Revisiting tips to prevent COVID-19 infection as Long Island cases rise

When the virus that causes COVID-19 emerged in 2019, no one had protective immunity. Nearly five years later, most of the United States population has some immunity, either because of vaccination, infection or both. In most cases, COVID-19 illnesses now are less severe than in the early days of the pandemic.

But the coronavirus remains a public health threat, according to the Centers for Disease Control and Prevention. And on Long Island and statewide, positive tests for COVID-19 have been on the rise since late spring.

The CDC's recommendations — from how to prevent getting infected or passing the virus on to someone else, to symptoms and therapeutic treatments — remain largely the same.

How is the virus transmitted?

The coronavirus that causes COVID-19 is still transmitted by airborne particles and droplets, according to the CDC. The risk of infection increases with close or prolonged contact with an infected person, especially in indoor or crowded settings.

How do I keep from becoming infected?

The CDC has long recommended vaccination against the virus as the best way to prevent serious illness from COVID-19. Vaccination also provides some protection from initial infection. Avoiding close contact with others if infected, masking in crowded indoor spaces and hand washing can also prevent infection, the CDC says.

Do I need to vaccinate again?

In most cases, yes, experts say. CDC recommendations call for everyone 6 months and older to get an updated 2024-2025 COVID-19 vaccine to protect against potentially serious complications of the disease this fall and winter. Getting an updated version of the vaccine is important because it will be better able to protect against new variants of the virus that causes COVID-19. Also, the protection from a vaccine declines over time. The updated COVID-19 vaccines will be available later this year from Moderna, Novavax, and Pfizer, most likely in September or October.

Dr. Bruce Farber, chief of epidemiology and public health with Northwell Health, recommended taking the vaccine as soon as it’s available.

"It’s a long time since we’ve had a vaccine — for many of us, it’s going to be a year," he said. Because Long Islanders and Americans in general have done a "remarkably poor" job keeping up with vaccinations in recent years, he recommended signing up to take the flu vaccine at the same time as the one against COVID-19.

People with COVID-19 can be infectious from 1 to 2 days before and up to 8 to 10 days after symptoms begin, according to the CDC. The majority of transmission appears to occur during the early periods of infection, particularly in the 1 to 2 days before symptoms start and within the first few days of their onset.

Are the signs of COVID-19 infection the same?

Yes. Symptoms include fever, chills, cough, shortness of breath, fatigue, muscle aches, headache, loss of taste or smell, sore throat, nasal congestion or rhinorrhea, vomiting, diarrhea and skin rashes. However, not everyone infected experiences these symptoms.

Anyone with symptoms who is planning to attend a gathering or visit someone especially vulnerable to illness, like an elderly person or the very young or immunosuppressed, should take a COVID-19 test, experts said.

But test wisely, Farber said. "The rapid tests that we now rely on are no longer particularly good at diagnosing COVID, with these newer variants that are circulating," he said. A positive result still likely means infection, but false negatives are possible with rapid tests, also known as antigen tests. For that reason, especially if you have symptoms but negative results, "if you want to test reliably, you need to do a PCR." The PCR tests are generally administered by a health care professional and results take longer, but they offer what the CDC calls the "gold standard" of accuracy.

Do I still need to quarantine?

Not necessarily. If you have COVID-19 symptoms, you should stay home until they improve, according to the CDC. But since March, the agency has advised that people can return to work and regular activities if their symptoms are mild and improving and it’s been at least a day since they’ve had a fever. "If you go out, think about wearing a mask," said Dr. Sharon Nachman, division chief of pediatric infectious disease at Stony Brook Children's Hospital.

Dr. Aaron Glatt, chair of the Department of Medicine and chief of infectious diseases at Mount Sinai South Nassau hospital, said "you’re probably contagious" if you test positive, even if you feel fine. At a minimum, Glatt said, consider the risk profile of the people you might be around and tell them you’ve been sick. Consider that "Most people won’t want to be around you" if there’s a chance you can get them sick too, he said.

Is exercise OK for someone infected?

Start by exercising common sense, said Nachman. "If you have a fever, you should be home drinking fluids and taking it easy." If you have no fever, see how your body responds to walking up the stairs: "if you are air hungry or getting short of breath … then no exercise." 

What about antivirals?

Antiviral treatments like Paxlovid have been shown to reduce hospitalizations and deaths among older people and people with underlying health conditions when taken soon after COVID-19 symptoms start. But "for people who are under 60 and healthy, there’s no evidence" to indicate their use, said Glatt.

Are COVID-19 infections in New York on the rise?

The experts say yes. New York State testing data shows that positive tests have been on the rise statewide and Long Islandwide since late spring, though the latest Long Island rate of 16.9 cases per 100,000 people is well below the January high of 72.3. What’s going on? "We are seeing new variants, and it’s possible that our current variant is more infectious than the prior one," Nachman said. Also, she said, "People have lost some immunity to COVID over the last year, so perhaps they’re a little more susceptible than last year." Changes in behavior like more socializing could also play a role, she said. However, "hospitalization rates and death rates are not up significantly," Farber said. "Most people are recovering very well."