A doctor answers questions on omicron plateauing, breakthroughs, N95s, kids at school

The omicron surge seems to be receding — in the Twin Cities, at least. But COVID-19 cases are still peaking in greater Minnesota, we’re learning about N95 masks as they’re adopted more widely and there’s confusion about boosters.

We’re gathering your questions about the pandemic on the MPR News Instagram account and via email at minnesotanow@mpr.org. Dr. Melanie Swift, a preventive medicine physician at Mayo Clinic, returned to answer more listener questions with host Cathy Wurzer.

The following transcript has been slightly edited for clarity. Listen to the full conversation using the audio player above.

It seems as though the omicron wave has peaked in the metro area, based on wastewater sampling, but that’s not the case in greater Minnesota. Is that your read?

What we're seeing here [in Rochester] and in some other parts of the state is that we've kind of taken our foot off the gas pedal, so the acceleration of cases has plateaued — but we haven't yet hit the brake, so we aren't seeing a fall in the case counts. But that plateau is very encouraging, and the falling case count should follow within the next week.

Question from Lindsay on Twitter: I’ve had breakthrough cases in my house. What can I do to help boost the immune system?

The breakthrough cases — sometimes people mean different things by that. It may just mean that they were fully vaccinated more than six months ago and don't have a lot of protection against omicron. It might mean that they got boosted and still had a breakthrough infection.

Either way, it does not mean there's a problem with your immune system, necessarily. It's just the fact that omicron has enough mutations that the vaccine doesn't provide full protection against infection — but it should still help your healthy immune system prevent serious disease and hospitalization.

So just rest, hydrate — [there’s] nothing special that you need to do for your healthy immune system.

Do we know what percentage of current cases are breakthroughs?

The last dashboard that I saw, less than half of infections were breakthrough. However, realize that we're a highly vaccinated population, especially here in Minnesota, so we're going to have more people getting infected who were vaccinated because we have more people who were vaccinated total.

The key thing here is that in the hospital, what we're seeing [is] people who were either not boosted, completely unvaccinated or had immunosuppressive conditions — and boosted people with immunosuppressive conditions in the hospital [are] still a minority of the cases we're seeing with serious infections.

Question from Alison on Instagram: How serious is catching COVID when pregnant but fully vaccinated and boosted? I know a lot of my friends and myself have put off pregnancy during this pandemic, but it seems it'll never really go away at this point.

We are all wondering if this is just the start of a new endemic infection phase, [if] we need to learn how to get on with our lives. Being vaccinated and boosted is the best thing you can do to prevent serious consequences if you get COVID. So at this point, it probably doesn't make sense for women of childbearing age to continue putting off their family planning in hopes of waiting for the pandemic to completely end.

By being vaccinated and boosted and staying current on any future recommended boosts, they are very likely to have a safe pregnancy and should not be terribly concerned about getting pregnant. Pregnant women who are unvaccinated certainly are at much higher risk of having complications [from COVID] during their pregnancy.

Question from Joan on Twitter: I'm an Uber delivery driver. If wearing an N95 [mask], would I be safe to resume driving?

Uber passenger drivers have a real concern because they're in this enclosed space [with other people]. The most important thing is that their passengers be wearing a mask that covers their nose and mouth tightly, as well as [the drivers themselves].

But it sounds like this [listener] is a delivery driver [and] wouldn't have passengers in the car, so I don't think an N95 is necessary in that situation. It's just when you're then encountering the person you're delivering to, if it's not a contactless delivery, wearing your own protection, as well as asking customers to wear a mask, is still good policy. Those brief interactions likely don't require an N95 mask; just a well-fitting face mask would be fine.

As a physician, I know you wear N95s. How long do you keep your N95?

It has to be thrown away immediately if it gets wet or soiled. Generally, people can use it for between one to five days.

We used to try to conserve them as long as we could. Fortunately, right now, supply is [in] a little bit better shape. We're trying to still not throw those out if they're in good shape.

So at least a day, and up to a week in some cases.

Question from Anna via email: We have an infant who can't be vaccinated and two elementary-aged kids who are vaccinated. What precautions can we take to protect our infant as the older kids attend school? How worried should we be for her safety?

Such a hard question right now. Of course, you have little control over the masking and social distancing [of] other children at school, as well as other children's vaccination status.

Best things you can do: Get your school-aged kids vaccinated. We don't yet have booster recommendations [for kids] under 12, but when those come out, get your kids boosted because we see that vaccine effectiveness is waning after six months or so, so those boosters become very, very important. And other than that, coach your own kids on wearing their mask and maintaining social distance from others — which [can be] really, really hard, depending upon their age.

But ultimately, that's about all you can control: the behavior and vaccination status of your own kids.

Question from John via email: I had my booster scheduled during my break from work over the holidays. Unfortunately, I got COVID just a few days before. What guidelines should I be following about rescheduling my booster [after] I've had a breakthrough case?

We know for sure [that] within 90 days after your breakthrough case, you [can] go ahead and get your booster. [But] you can't go in while you're still [in] isolation, so within those first 10 days, I would say don't go in. What we are still learning is: Should you really wait about a month? My advice is probably to wait about a month, but you could get your booster anytime after you're out of isolation.

We want you to have a really good response to that booster, and a month or so after the infection, you should be able to mount a really good response to it. But definitely before 90 days.

I just had a mammogram. And [I was asked], ‘Have you been vaccinated recently?’ Do you know why they're asking that?

They're asking that because some people after vaccination will have swelling of the lymph nodes in their armpits, and that can make the mammogram really uncomfortable. They're just checking to make sure you haven't had a vaccination in the past few days [so that] your mammogram [isn’t] too painful.

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