COVID-19 is no longer an official public health emergency, but we should keep thinking of it as a public health priority.
Getting fully vaccinated, wearing a mask, and washing your hands are still top defenses against COVID-19 in 2023.
Nearly everyone should get an updated COVID vaccine in 2023, health officials recommend. Talk to your doctor about when to get vaccinated.
While the COVID-19 is no longer a public health emergency, it remains a public health priority. And that's a good way for us to think about it, too.
“The pandemic is not over,” said Georges Benjamin, MD, executive director of the American Public Health Association. “But we are transitioning from a phase where we had to stay in our homes, and any interaction with any individual was a high risk of getting COVID, to a phase in which the risk of interacting with other people, with or without a mask, and getting COVID is much lower. And with that in mind, we need to think about how we adjust.”
So, how do we navigate this changing landscape? What does the pandemic look like now?
I think the way to think about this is that when we leave our homes every day, there's a risk of getting COVID, and there are things that we can do to reduce that risk,” Benjamin said.
“It's making sure your vaccinations are up to date, wearing a mask in appropriate settings, and washing our hands. And that's the best we're going to be able to do," Benjamin told NCOA. "And I think that's the way our lives are going to be for the foreseeable future.”
How risky is COVID now for older adults?
“The basics of COVID haven't changed, and what I mean by that is that the risk of getting COVID and getting seriously ill with COVID increases with age,” Benjamin said.
Even as COVID hospitalization and death rates decline, older adults continue to be the most at risk because of their age.1 The disease has been far deadlier for older adults than the rest of the population throughout the pandemic, not only in the United States but worldwide.2,3,4
Underlying health conditions like cancer, chronic lung disease, heart disease, weakened immune system, and sickle cell disease continue to add to the already elevated COVID risk levels for older adults.
If cases are declining, will COVID eventually fade away?
“I think while all of us would've have liked to see this thing kind of just disappear, like it did several years ago when we had SARS-1, it's pretty clear that's not going to happen," Benjamin said.
We're going to be living with this as we do other infectious diseases. And so, we're just going to have to adapt to this.”
“We've only had one infectious disease that has really ever gone away completely, and that’s smallpox," Benjamin said. "So, we should not be surprised that this disease hasn't gone away.”
How can I still participate in activities and reduce my COVID risk?
Benjamin recommends a “layered series of protections:”
1. Get fully vaccinated
“The most important thing that all of us ought to do is make sure that we are up to date on our vaccinations,” he said.
What is the latest COVID vaccine guidance for older adults? The U.S Food and Drug Administration and CDC approved an updated COVID vaccine in September 2023 designed to target the newest variants. Talk to your health care provider about the best timing of the new COVID shot, especially if you recently received a COVID booster or had a COVID infection.
“We have more tools than ever to prevent the worst outcomes from COVID-19,” said CDC Director Mandy Cohen, MD, MPH, in a Sept. 12 news release. “CDC is now recommending updated COVID-19 vaccination for everyone 6 months and older to better protect you and your loved ones.”
Older adults were slow to get their first bivalent booster. While more than 94% of people 65 and older completed the primary series, as of early May 2023 just 43% had received the one-dose booster.5
“I think at the end of the day, it's complacency. These are not people who are opposed to getting the shot; they just hadn't gotten around to getting it done," Benjamin said. "And you know, they're doing OK and they're seeing their friends. They’re out and about. We’ve kind of normalized our activities. But the risk is still there,” he cautioned.
You can visit Vaccines.gov to find COVID vaccine locations in your community. In certain cases, Medicare may pay for a health care professional to come to your home to administer the vaccine. Learn more from Getting the COVID-19 Vaccine in Your Home.
Vaccination against COVID-19 may offer other protections, too. A Cedars-Sinai study found that vaccinated people had a lower risk of developing post-COVID diabetes.6 And a study in the International Journal of Environmental Research and Public Health concluded COVID vaccines protect against such persisting—or "long COVID"—symptoms as kidney disease, cognitive problems, and sleeping disorders.7
2. Wear a high-quality mask
The World Health Organization (WHO) says good masks continue to be a “key tool” against COVID-19. For best protection, choose a high quality mask such as an N95 mask that fits snugly around your mouth and nose.
“Masks are recommended following a recent exposure to COVID-19, when someone has or suspects they have COVID-19, when someone is at high-risk of severe COVID-19, and for anyone in a crowded, enclosed, or poorly ventilated space,” WHO officials said in a news release.
When you’re around people you don’t know, or out in big crowds, wear the most protective mask that you can, that fits well,” Benjamin said.
Benjamin wears his on a lanyard. “I put it on when I think I need to put it on, and I take it off when I don't think I need to have it on. I think that works well, particularly as we're traveling more and we're getting out more.”
Although fewer people are wearing masks at this stage of the pandemic, Benjamin said he does expect that to change.
“I think our society is moving to one in which we will see more and more people wearing masks in a variety of settings. And as a nation, we need to become more accepting of that.”
Mask-wearers are safeguarding their health, and possibly yours, too.
