Surviving this year's cold, flu, and Covid-19 season

Plus: A new reason behind rising rents, the golden age of Beetlejuice, and more. September 9, 2024 [View in browser]( [Keren Landman]( is a senior reporter covering public health, emerging infectious diseases and more at Vox. She trained as a physician, researcher, and epidemiologist with specialties in internal medicine, pediatrics, and infectious diseases. [Keren Landman]( is a senior reporter covering public health, emerging infectious diseases and more at Vox. She trained as a physician, researcher, and epidemiologist with specialties in internal medicine, pediatrics, and infectious diseases.   A practical guide to staying healthy this virus season [A researcher works in the lab at the Moderna Inc. headquarters in Cambridge, Massachusetts, US, on Tuesday, March 26, 2024. Moderna has a forthcoming RSV shot,] Bloomberg The baddies of respiratory viral season are at your doorstep: The US is currently in the midst of a [large uptick in Covid-19 cases](, and flu and RSV season is just a few months away. “Respiratory infections are actually inevitable,” says [Shira Doron](, an infectious disease doctor and hospital epidemiologist at Tufts Medical Center in Boston. But you can minimize respiratory viruses’ effects on your life. Here’s how to think about this year’s cold, flu, and ongoing Covid-19 season, how to keep yourself healthy and safe, and how to be strategic about testing, vaccines, and medications. Should I treat Covid like the flu? Or like the common cold? The further we get from the OG Covid of 2020, the less likely it is that infections will translate into hospitalizations, deaths, or long-term disability. That doesn’t mean the virus doesn’t carry risk. Last season, Covid-19 caused[more hospitalizations]( than flu and RSV combined, and it does still carry the risk of persistent symptoms — also called [long Covid](. However, with each successive wave of Covid, a [smaller proportion]( of infected people, especially those who are vaccinated, are hospitalized, die, or get long Covid. That suggests the virus is less likely to cause severe illness, especially in low-risk people. One important question when thinking about Covid risk remains: “Who are you?” says [William Schaffner](, an infectious disease specialist at Vanderbilt University Medical Center in Nashville. Older, immunocompromised, pregnant, and frail people still “ought to be clearly more concerned,” he says, because the consequences of an infection are worse for them than for others. Should I be testing for Covid-19 or flu if I get sick? The main reason to get tested if you’re sick is to determine whether you should take medicines directed at specific viruses. Tamiflu (the brand name for oseltamivir) and other medications can make flu infections[less lethal]( for high-risk people.[Paxlovid]( (the brand name for nirmatrelvir-ritonavir) can have similar effects in older and immunocompromised people with Covid-19 infections. Americans can once again request [free Covid-19 tests]( starting at the end of September, and you can get tested for flu at many pharmacies, at urgent care centers, or at a health care provider’s office. Just because the testing recommendations have changed, if you’re feeling ill, it’s important not to be flippant about the risks, says Doron. “You should stay away from people who are high-risk or immunocompromised regardless of what virus you have,” she says, “because all viruses can be dangerous to high-risk people.” The CDC and other experts say that the methods for protecting others should be the same for all respiratory infections: [Stay home]( and away from others if you have symptoms. Don’t go back to normal activities until your symptoms are improving overall and you’ve been fever-free without meds for at least 24 hours. [Roche Pharmaceuticals Tamiflu Pills] NurPhoto What’s the deal with all these different vaccines? Before the pandemic, the only seasonal vaccine most people needed to think about was a flu shot each fall. Now, there’s a Covid-19 booster vaccine available at about the same time. Additionally, shots exist to protect babies and older adults from the pneumonia-causing RSV virus. The toolkit is bigger now than it was a few years ago. It’s a good thing, but it can feel confusing. Here’s how to keep things simple: The CDC [recommends]( everyone over 6 months old get a Covid-19 booster and a flu shot for this fall. Just three categories of people should be getting an RSV vaccine: Older people, pregnant people, and babies. For now, this is a one-and-done shot — there’s no annual booster. How should I time the flu and Covid vaccines