Disclaimer: I’m going to be really honest right now. I just ran out of steam on this. I had been working on this post for many hours over the past week, and it’s just so hard to be doing this kind of research and synthesis work when everything is so confusing and, more so, when most people don’t seem to care.

So, I feel bad that I haven’t finished properly sourcing, citing, and triple-checking every single fact I share below. But here’s what feels true to me right now: A big part of me wants to just let this draft sit on my computer abandoned, but it feels better to put it out there unfinished. Even if it’s not up to my usual standards, I’ve put so many hours into this that you might as well see what I managed to come up with in that time 🙂

I’ve also been thinking that there are probably more effective techniques than the kind of “you probably don’t realize just how dangerous all this is, so let me give you some scary numbers” vibe in this post. I had imagined trying a different approach this time with more jokes or some other way of engaging you. But I find that in this moment I just don’t have the energy to go back through this post again and make it more like that. Sorry.

Disclaimer 2: As always, I’m not a medical professional. I just read a lot of different articles and synthesize the information as best I can from the most reputable sources.

You’re sick of COVID. I’m sick of COVID. And even more than that, I’m sick of how hard it is to find clear, accurate information on COVID.

Pretty much every conversation I’ve had with people about COVID lately touches on one or all of these:

• “This is all just too much. It’s never going to end. I’m giving up. I’ve been good for two years now, but I can’t keep this up. I’ve decided to just relax and stop taking this so seriously. If I get COVID, oh well.”
• “Omicron isn’t so bad—it’s just like getting a cold. My whole family got it over the holidays and they were all fine. No big deal.”
• “I have no idea who to trust anymore. Every article is saying something different. All those memes about the CDC aren’t so farfetched. I’ve just stopped following the news around COVID.”

I get it. 

And, I’m the kind of person who refuses to accept that there aren’t answers out there. So I’ve kept digging.

Part 1: What you should know about exposure and testing:

• Here’s some of the clearest guidance I’ve seen:
  • If you were exposed to someone who tested positive: “If you’re not boosted, you should quarantine for five days and continue to wear a mask around others for five more days after that… If you are boosted, then you don’t need to quarantine, according to the CDC guidelines. But you should still wear a mask around others for 10 days after the exposure. And yes, ‘wear a mask around others’ includes others in your home — like children or roommates — if possible.”
  • “Testing negative doesn’t mean you can go mask-free [because “antigen tests do detect the omicron variant but may have reduced sensitivity”]. You should still mask around others in public until it’s been 10 days since the exposure. Even with a negative test, if you have exposure and symptoms, it’s best to assume you are Covid-positive and act as such.“
  • In short, rapid tests are reliable for confirming positive cases (i.e., if it’s a positive result, it’s probably true), but they’re not as reliable for negative results (i.e., it might be wrong and you might still have COVID). Yes, this is really frustrating 😒.
• If you’re exposed to someone with COVID, you probably won’t test positive on an at-home test for 3-5 days. So, if you think you might have been exposed and it hasn’t been that long yet, the ethical thing to do is wear a mask or stay away from people if you can until testing at the 5-day mark.
• PCR tests can return accurate results a day or two faster, but appointments are very hard to find right now.
• If you use an at-home test, you should probably swab your throat too. Experts are divided on this, but I haven’t seen anyone explain a realistic downside to this, and many authorities outside the US (e.g., the Israel Health Ministry) do believe it helps. An instructor at Stanford University’s Institute for Stem Cell Biology suggests people “swab not only their nose but their cheeks, the roof of their mouth, under their tongue and — if they don’t gag easily — their throat near the tonsils.” The idea here is to swab your throat first and then put the same swab in your nose to make the usual circles in each nostril according to the test instructions.
• Some good news is that a study released in January shows that 90% of COVID particles in the air dissipate in 20 minutes, and most of those within 5 minutes. So, we don’t have to be quite as worried if someone else was in an indoor space before us but left 5-20 minutes ago.

