The highly transmissible omicron subvariant BA.5 represents at least 65% of new COVID-19 infections in the United States, according to the US Centers for Disease Control and Prevention. Infections are rising in most parts of the country, and these numbers are almost certainly an undercount, given how many people are determining their status through home tests that are not reported.At the same time, many people have lots of summer events planned, including weddings, birthday celebrations and casual get-togethers. What should event organizers keep in mind? How can people think about their own risk in deciding whether to attend and what precautions to follow? What if you have to attend something — for example a work function — but really don't want to bring COVID back to your family? And what about people who have already recovered from an infection — do they still have to worry about reinfection and the risks of illness, including long COVID?Video above: BA.5 variant leads U.S. cases and sparks concerns about contagiousnessCNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health helped answer these questions. She is also the author of "Lifelines: A Doctor's Journey in the Fight for Public Health."Why is BA.5 a concern right now? Dr. Leana Wen: BA.5 is now the dominant variant here in the United States and in many parts of the world. It appears to be the most transmissible variant yet. It also may be partially immune-evasive, meaning that people who have gotten their vaccinations or who have previously had COVID-19 may not have much protection against mild or asymptomatic infection.However, vaccination does protect against severe illness. People who are unvaccinated should get vaccinated, and those not yet boosted should do so. Being up to date on vaccines will help to protect you from the potentially severe consequences due to COVID-19, which ultimately is the goal of vaccination.The reason it's a concern now is that there are high levels in many parts of the country. In areas with a lot of circulating virus, with such a transmissible pathogen, one's chances of catching COVID-19 are high.Does that mean people should cancel in-person events?Wen: After two and a half years of the pandemic, I don't think it's reasonable to ask that people continue to forgo weddings, birthday parties and other get-togethers. A lot of people have decided that as long as they are unlikely to become severely ill from COVID-19, they will not take precautions to avoid it.On the other hand, a lot of people still really want to avoid COVID-19. Event organizers should take into account the wishes of those gathering.What are some things people can do if they are organizing a get-together?Wen: First is recognizing that any time people are gathering, especially indoors, there will be a risk of coronavirus transmission. This is especially true with a very contagious virus, and when there is so much virus around us. It's not realistic to set the expectation that no one could get coronavirus at the event, though you should try to reduce risk.Some ways to do that include, first and foremost, trying to have the gathering outdoors. We have said this throughout the pandemic, and it remains true now that outdoors is much safer than indoors. Coronavirus is airborne, and the more air circulation you have, the better.Ventilation also matters. A partial indoor/outdoor space where there is good air circulation will be better than one that's entirely enclosed. And one with open windows and doors and lots of spacing will be lower risk than a small, enclosed room with everyone crowded together.Video above: Doctor talks about omicron BA.5 variantIf organizers want to reduce risk further, they could ask that everyone take a home rapid test just prior to the event. Rapid tests aren't perfect, but they are very good at detecting if someone has enough virus at that point in time that they could infect others. Providing testing at the door is an additional safeguard, in case not everyone has access to testing beforehand.Of course, masks can also reduce virus transmission. At this point in the pandemic, it may be difficult to get people to keep masks on when most places no longer require them. I think it's more realistic to plan for an outdoor event, and, if it has to be indoors, to ask for testing instead of required masks (though masks should, of course, be an option for those who want additional protection).What's your advice for immunocompromised individuals or folks who just really want to avoid contracting COVID-19?Wen: When you are invited to an event, find out what precautions the organizer is taking and then gauge risks accordingly. An outdoor event, or at least one where you could stay outdoors the entire time, is quite low risk. An indoor event that requires either testing or masks is also lower risk.What about crowded indoor events that don't require testing and masks? One-way masking with a high-quality mask — N95 or equivalent — remains protective, but your mask must be well fitting and you must keep it on the entire time. If you go, consider eating beforehand and taking off your mask only when outdoors or in a place where you are by yourself.At the end of the day, there is no clear answer to whether you should go — it depends on how much you want to avoid Covid-19 versus the benefit you would derive from attending.If someone has had COVID-19, do they need to worry about reinfection? What do we know about the risk of long COVID with reinfection?Wen: Reinfection is certainly possible. Those who had pre-omicron variants like delta or alpha are susceptible to reinfection with omicron subvariants. We are even seeing reinfections with people who had the original omicron variant and are now getting BA.5.The chance of reinfection within the first two or three months following the initial infection is pretty low but increases after that. People previously infected benefit from vaccination and boosting, which further decreases their chance of both severe illness and infection.There is a new study, posted online but not yet peer-reviewed, that shows those with reinfection are at higher risk for long COVID and other potential consequences with each infection. These results could well prompt some people to say they want to avoid reinfection as much as possible.A lot of people are having to travel for conferences, meetings and other work functions. What's your advice if they don't want to bring COVID-19 back to their families?Wen: There are two options. One is to try to reduce their risk while traveling and at these functions as much as possible, including limiting time indoors with others, masking during all indoor interactions, and avoiding indoor events with food and drink -- or at least keeping a mask on during these functions and eating and drinking separately elsewhere.The second option is to assume that you will be exposed and could contract COVID-19 during these work functions, then quarantine yourself and test before interacting with family members. Not everyone is able to do this — perhaps they have young children or other family responsibilities — but that is another option that may be right for some people.