to give myself the best protection? Getting the flu shot and the Covid-19 vaccine at the same time is perfectly fine, and you can even get them in the same arm a few inches apart. Any time before New Year’s is good protection, although you can be strategic with the timing if you need to. Experts have landed on Halloween as optimal vaccination time for both to avoid the worst of the winter flu season and whatever Covid might also be bouncing around in late winter. The main benefit of Covid-19 vaccination is protection from severe infection and hospitalization. However, there is a short-lived period after vaccination when antibody levels are so high that even infection is unlikely. If you have a big overseas trip or a wedding planned, it’s not unreasonable to try to time your vaccine for about a month before that event in order to make it less likely you’ll be sick during your big moment, says Doron. If you’re someone who’d benefit from the [RSV vaccine](, the best time to get it is in the late summer or early fall, before the virus starts spreading. Vaccination for pregnant people in particular should happen between September and January. Seriously, do I really need to get another Covid vaccine? “You betcha,” says Schaffner, echoing the CDC’s broad recommendation. Experts have determined that in the US, the benefit of getting the vaccine exceeds the risk for all age groups. All three Covid-19 vaccines expected to be offered this fall are safe and effective at preventing hospitalization. Novavax is[less likely to cause side effects]( than the Pfizer and Moderna mRNA vaccines; in her[latest newsletter](, epidemiologist Katelyn Jetelina noted that’s a major reason she’ll be waiting to get a Novavax booster. There’s [not much benefit]( to receiving a Covid-19 vaccine in the three months after a Covid-19 infection. Holding out for longer gets you more bang for your vaccine buck and allows the immunity produced by a Covid-19 infection to mature and solidify, says Doron. On the flip side, the longer you wait to get vaccinated after a Covid-19 infection, the more likely you’ll get infected in the interim. (However, most people are not reinfected in the first nine to 12 months after an infection, says Doron.) What else can I do to stay healthy this season? If you’re not sick, several familiar strategies can help keep you healthy: Wash your hands before touching your face or preparing food and after touching shared surfaces or using the bathroom; use a mask in crowded places; ventilate shared spaces by opening a window and turning on a fan if possible, and consider using an air purifier when gathering with others. “During the height of Covid, we forgot about reinforcing how important sleep, exercise, nutrition, stress reduction, all of those things impact the immune system,” says Doron. Optimizing those factors — while also maintaining a healthy weight and controlling underlying medical conditions — makes it more likely you’ll stay healthy if and when you get a respiratory infection.   [Listen]( Antibiotics for coral reefs Vox’s Benji Jones takes us diving in a coral reef to learn how scientists are trying to save them. [Listen now](   [ A row of yellow school buses at charging stations.] Getty Images The rent are too darn high. And it might not be just in your head. The [Justice Department has brought an antitrust lawsuit against RealPage](, a software company that used an algorithm to suggests rent prices to corporate landlords and may have driven up rent prices in the process; one landlord even praised the company's product as "classic price fixing." Animal testing, explained. 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One child holds the hand of another child, pulling them toward the crowd.] Michelle Kwon for Vox Explain It to Me podcast [Explain It to Me]( is Vox’s new series focused on answering your questions. Check out the trailer [here.]( The podcast is your hotline for all of your unanswered questions, and host [Jonquilyn Hill]( is your friendly guide who will find you the answers you’re looking for — and maybe even the ones you don’t expect. You can always call us at 1-800-618-8545 or [fill out this form](vox.com/ask-vox) and tell us what’s on your mind. The podcast launches on September 19.   Are you enjoying the Today, Explained newsletter? Forward it to a friend; they can [sign up for it right here](. And as always, we want to know what you think. Specifically: If there is a topic you want us to explain or a story you’re curious to learn more about, let us know [by filling out this form]( or just replying to this email. 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