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.

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.  

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.

NurPhoto

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. 

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. 

“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.) 

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.

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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.  Americans are roughly split on whether animals should be used in scientific research, and it makes sense why: The practice pits medical innovation and animal welfare — two things most people can get behind — against each other in a debate that doesn't seem to have any clear winners. This piece breaks down the nuances and explores what the future could look like without such testing.

Money talks. Maybe. Democrats say they now have $404 million in the bank, compared to Republicans’ $295 million, and they are using it to try to expand the number of states their party is competitive in at both the presidential and congressional levels. But can loads of cash really affect the outcome of the election?

The original Beetlejuice was the best. Discuss.  With a new version, Beetlejuice Beetlejuice, in theaters this past weekend, it's an ideal time to reconsider the original: a pretty perfect film from the pre-CGI era that found Tim Burton in his finest, most ghoulish form. 

Tucker Carlson, on brand as ever. The disgraced former Fox News host's interview with a Nazi-sympathizing amateur historian has him in hot water once again. Now, the question is whether "conservatives will learn a broader lesson about how far-right ideas infiltrate their movement — with their own tacit support."

Careworkers to the polls: With the election looming, here’s a look at an oft-overlooked demographic with ascendant political power: child care workers. [Glamour]

Little League meets Wall Street? Youth sports may just be the next thing you love that private equity might ruin. While the industry is certainly broken, it’s not clear pumping it with this kind of cash makes sense. [Bloomberg]

Joe Burbank/Orlando Sentinel

That's the portion of children who show behaviors of shyness — generally understood to be a fear of new people or social situations. It’s separate from introversion, where people recharge their social batteries with alone time, or social anxiety, which is a clinical disorder.

The start of a new school year can be a particularly difficult time for shy kids, but it’s manageable with the right tools and perspective. Senior reporter Allie Volpe explores why parents and caregivers don’t need to — and shouldn’t — try to change their child’s disposition.

Michelle Kwon for Vox

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 and tell us what’s on your mind.

The podcast launches on September 19.

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Today’s edition was produced and edited by senior editor Lavanya Ramanathan, with contributions from staff editor Melinda Fakuade. We'll see you Monday!

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