The highly transmissible omicron subvariant BA.5 represents at least 65% of new COVID-19 infections in the United States, according to the US Centers for Disease Control and Prevention.
Infections are rising in most parts of the country, and these numbers are almost certainly an undercount, given how many people are determining their status through home tests that are not reported.
At the same time, many people have lots of summer events planned, including weddings, birthday celebrations and casual get-togethers. What should event organizers keep in mind? How can people think about their own risk in deciding whether to attend and what precautions to follow? What if you have to attend something — for example a work function — but really don't want to bring COVID back to your family? And what about people who have already recovered from an infection — do they still have to worry about reinfection and the risks of illness, including long COVID?
Video above: BA.5 variant leads U.S. cases and sparks concerns about contagiousness
CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health helped answer these questions. She is also the author of "Lifelines: A Doctor's Journey in the Fight for Public Health."
Why is BA.5 a concern right now?
Dr. Leana Wen: BA.5 is now the dominant variant here in the United States and in many parts of the world. It appears to be the most transmissible variant yet. It also may be partially immune-evasive, meaning that people who have gotten their vaccinations or who have previously had COVID-19 may not have much protection against mild or asymptomatic infection.
However, vaccination does protect against severe illness. People who are unvaccinated should get vaccinated, and those not yet boosted should do so. Being up to date on vaccines will help to protect you from the potentially severe consequences due to COVID-19, which ultimately is the goal of vaccination.
The reason it's a concern now is that there are high levels in many parts of the country. In areas with a lot of circulating virus, with such a transmissible pathogen, one's chances of catching COVID-19 are high.
Does that mean people should cancel in-person events?
Wen: After two and a half years of the pandemic, I don't think it's reasonable to ask that people continue to forgo weddings, birthday parties and other get-togethers. A lot of people have decided that as long as they are unlikely to become severely ill from COVID-19, they will not take precautions to avoid it.
On the other hand, a lot of people still really want to avoid COVID-19. Event organizers should take into account the wishes of those gathering.
What are some things people can do if they are organizing a get-together?
Wen: First is recognizing that any time people are gathering, especially indoors, there will be a risk of coronavirus transmission. This is especially true with a very contagious virus, and when there is so much virus around us. It's not realistic to set the expectation that no one could get coronavirus at the event, though you should try to reduce risk.
Some ways to do that include, first and foremost, trying to have the gathering outdoors. We have said this throughout the pandemic, and it remains true now that outdoors is much safer than indoors. Coronavirus is airborne, and the more air circulation you have, the better.
Ventilation also matters. A partial indoor/outdoor space where there is good air circulation will be better than one that's entirely enclosed. And one with open windows and doors and lots of spacing will be lower risk than a small, enclosed room with everyone crowded together.
Video above: Doctor talks about omicron BA.5 variant
If organizers want to reduce risk further, they could ask that everyone take a home rapid test just prior to the event. Rapid tests aren't perfect, but they are very good at detecting if someone has enough virus at that point in time that they could infect others. Providing testing at the door is an additional safeguard, in case not everyone has access to testing beforehand.
Of course, masks can also reduce virus transmission. At this point in the pandemic, it may be difficult to get people to keep masks on when most places no longer require them. I think it's more realistic to plan for an outdoor event, and, if it has to be indoors, to ask for testing instead of required masks (though masks should, of course, be an option for those who want additional protection).
What's your advice for immunocompromised individuals or folks who just really want to avoid contracting COVID-19?
Wen: When you are invited to an event, find out what precautions the organizer is taking and then gauge risks accordingly. An outdoor event, or at least one where you could stay outdoors the entire time, is quite low risk. An indoor event that requires either testing or masks is also lower risk.
What about crowded indoor events that don't require testing and masks? One-way masking with a high-quality mask — N95 or equivalent — remains protective, but your mask must be well fitting and you must keep it on the entire time. If you go, consider eating beforehand and taking off your mask only when outdoors or in a place where you are by yourself.
At the end of the day, there is no clear answer to whether you should go — it depends on how much you want to avoid Covid-19 versus the benefit you would derive from attending.
If someone has had COVID-19, do they need to worry about reinfection? What do we know about the risk of long COVID with reinfection?
Wen: Reinfection is certainly possible. Those who had pre-omicron variants like delta or alpha are susceptible to reinfection with omicron subvariants. We are even seeing reinfections with people who had the original omicron variant and are now getting BA.5.
The chance of reinfection within the first two or three months following the initial infection is pretty low but increases after that. People previously infected benefit from vaccination and boosting, which further decreases their chance of both severe illness and infection.
There is a new study, posted online but not yet peer-reviewed, that shows those with reinfection are at higher risk for long COVID and other potential consequences with each infection. These results could well prompt some people to say they want to avoid reinfection as much as possible.
A lot of people are having to travel for conferences, meetings and other work functions. What's your advice if they don't want to bring COVID-19 back to their families?
Wen: There are two options. One is to try to reduce their risk while traveling and at these functions as much as possible, including limiting time indoors with others, masking during all indoor interactions, and avoiding indoor events with food and drink -- or at least keeping a mask on during these functions and eating and drinking separately elsewhere.
The second option is to assume that you will be exposed and could contract COVID-19 during these work functions, then quarantine yourself and test before interacting with family members. Not everyone is able to do this — perhaps they have young children or other family responsibilities — but that is another option that may be right for some people.
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