, replicating in human and animal hosts, we end up with variants like Delta and Omicron. In fact, Mayo Clinic reports that even cats and dogs (to a lesser degree) can be infected with Covid-19 being transmitted from humans!

As the Delta variant emerged and spread, some individuals who previously went unvaccinated sought vaccines when loved ones were infected, disabled, or died. But just as we seemed to be winning the fight against Delta, the virus pivoted to form the Omicron variant, which is more transmissible than Delta. A February 2022 Wall Street Journal explains that its “heightened transmissibility appears to be a combination of several properties, including its seeming ability to bind more easily to and break into human respiratory cells and replicate faster once within our bodies.” Omicron quickly overtook Delta as the dominant variant in the United States; in fact, as of  March 2022, the CDC reported that all new US COVID cases are caused by the Omicron variant. Unfortunately, some people who were infected and survived the Delta variant have also gotten ill with Omicron, demonstrating that previous infections, as many people thought, don’t necessarily provide immunity from new variants! Recent research from England reports that some individuals and families have been infected for a 3rd and 4th time with Covid. The CDC does not track 3rd or 4th infections and only lists them as re-infections. However, we know of at least one family in Columbia, SC with six members who were infected with Covid “three” different times! Fortunately, 217 million people have been fully vaccinated or 65% of the population according to the CDC.

The good news is that, although Omicron has caused “the highest reported numbers of COVID-19 cases and hospitalizations during the pandemic,” according to the CDC (just from the sheer numbers of people infected), “disease severity indicators, including length of stays, ICU admissions, and deaths, were lower than during previous pandemic peaks.” The bad news is that, because Omicron appears less deadly that Delta and other forms of COVID, some people aren’t taking it seriously thinking their being infected will just result in cold-like symptoms and discount that their infections could spread to others, especially seniors with underlining health conditions like diabetes. However, the fact of the matter is that over 2,500 Americans are dying from COVID daily! Those numbers don’t really matter to most Americans until it is someone you love or know.

Even individuals who aren’t hospitalized or killed by the coronavirus, these people who have no symptoms or even mild-moderate infections still run the risk of experiencing “Long COVID.” That’s when, four or more weeks after first being infected with COVID-19, an individual experiences health problems that can include: brain fog, memory losses, shortness of breath, fatigue, headache, joint or muscle pain, chest or stomach pain, cough, heart palpitations, diarrhea, fever, dizziness, loss of taste and smell, and more. The CDC notes that Long COVID can occur even if the person had mild to no symptoms when they had COVID! Based on multiple studies, especially the latest Denmark research of 185,000 individuals infected with Covid found that 30% experienced Long Covid.

We have interviewed individuals who have Long Covid a year later after being infected and it’s worrisome! In a study of 11 million veterans and other studies, the five most commonly Long COVID-19 symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%), which is also known as labored breathing. Other more severe long-term symptoms were related to the lungs such as coughing, chest discomfort, reduced ability for blood to take in oxygen, sleep apnea, and pulmonary fibrosis. The results show that COVID-19 can lead to “substantial burden of health loss” beyond the first 30 days of illness, according to the researchers. Notably, they found that the risk of all of these post-acute conditions existed even among patients whose infections did not warrant a hospital stay. However, patients who had severe acute COVID-19 infections were at a higher risk of Long Covid conditions. Some individuals also experienced cardiovascular symptoms like heart arrhythmias and inflammation, as well as neurological symptoms such as dementia, depression, anxiety, attention disorder, and obsessive-compulsive disorders.

Clearly, we are not out of the woods yet, and we all need to continue to practice safety measures to help us avoid contracting any of the existing or future COVID variants. The most important course of action is to get vaccinated. Unvaccinated adults are 5 times more likely to become infected and 50+ times the chance of dying from COVID than adults who are fully vaccinated, according to a January 2022 report from the CDC. Vaccinations also prevent those who contract the virus from getting severely ill: The Wall Street Journal reported in late January 2022 that persons who received both injections of a two-shot vaccine with a booster, had a 90% protection against hospitalization. Research has indicated that the Moderna vaccine may target better against Omicron, so if you have not yet been vaccinated or still need your booster shot, consider that option with your doctor’s input. Pfizer is currently working on a 4th booster vaccine that will protect specifically against the Omicron variant due out soon. The CDC and FDA are currently studying the research from other countries that have administered a 4th shot and some experts report we might need another booster in the Fall of 2022, while others are saying that a booster only provides a minimal increase in protection. Other good news is that companies are working on a nasal Covid vaccine nasal spray which might increase the number of individuals and children adverse to shots to take the vaccine through this new method. And Moderna is developing a dual Covid-Flu single shot. Novavax has asked the FDA to approve its Covid shot soon which, unlike the Pfizer and Moderna MRNA vaccines, the Novavax vaccine is based on an older, successful technology used for decades to inoculate babies against Hepatitis B and has fewer side effects. This should attract more people to take the Novavax shot who were against taking the other, rapidly developed MRNA vaccines.