Part 2: Risks of Omicron (i.e., why I think you should not dismiss it as “mild, just like a cold”):

After 10+ hours of research over the past few days, I’ll summarize things this way:

1. Yes, Omicron is probably milder for most people. If you’re vaccinated, you almost certainly won’t be hospitalized or die. 
   1. But, it’s only milder for most people, not all. Some people still have it very bad, and you might not know if this is you until you get it.
2. Yes, it’s “milder” compared to Delta, which was a lot worse than the earlier strains. So yes, you probably won’t end up in the hospital, but there’s also a good chance you’re still going to feel pretty terrible.
   1. And, even if you get a milder case, you might spread it to other people whose cases will not be mild. They might have to miss work, which can be devastating to everyone if they’re in a role that a lot of other people rely on (e.g., a teacher, a pilot, a nurse, etc.) or if they’re part of a marginalized community and can’t afford to miss work or they have a job that doesn’t offer sick leave.
3. Long COVID is terrifying to me. If you get COVID, the data from past strains shows that you have a 1 in 3 chance of Long COVID (i.e., symptoms lasting months or potentially never going away). This includes some scary symptoms like permanent brain or heart damage.
4. Omicron has only existed a little more than a month, so we simply don’t know yet how much it might reduce the chances of Long COVID. 
   1. One factor here is that a lot of the initial data came from South Africa, which has a younger population (a median age of 10 years younger than the US), so it might end up being less mild on the different demographics in the United States.
   2. From Fauci: “Long Covid can happen no matter what virus variant occurs. There’s no evidence that there’s any difference between Delta or Beta or now Omicron.”
5. Anyone confidently telling you that Long COVID is unlikely because Omicron is milder is simply wrong. We don’t have the data yet to know either way. So, I invite you to read the facts below and decide for yourself if you’re willing to risk it until we know more.
6. A new study found that people wearing protective masks are perceived as more attractive 😆.

Ok, we know that most vaccinated people aren’t going to be hospitalized or die from Omicron. Is it still a big deal?

In my mind, these are the two questions that each of us needs to be asking ourselves right now: 

First: If you’re considering doing something risky (e.g., an indoor maskless party), is it worth the risk of potentially spreading COVID and putting a greater strain on our hospitals and essential workers? Again, even if you are not hospitalized, you might spread it to others who will need to be.

From The Atlantic: “‘The staffing crisis is the worst it has been through the pandemic.’ This is why any comparisons between past and present hospitalization numbers are misleading: January 2021’s numbers would crush January 2022’s system because the workforce has been so diminished. Some institutions are now being overwhelmed by a fraction of their earlier patient loads. ‘I hope no one you know or love gets COVID or needs an emergency room right now, because there’s no room,’ Janelle Thomas, an ICU nurse in Maryland, told me.”

Second: Given that we’re still not sure how likely Long COVID is from Omicron, are you willing to risk getting symptoms that might last months? Or, should you be extra safe for another month or two until we know more?

To answer that question for yourself, you need to better understand what we know about Long COVID based on millions of data points:

“Long COVID” is terrifying. 

Again, we simply don’t yet know this will be different for Omicron versus Delta. It’s very likely that the following numbers won’t be quite as bad with Omicron. But, given how scary these symptoms are, how much of a chance are you willing to take?

Based on studies in scientific journals like Nature (sources below), the average person who gets COVID (even a “mild” case) has a…

• 1 in 3 chance (30%) of developing sensorimotor issues (e.g., tremors, tingling, skin burning)
• 1 in 3.5 chance (28%) of developing cognitive dysfunction (e.g., brain fog, difficulty thinking, forgetting how to do normal routines)
• 1 in 4 chance (24%) of developing memory loss
• 1 in 20 chance (5%) of developing sexual dysfunction in men
• 1 in 25 chance (4%) of developing suicidality

…lasting 3 months or longer.

(Regarding those percentages: It’s very difficult to find all this kind of data in one place, so I had to piece together multiple sources. Basically, I took the “1 in 3” chance of Long COVID from here and multiplied it by the percentages here.)

Still not concerned enough to take action?

