COVID continues to mutate, and a new strain is causing spikes in cases across the country. A conversation with the physician and New Yorker contributor Dhruv Khullar about how we should think about the virus now, and what people can do to protect themselves this fall. Plus:
Daniel A. Gross
A story editor at The New Yorker.
The attacks on mainstream vaccine science and policy in the United States—spearheaded by Robert F. Kennedy, Jr., the Secretary of Health and Human Services—have created a disjointed and confusing public-health landscape ahead of the traditional arrival of flu season. I reached out to Dhruv Khullar, a physician and contributing writer at the magazine who has written extensively about COVID, to talk about some steps that individuals should consider taking this fall. Our conversation has been edited and condensed.
There’s a new variant—called Stratus—that is causing a spike in cases in Texas, California, and beyond. Is that a name that people need to know?
Stratus doesn’t necessarily cause more severe illness than the variants we’ve seen before, and the symptoms are broadly similar—cough, fever, fatigue, and so on. There are some reports of “razor-blade throat,” although that kind of extreme sore throat was seen with prior variants as well. But, by their nature, variants that arise are more transmissible; they’ve outcompeted other variants. From that perspective, they should be on our radar.
People should ask themselves: What is my personal risk, and what is the risk to the people around me? Do I or my loved ones have conditions that would make an infection worse? What is the community spread in my area? Public-health officials look at things like wastewater surveillance, hospitalizations, and emergency-room visits. And the Centers for Disease Control and Prevention estimates that cases are currently rising in more than thirty states.
What do you do if you think you have COVID, or you test positive, in 2025?
These days you’re less likely to end up in the hospital from COVID, but the principles of what to do are not so different from what they were in the past. If you have symptoms or a meaningful exposure—if you spent time in a closed environment with someone who has tested positive—you should test. Over-the-counter rapid tests are not as reliable as P.C.R. tests that you’d get in a doctor’s office, but they’re convenient. If you test negative, then test again two days later.
If you test positive, you should stay home. If you have a condition that puts you at higher risk for serious illness, you could consider taking an antiviral pill like Paxlovid—and the earlier you take it, the better, which is another reason to test. Limit your exposure to other people until you no longer have a fever (even without taking fever-reducing medications such as ibuprofen) and your symptoms are improving. Then you should wear a high-quality mask, such as a KN95, in the days that follow.
Is now the time to get a COVID shot?
The Food and Drug Administration, under Robert F. Kennedy, Jr., approved updated COVID boosters for people over the age of sixty-five, or those with various medical conditions that increase their risk. For everyone else, going forward, it’s going to be more complicated to get the vaccine. If you have the resources and you’re dogged, you can probably still obtain it in most states. A doctor could prescribe shots off-label—but not everyone sees a doctor regularly, and some insurance companies may not cover off-label vaccinations. (The C.D.C. vaccine-advisory panel, which R.F.K., Jr., replaced with new members, will meet in a couple weeks, so guidance could change.)
I think now is the time to get the shot—say, by October or November. Vaccination isn’t a guarantee against infection, or against bad outcomes. But it provides some protection. It’s a good idea to get the COVID vaccine along with the flu vaccine, which should carry you through the winter season.