Despite what you may see in some stores and restaurants, where disturbing numbers of people are now neglecting to wear them, it’s important to continue masking to keep the virus from entering your respiratory tract. (In fact, because these people may be sick without even knowing it and could expel the virus into the air through coughing, breathing, or talking, it’s particularly important that you wear your mask!) Invest in some quality N95 masks made by the 3M company or KN95 masks (Powecom brand on Amazon is a cost-effective option) rather than cloth or inexpensive surgical masks, which are less effective against Omicron, and rotate a new mask each day for 7 days. The best mask is the American-made N95 mask that screens about 95% of any virus but after researching 20 different mask versions, we have found the N95 masks are more difficult to put on with two rubber bands being assembled around our heads. So, we prefer the KN95 Powecom masks with ear connectors that provide near the same protection and are easy to quickly put on and take off.

When in public, you should also continue social distancing from others or avoid staying in close contact with another individual for more than 15 minutes. Avoid touching high-traffic surfaces like public doorknobs and gas pump handles if possible and sanitize your hands thoroughly afterward if you can’t avoid encountering them. And your smartphone needs daily sanitizing since whatever you touch, ends up on your cellphone. It’s the little things you can do to prevent the spread of the virus that only take seconds!

When the pandemic started, we were all advised to stay home as much as humanly possible. However, three years into the pandemic, we are realizing that isolating is not realistic—especially with no end to the virus in sight. For our own mental health, we need to exit our homes and occasionally see other people and even going to high-risk areas like grocery stores with safety precautions! Of course, it’s up to us to decide where to go, when, and how to prevent infection. Research has shown that some places and situations are safer in terms of risk of infection while others posed greater dangers.

Here are the top 10 riskiest places for being infected and spreading Covid-19, along with 42 “reasonable” but prudent suggestions in each category on how to mitigate risks. You don’t want to become obsessive-compulsive and fearful, but a little extra precaution can prevent your being infected.

Grocery Stores: In a recent United Kingdom study, Virus Watch calculated the COVID risk of performing a variety of activities outside the home. Surprisingly, going to the grocery store was the highest-risk activity they studied: people who went to the store once per week were over 2 times as likely to be infected with COVID than those who avoided shopping in person! What to do: Ideally, utilize grocery delivery services or curbside pickup (now offered by many stores) to avoid entering the store. We have tried this option multiple times and it works great unless you want to inspect your items in the store like fruit! If you must go in, however, wear your mask, and thoroughly sanitize your hands (i.e., grocery carts, credit card machines, etc.) upon entering, exiting, and returning home. We are not fearful of going into grocery stores and frequent them weekly but when you enter, avoid the crowds. Choose aisles where there is no one or a few people and hold your breath when you pass others without masks. If you bring your own canvas bags to shop, it’s a good practice to wash them after each trip to the store in case they have picked up germs.

Indoor Bars And Restaurants: They tend to be filled with maskless people—after all, it’s hard to eat and drink with your mouth covered! HVAC systems can pull in heated patrons’ breath and re-distributes throughout all the seating areas. When these places are crowded, they’re hotspots for virus transmission. Also, alcohol consumption tends to lower inhibitions, so people are more likely to slack off on safety measures like masking or hand sanitizing once they’ve had a few drinks. What to do: Weather permitting, visit restaurants where you can eat in outdoor settings which are becoming more popular. Call ahead to inquire or visit to observe about COVID safety measures are being implemented so that you can choose restaurants where servers wear masks, surfaces are regularly sanitized, and disposable (or scan-able) menus are used. If you eat inside, try to go at unpopular times to limit crowds and select a table or booth in a secluded area. Wear your mask until seated and bring hand sanitizer to use after viewing hard menus. We have learned that some restaurants have private rooms, tall booths, or plastic shield dividers between tables that provide some protection versus being seated in the middle of other crowded groups. We have decided we are not going to be prevented from living our normal lives but with caution. (Of course, takeout is still the best option but it is simply fun going out!)