From the above studies:

• There was no difference on any of that with age—the symptoms happened as often in the 18-29 year old group as the 70+ group.
• Cognitive impairment and fatigue from Long COVID do NOT seem to improve over time—the rates of both symptoms were the same before and after 6 months.
• There was no difference in Long COVID symptoms between people who were hospitalized and not. In other words, even if you experienced a “mild” case and were not hospitalized, you’re just as likely to experience Long COVID symptoms.
• You might think you’re fine for a while, but some symptoms (e.g., bone ache/burning, tinnitus) only appeared 6 months after the initial diagnosis.
• Even being vaccinated only has little effect on Long COVID symptoms. At worst, they’re no different. At best, they’re only half as likely.
  • But, the vaccine can prevent you from getting COVID at all, including Long COVID. And, it dramatically reduces your chance of being hospitalized or dying.
• From the Mayo Clinic: “A study of patients ill 6 months after mild or moderate acute COVID-19 found that about half met criteria for ME/CFS [myalgic encephalomyelitis].”
  Here’s what a writer shared about what ME/CFS is like: “…I’d been a strategy consultant for tech startups for years. Suddenly, I was too sick to work full-time. I went from being an avid salsa dancer to needing a wheelchair to walk more than a block. I went from being healthy to disabled in the blink of an eye.” (Source)

So what can you do?

• Don’t get COVID and you won’t have to worry about all those symptoms. I say that flippantly, but what I mean is: Take it seriously. Omicron is not “mild” since it can still most likely lead to Long COVID.
  • So, get vaccinated and boosted. It might not change those above symptoms of Long COVID, but you can’t have Long COVID if you don’t get COVID at all. 
  • The vaccines reduce your risk of getting COVID by 90% (and by 30-40% for Omicron). That goes up to 70-75% for Omicron if you have the booster as well.
• Hang out with your friends outdoors.
• Always wear masks when indoors outside your home.
• You really need a high-quality mask at this point: N95, KN95, or KF94. Other masks are not effective enough against Omicron (a recent study showed that N95’s are 75x more effective at preventing infection).
  • Get these masks (I received mine much sooner than Amazon’s far-away delivery estimate), or check here. P.S. Important bonus: You get to cosplay as a duck 😆😅🦆:
     

More to potentially incorporate:

• https://www.nytimes.com/article/omicron-coronavirus-variant.html
  • “Can vaccines reduce the severity of Covid? Yes. In a large study of more than a million cases of Covid, British researchers found that people who had received booster doses were 81 percent less likely to be admitted to the hospital, compared with unvaccinated people. The risk of being admitted to a hospital for Omicron cases was 65 percent lower for those who had received two doses of a vaccine.”
• https://www.nbcnews.com/health/health-news/long-covid-patients-are-terrified-omicron-rcna9797
  • “Omicron’s apparent propensity to cause less serious illness may provide a false sense of security, said Dr. Greg Vanichkachorn, medical director of the Mayo Clinic’s Covid-19 Activity Rehabilitation Program in Rochester, Minnesota… ‘Over three-quarters of our patients had very mild illnesses and then went on to develop long-haul Covid,’ he said.”
• From June 2021 (https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/A%20Detailed%20Study%20of%20Patients%20with%20Long-Haul%20COVID–An%20Analysis%20of%20Private%20Healthcare%20Claims–A%20FAIR%20Health%20White%20Paper.pdf):
  • “Using longitudinal data from a database of over 34 billion private healthcare claim records, FAIR Health studied a total of 1,959,982 COVID-19 patients for the prevalence of post-COVID conditions 30 days or more after their initial diagnosis with COVID-19. To FAIR Health’s knowledge, this is the largest population of COVID-19 patients so far studied for post-COVID conditions.”
    