“Remember that if you get COVID, we're telling people to stay home for at least the first five days," he said. "And then if you become asymptomatic, you may still be infectious, but much less so, and it's OK to go out with a mask. So, they very well may be somebody getting over COVID.”
3. Wash your hands frequently
Not only does this help stop the spread of COVID, it's a tried and true public health practice to protect against all types of infections like colds and flu. Most of us became expert hand-washers at the start of the pandemic, but it may be time for a refresher on hand hygiene best practices.
4. Avoid large crowds
But if you can’t, public health officials advise wearing a mask, and, if indoors, opening a window to improve ventilation.
Find other preventive actions you can take from the CDC's How to Protect Yourself and Others.
What should I do if I think I have COVID?
“Getting in the habit of getting tested when you think you might have COVID, and getting early treatment … is very helpful,” Benjamin said.
Epidemiologist Michael Osterholm, PhD, MPH, Director of the University of Minnesota's Center for Infectious Disease Research and Policy, drove home the importance of testing when he shared his experience of coming down with COVID-like symptoms but not testing positive until more than a full day after the symptoms started. Throughout the pandemic, he has been cautious, including wearing a fitted, N95 respirator mask when out in public and being fully vaccinated.
"When I look back on it, I do not have an explanation for how I got it," Osterholm said during an episode of the podcast Osterholm Update: COVID-19. "I didn't fail. And yet I know that I feel with this virus, somehow, I should have done something better, something different."
Yet Osterholm said the silver lining of coming down with COVID is that he is even more inspired to keep up his public health work.
It is recommended that you keep a ready supply of COVID-19 rapid tests at home so that you can test if you have symptoms of COVID-19. To learn about tests for COVID-19 and where to get home rapid tests, check out this Guide to COVID-19 Testing for Seniors. When taking an at-home rapid test, be sure to follow the instructions carefully as instructions may vary slightly from manufacturer to manufacturer.
What do I do if I test positive for COVID?
If you test positive for COVID-19, talk to your doctor right away. Treatments are available that can decrease your chances of getting seriously ill and dying from COVID. People who are more likely to get very sick are:
- Adults age 50 and older (with risk increasing with age)
- People who are not vaccinated against COVID-19
- People with certain medical conditions, such as chronic lung disease, diabetes, heart disease, obesity, or a weakened immune system
Medications to treat COVID-19, such as Paxlovid, must be prescribed by a health care provider, including your pharmacist. And for treatment to be effective, it must be started within five days after you first develop COVID symptoms.
What does the future of COVID look like in the U.S.?
"I don't know where we are in the pandemic, but I can surely say we are in a much better place," Osterholm said.
Public health experts are wary of making any grand predictions, especially considering the pandemic has thrown its share of curve balls.
“Right now, where we are, I think we should anticipate that there will be, surges periodically, a couple times a year, and that wearing a mask and getting vaccinated are now part of our norm,” Benjamin said.
Empowering community vaccination efforts
As the recipient of a $50 million grant from the U.S. Administration for Community Living, NCOA is spearheading a nationwide campaign to help make COVID and flu vaccines more accessible to older adults and people with disabilities.
Under the Vaccine Uptake Initiative, grants and technical assistance were provided to 180 diverse, community-based organizations across the U.S. This funding and support is helping these organizations conduct outreach, host vaccine clinics, and offer transportation and other services older adults may need to get vaccinated. NCOA is also contracting with up to 150 senior centers to help older adults and people with disabilities get the latest COVID and flu vaccines.
“There’s no time to waste in ensuring everyone gets these lifesaving vaccines,” said Ramsey Alwin, NCOA president and CEO.
1. Centers for Disease Control and Prevention. COVID Data Tracker Weekly Review. Nov. 4, 2022. Found on the internet at https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html
2. CDC. Morbidity and Mortality Weekly Report. COVID-19 Mortality and Progress Toward Vaccinating Older Adults — World Health Organization, Worldwide, 2020–2022. Feb. 3, 2023. https://www.cdc.gov/mmwr/volumes/72/wr/mm7205a1.htm
3. Omid Dadras, et al. COVID‐19 mortality and its predictors in the elderly: A systematic review. Health Science Reports. May 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9125886/
4. CDC. Provisional COVID-19 Deaths by Sex and Age. Found on the internet at https://data.cdc.gov/widgets/9bhg-hcku and https://data.cdc.gov/NCHS/Provisional-COVID-19-Deaths-by-Sex-and-Age/9bhg-hcku
5. CDC. Trends in Demographic Characteristics of People Receiving COVID-19 Vaccinations in the United States. March 8, 2023. Found on the internet at https://covid.cdc.gov/covid-data-tracker/#vaccination-demographics-trends
6. Alan C. Kwan, et al. Association of COVID-19 Vaccination With Risk for Incident Diabetes After COVID-19 Infection. JAMA Network Open. Feb. 14, 2023. Found on the internet at https://www.cedars-sinai.org/newsroom/verified-covid-19-infection-increases-diabetes-risk/
7. Peng Gao, et al. Effect of COVID-19 Vaccines on Reducing the Risk of Long COVID in the Real World: A Systemic Review and Meta-Analysis. International Journal of Environmental Research and Public Health. September 2022. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/36231717/