Gatherings With Friends And Family: Most of us cherish the time we spend with our families (and friends) and want to enjoy holidays and other occasions together. However, one sick person can unintentionally spread the virus to everyone, which is especially dangerous if your family and friends include high-risk individuals like the elderly and the immunocompromised, which can result in a domino effect through hundreds of others. What to do: Whenever possible, meet with family and friends outside (thankfully, warmer weather is coming and the fewer individuals you invite the better) or ensure that they have been fully vaccinated. If you must gather indoors, make sure ventilation is as good as possible by cracking or opening doors and windows, using ceiling fans, and turning your home HVAC system fan to “ON” to circulate stagnant air. (For extra protection that also kills mold and other germs, consider having a UV light air purifier added to your home’s HVAC system!). Of course, if you are fearful about being around individuals and family who might be unvaccinated or possibly infected without symptoms, while not foolproof, ask all attendees to take rapid COVID tests the day of your gathering. It’s embarrassing to think about getting everyone tested and/or ensuring they are fully vaccinated. You can order 4 free tests per household at www.covidtests.gov. The most reliable fast home tests are made by Abbott called BinaxNow. Please note that fast home tests are reliable in detecting Covid (especially if you have symptoms) and you learn the results in 15 minutes. However, the PCR test, administered by most pharmacies, is the most sensitive to the virus, provides more accurate results, but takes several days to obtain results. If you have been exposed to Covid or have symptoms, we recommend both tests to ensure correct readings. Any fast tests that were shipped during cold weather can provide false-negative results. Additionally, there is a new, single test available that detects three health issues: Covid, flu, and respiratory Viruses (RSV) available at most pharmacies and physicians’ offices.

Sports Games And Concerts: People love the rush of attending athletic events and concerts in huge stadiums. But even though these events are technically outdoors, they still pack large numbers of people into contained spaces (especially bathrooms and lines for food and drink). What to do: Choose events where you can spread out…or purchase pay-per-view to watch sports and concerts from home. Wear a mask if you attend an event. I have learned to wear masks even though I would prefer not to!

Airports And Airplanes: Air travel security measures require that we stand in lines to go through metal detectors, have our tickets checked…and when the airport is crowded, people stand close together in lines and place their belongings into possible germ-infected bins and moving conveyor belts! Then, when you enter the airplane, you’re packed in like sardines. What to do: As you move through the airport, wear your mask properly as required by law and sanitize your hands after touching anything. If connection schedules permit, try to board and exit the plane last to avoid close contact with hundreds of people passing by your seat to their own or exit quickly if your seat is near the exit. (You may still, unfortunately, be seated next to a sick person (with or without symptoms) who may be wearing an inferior surgical mask or not properly with their nose sticking out of the mask). But the good news is that airplanes’ ventilation systems with HEPA filters are very good and will distribute fresh air from the outside. And the airlines are doing a better job at cleaning and sanitizing their planes. In some flights we were on, fresh air was not available until we were taxiing or airborne. If it is fiscally feasible, buy first-class tickets well in advance when prices are lower, where there is more distance between seats with higher volumes of outside air being pumped into the cabin. Other options are to select seats on an exit row or window seats on airplanes with 2-seat configurations (never sit in a middle seat). Before booking reservations, examine the type of airplane you will be traveling on for seating designs which can be viewed at www.seatguru.com or your airline app. Of course, double up on masks while on the airplane and bring sanitizer to wipe down your seat and tray table areas; then, turn on your air vents blowing air into your face while on the ground or airborne! We have flown several times since the pandemic surfaced and it’s doable! Be sure to sanitize “checked luggage” handles upon arrival at your destination since airport staff has placed their hands on them, along with hundreds of other pieces of luggage.

Automobiles: As small, tightly-enclosed spaces, cars can be great places for COVID to spread, especially if someone from outside your household is riding with you like friends and carpools! What to do: Enhance ventilation by turning off the feature that recirculates inside air through the car (it’s the button with an image of a car and a half circle), increase fan speed for outside air, and crack a window(s) to let in outside air. Although it may feel strange, if you are in a car with someone who does not live with you, it’s advisable to wear a mask! So, let them know in advance about your wearing a mask to avoid embarrassment and sometimes, to their relief.

Public Gyms: Exercise is good for us, but close contact with other people in enclosed, public spaces are not. Individuals who may not even know they are infected with coronavirus (or have mild-moderate symptoms thinking it’s just a cold or allergies) will visit gyms to perform intense workouts that have them breathing heavily, and invisible saliva droplets through breathing infected virus can linger in the air for hours. If equipment isn’t cleaned properly, sweaty germs from these people who touch their workout machines, cellphones, and faces can also linger for hours…or even days! What to do: Most gyms have rules about wiping down equipment after use (good luck on trusting others to follow them) but clean yours before and after use to be on the safe side. Try visiting public gyms during off-hours to avoid crowds or consider attending a private gym (Google “private personal fitness gym” plus your city/state location to find options). Private gyms usually cost more, but you’ll come into contact with fewer people…and receive tailored, one-on-one advice from a personal trainer! You can also briskly walk at the mall with a mask or walk-in stores with few people present, but better yet, exercise outside with a friend or relative. It’s important that you have natural sunlight exposure each day for 15-30 minutes to decrease your chances of depression or sadness. If you stay inside, you can use a natural light lamp to substitute sunlight which provides you with extra energy and improved moods. Go to Amazon.com and type in “Natural Light Device to Prevent Depression” which sells for about $50. It works!