    • Of patients who had COVID-19, 23.2 percent had at least one post-COVID condition.
    • of patients who were asymptomatic, 19 percent.
• From January 4, 2022 (https://www.infectioncontroltoday.com/view/even-mild-covid-19-can-make-you-the-sickest-you-ve-ever-been)
  • “Much of the abandonment of public health measures has been spurred by a massive disinformation campaign which has successfully convinced a relatively large portion of our population that as long as one lives through COVID-19 all will be well. The young and healthy have especially embraced this narrative. A narrative which offers false hope for the following reasons:”
  • “First, the premise that mild infections do not carry significant risks is false. In part this belief is driven by those who have not died from COVID-19 being counted as “recovered” as opposed to “survived.” SARS-CoV-2 causes a system infection and is commonly detected in the heart and brain, exemplified by the loss of smell from brain tissue destruction and loss of cardiac function from myocarditis. Even those who develop “mild” COVID-19 can develop long COVID-19 which in many cases lasts for a year or longer.”
  • “…Finally, even “mild” disease can cripple a nation. For all too many, their encounter with “mild” COVID will result in the sickest they have ever been.“
• From Dr. Lee (https://www.thedenverchannel.com/news/national/omicron-variant-raises-questions-about-long-haul-impact):
  • “So, it’s not clear what percentage of people who’ve been infected with the omicron variant will develop these persistent long COVID symptoms versus other variants… It is something that, for omicron cases, might not become clearer until the spring.”
• From Fauci (https://www.business-standard.com/article/current-affairs/no-plausible-reason-for-long-covid-to-be-less-with-omicron-experts-122010701173_1.html):
  • “Long Covid can happen no matter what virus variant occurs. There’s no evidence that there’s any difference between Delta or Beta or now Omicron… We should always be aware that when people get symptomatic infection – anywhere from 10 to up to 30 plus percent of people will go on to have persistence of symptoms… even mild cases are included in that possibility.”
• https://newrepublic.com/article/164972/omicron-really-milder
  • “Severity is also relative. Omicron may be less severe than delta—but delta was more severe than previous variants, recent research shows. It’s possible, for someone who is not vaccinated or hasn’t encountered Covid before, that omicron will be just as severe as the virus that wrought devastation throughout 2020.”
• https://www.reuters.com/business/healthcare-pharmaceuticals/long-covid-risk-no-lower-with-breakthrough-infection-covid-19-survival-improves-2021-11-24/
  • “COVID-19 vaccines are highly effective in protecting against serious illness, but they do not protect against “long COVID” in people who become infected despite vaccination, new data show. For six months, researchers tracked 9,479 vaccinated individuals diagnosed with COVID-19 and about the same number of infected patients who had not been vaccinated. Compared to the unvaccinated patients, people with so-called breakthrough infections were “at a much lower risk of severe complications of COVID-19” such as the need to be admitted to an intensive care unit, requiring breathing assistance, or developing a blood clot in their legs or lungs, said Maxime Taquet of the University of Oxford. But other complications of the virus, including the syndrome of lingering symptoms known as long COVID, occurred at similar rates regardless of vaccination status, his team said in a paper posted on medRxiv ahead of peer review.”
• Debunking the idea viruses evolve to become less virulent (https://www.reddit.com/r/Coronavirus/comments/s2yhiw/debunking_the_idea_viruses_evolve_to_become_less/ and https://apnews.com/article/fact-checking-011488089270):
  • *Simple and elegant, Smith’s theory was that to ensure their own survival, pathogens evolve to stop killing their human hosts. Instead, they create only a mild infection, allowing people to walk around, spreading the virus further afield. Good for the virus, and, arguably, good for us… But over the past 100 years, virologists have learned that virus evolution is more chaotic. Virus evolution is a game of chance, and less about grand design… In some cases, viruses evolve to become more virulent.”
    
    “People who are vaccinated or recently infected will have milder symptoms if they experience a breakthrough infection or a reinfection, studies show. “This is not because the variant is less virulent, but because your immune system was primed from prior vaccination and infection,” said Pekosz.”
    
    “People who are unvaccinated remain significantly more at-risk, with officials estimating they are 17 times more likely to be hospitalized and 20 times more likely to die of COVID-19 compared to people who are vaccinated.”
  • A post on Facebook reads, “In the history of virology, there has never, EVER, been a viral mutation that resulted in a virus that was MORE lethal. As viruses mutate, they become more contagious/transmissible and LESS lethal.” But in fact, there have been cases of viruses that mutated to become more deadly.

    “That claim as a whole is just nonsense,” said Troy Day, a professor of mathematics and biology at Queen’s University in Canada, who has studied the ways infectious diseases, including coronavirus, can evolve.

    Some examples of viruses that became more deadly over time include those that developed drug resistant variants, and animal viruses such as bird flu, which were harmless to humans initially but then mutated to become capable of killing people, according to Dr. Amesh Adalja, a senior scholar at Johns Hopkins University’s Center for Health Security.

    “Flu viruses have developed resistance to certain antivirals that make them more difficult to treat, and therefore make them more deadly,” Adalja said, also noting the same has happened with HIV and certain Hepatitis C strains.