Coronavirus FAQ: Are we in a surge? How do you cope if your whole family catches it?

BY Max Barnhart

We regularly answer frequently asked questions about life in the era of COVID-19. If you have a question you'd like us to consider for a future post, email us at goatsandsoda@npr.org with the subject line: "Coronavirus Questions." See an archive of our FAQs here.

New year, new COVID surge – or at least that's what it feels like.

It seems like everyone I've talked to either caught COVID over the holidays or knows someone who did.

With that in mind, I decided finally to get my COVID booster (it had been about 8 months since my last dose) and flu shot.

So while sitting in bed, popping ibuprofen to deal with the post-vaccine aches and chills (pretty mild this time around, thankfully), I reached out to some experts to get the scoop on readers' latest COVID questions.

Are we really in a surge? Is this what we can expect every winter? What should I do if my whole family gets COVID? Read on for those answers and more.

Is a surge of COVID happening? With lots of folks taking at-home tests and not reporting the results, how do we know the data that's out there is accurate?

"The most reliable data shows that a surge is happening," says Jeremy Kamil, a virologist at Louisiana State University Health Shreveport.

Testing data may not be as reliable as it was a few years ago before home tests became widespread, but there are other metrics to estimate the amount of COVID circulating. For one, hospitalizations and deaths due to COVID are both up. About 5,000 people in the U.S. are being hospitalized per week, up from under 1,000 per week at the last low point in June. The weekly death toll has tripled since that point too, from around 500 a week to more than 1,600. That's got hospitals from Mass General to Johns Hopkins Medicine reinstating universal masking requirements and other precautionary measures. Abroad, governments in India, Spain and elsewhere are bringing back masks in health-care facilities.

But the clearest picture showing how much COVID is circulating among people who don't end up in the hospital (or worse) may be in the sewage.

Kamil says that wastewater surveillance "is an imperfect but highly reliable tool to show that COVID is on the uptick" over the past few months. In places like Boston, wastewater data showed COVID peaking right before the new year. And even though the wastewater data and hospital data are showing a slight dip since that latest peak, there's still plenty of COVID to go around.

Is COVID just the new flu? I've been vaccinated and had COVID in the past, why is this still a big deal?

After the last few years of crisis, it's understandable that many folks are sick of hearing about COVID. "It's four years now [since COVID first emerged], and we're starting the fifth year," says Dr. Preeti Malani, an infectious disease physician at the University of Michigan. "That's hard to believe."

But that doesn't mean we can let up on precautions entirely. The number of cases right now may be fewer than in past surges, but "relatively speaking, it's a lot," according to Dr. Abraar Karan, an infectious disease physician at Stanford, who authored our most recent coronavirus FAQ answering the question: "My partner/roommate/kid got COVID. And I didn't. How come?"

We should also be careful about underplaying the flu. Influenza has a devastating impact on people year after year, even if we don't always hear much about it. Still, the number of deaths from the flu don't come close to that of COVID: The CDC reports there have been roughly 9,500 deaths from the flu this season and approximately 34,000 deaths from COVID in the last three months.

Not everybody shares the same level of risk, of course. But while Kamil says COVID is most dangerous for elderly and immunocompromised people, he also stresses that COVID is a disease that specializes in "making healthy people sick."

Which is why even if you're young and healthy, you should consider getting a booster shot. "Boosters are really important," Kamil says. "If more Americans got them they would be avoiding the very worst that this virus can serve."

So does the uptick in COVID cases we're seeing now mean that this coronavirus is basically a seasonal disease and will surge around this time every year?

It's reasonable to think that COVID is just another bug joining our wintery mix of sicknesses. But experts stress that, unlike the flu, it's not mainly a seasonal problem.

"We had an increase [of COVID cases] in the late summer," says Dr. Karan. "So it's not exactly the same as the flu or RSV in that way." Part of the reason COVID can pop up any time of year is because of how quickly new strains can emerge and break through our immunity. The strain currently circulating most widely in the U.S. is called JN.1, and experts say it's highly transmissible.

The spread of JN.1 is helped, in no small part, by the fact that more people have been gathering indoors because of colder weather and holiday and other celebrations.

Dr. Malani expects her community to see an uptick in COVID cases for that reason. "'I'm in Ann Arbor, Michigan, where we won the [College Football Playoff National] Championship," she says. "There was a lot of indoor activity on Monday night in this town. A lot of people were packed into bars or people's living rooms, so we'll probably see some of that effect in a few days."

So even though COVID is likely to be a year-round concern, it does seem to gain strength around holidays and other big events. As Dr. Kamil puts it, "COVID has joined the team of critters that are going to be attending your Christmas party, your Thanksgiving gathering and any other kind [of gathering]."

What happens if you were celebrating with your family, and now everybody has COVID? Does each family member have to isolate from one another?

If your whole family gets COVID, our experts say, there's no need to make things harder on yourselves.

"Getting more exposed from the other individuals in your house isn't going to prolong your COVID," Kamil says. All isolating will do in that case, he says, is "cause you inconvenience and additional misery on top of feeling tired and ill."

Isolating is tough to do, especially if you have to separate from your partner and children. "Loneliness is an issue," Dr. Malani says. "If you can't do a lot of things and you don't feel well, at least be together."

That being said, we do need to reiterate some obvious advice: Don't hang out with members of your family who aren't sick or testing positive.

But if you've all been bitten by the bug, go ahead: Binge TV and eat meals with the rest of your sick family. Our experts are unanimous that there's nothing to fear from hanging out together if you're all infected.

Max Barnhart is a Ph.D. candidate and science journalist studying the evolution of heat-stress resistance in sunflowers at the University of Georgia.