Houses Of Worship: Religious services and events such as weddings and funerals bring groups of people together indoors and usually feature singing, handshaking, hugging, socializing up close (especially seniors who cannot hear well), and loud speaking, which can propel the virus into the air. Add in poor ventilation, and illness can spread quickly! What to do: In times when local infection numbers are high, watch live-streamed and television church services from the safety of your home. It’s not as spiritual as being present in service but it’s a safer option. If attending in person, try to sit in uncrowded areas, like the back of the room. Double up on masks: wear a high-quality, five-layer N-95 or KN95 mask closest to your face and cover it with a cheaper three-layer surgical mask for additional protection. When visiting high-risk areas, throw away the surgical mask after a single-use. Amazon sells these cheap, three-layer masks for about $10 for 50. However, these cheap surgical masks that many people wear, while they offer some minimal protection, have low resistance against Covid.

Hospitals, Dentists’, And Doctors’ Offices: Although they usually take many precautions to prevent the spread of illness, medical facilities are still risky because of the large numbers of sick people—and health professionals who come into contact with patients—that pass through them daily. What to do: If possible, try to avoid going to the hospital; for example, consider delaying any elective surgical procedures until COVID numbers decrease. Many doctors are now offering telephone or online Zoom appointments for regular check-ups, and drive-through clinics for the sick so select safer options whenever possible. For those, you must attend in person, call ahead to ensure that the office is practicing safety precautions. At the dental offices, for example, check to ensure that your dentist and hygienist are fully vaccinated and wear quality masks (not cheap surgical masks) and plastic face shields since they will be exhaling their breath (possibly infected after being exposed to many other patients) just inches from your face and nasal passages! Hygienists wearing masks, even the highest quality versions, alone are not foolproof in protecting you since no masks are 100% effective!

Nursing Homes And Older Populations: As we age, more Americans have relatives in nursing homes who they would like to visit. Unfortunately, the CDC has determined that nursing home residents are at a particularly high risk of contracting the coronavirus, as they live in a group environment and are assisted by workers who move from room to room with many, different patients…potentially bringing the virus with them. Based on our experiences with relatives in nursing homes, many of the workers are from lower-income families and often facilities do not provide these employees with leave so they may come to work sick and spread germs. In addition, older adults are at greater risk of hospitalization or death from the virus due to weakened immune systems and comorbidities. What to do: If they have not already done so, encourage loved ones who live in or visit nursing homes to get their vaccine and booster shots. This is especially important for older adults (65+), who tend to be more vulnerable to health issues and have a harder time recovering from Covid or other highly transmissible germs and viruses than younger age groups. The CDC reports that, in December 2021, “unvaccinated adults ages 65 years and older were 50 times more likely to be hospitalized for COVID-19 than people in that age group who were up to date with their COVID-19 vaccines.” When you visit, mask up, and be sure to sanitize your hands and surfaces you come into contact with as you would in other high-traffic areas. If possible, visit with loved ones and friends outdoors or in private waiting areas.

The Bottom Line: Unfortunately, COVID-19 is a highly adaptable, smart virus that can mutate into new variants in an attempt to overcome our defenses. The more people infected, the increased chances the virus grows, evolves and mutates so we all need to band together to lower infection rates. As tired as we all are of wearing masks, avoiding large groups, socially distancing, being fully vaccinated with boosters, and changing our lifestyles, it’s worth protecting ourselves and others from potential death or serious illness…and to put an end to this evil virus! You can click here for other articles on Covid-19, masks, vaccines, and safety precautions to prevent the virus. Never live your life in fear about Covid but rather respect the virus and the ravages which can impact your body and mind for many years into the future! And, most important, remember all it takes is one person to infect you! Be safe and not sorry!

Mike DuBose has been an instructor for USC’s graduate school since 1985 when he began his family of companies. He is a contributing guest author for Midland's Biz and is the author of The Art of Building a Great Business. Please visit our blog for additional published business, travel, and personal articles, as well as health articles written with Surb Guram, MD.

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