COVID testing site

People wait in line at a COVID testing site in Washington, D.C., on Dec. 28, 2021. (Anna Moneymaker | Getty Images 2021)

COVID infections are off the charts in Minnesota. This week, the state hit a new all-time high in the pandemic, averaging more than 10,000 cases a day. The real number of cases could be even higher because at-home tests are not tallied by the state health department.

At the national level, one in every 60 Americans has tested positive in the last week alone.

Of course, people want to know how to stay safe and what might come next. So we asked our Minnesota Now audience for questions to ask Dr. Susan Kline, an infectious disease expert and professor of medicine at the University of Minnesota Medical School.

The acting head of the FDA said most people are going to get COVID. What’s your response to this?

I didn’t hear her quote directly until what you just told me now. I would think [it’s] not necessarily a foregone conclusion that everybody will end up getting COVID. I still think that these measures we’ve been taking — such as vaccination, wearing masks [when] we’re in close proximity to others, especially in indoor spaces — I think that still works. I don’t want to throw up our hands and say we can’t prevent it, period. I think there are still things we can do to help protect people from getting COVID.

Dr. Anthony Fauci recently said infection with omicron might not provide immunity against potential new variants. Do you agree?

I think the new variants will be an ongoing challenge. And we have seen that a few times in the last couple of years — in particular this summer, when the delta surge hit the U.S. and our state going into the fall and early winter. Now we’re seeing it with omicron.

We do know that these variants differ from each other in their mutations, and the mutations can affect [the ability of] our body’s immune system to recognize the variant and respond to it in an efficient way. And so some of the antibodies from previous vaccines [or variants] may not be as effective as they were with the original strain.

So many people are getting omicron — including those who are vaccinated, boosted or have had COVID. Does this mean vaccines don’t work?

I think what we’re seeing suggests that they have reduced effectiveness against omicron. But I think it’s too early to say they don’t work at all. Really, I think that probably it’s still benefiting your immune system to have that prime from the vaccination, and it puts you in a better position than if you’ve never been vaccinated.

There’s very good evidence with delta now that the vaccines did exactly that. They still help decrease hospitalizations and deaths.

This omicron strain in our country has been going on for just a short period of time, so we’re still gathering that information about omicron. I think that we can say [vaccination is] likely going to give you some protection [against omicron], but not as much protection as you had against the original strain or even against the delta variant. But that’s primarily based on laboratory testing, not a lot of real-world data yet. We’re still waiting for all that real-world data to come in.

What’s the prognosis for an older person with underlying conditions who gets omicron?

I think the good news, based on what we’ve heard so far, is that omicron does not seem to be causing as severe [of] disease as some of the earlier variants that we have seen, even with underlying conditions. But [the vaccines] may not protect people completely. We are seeing people getting admitted to the hospital who have had vaccines. We are seeing proportionately more people getting admitted to the hospital, though, who have not been vaccinated, and fewer that have been vaccinated, especially those that have had three doses.

Will we soon reach the 70 percent herd immunity we’ve heard we needed to end the pandemic, or has that percentage changed? Do we even care about herd immunity?

I think, based on the data that’s coming in nationally, that 70 percent herd immunity is not going to be good enough, because there are quite a few states, especially in the northeast, that had over 75 percent of their state population vaccinated [and] are still seeing these surges in omicron. So I think the idea of herd immunity is changing. I think it’s probably going to require a higher level of vaccination and some natural infection. I think it’s closer probably — and this is just an estimate — to 90, 95 percent.

If someone is vaccinated then gets COVID, does that infection effectively serve as a ‘booster dose’?

There is some data showing that if you were vaccinated and then subsequently had infection, that it does boost your immune system and help protect you against future variants. But how long that will last? I don’t think we know for sure. So my recommendation would be: If [people] had their primary series, and then they get COVID, and then they’ve recovered — I would still recommend getting the booster vaccine.

How long is a vaccinated person contagious if they contract COVID?

We do have some data from sites around the world suggesting that people who have been vaccinated shed the virus. [But] they’re potentially contagious for shorter periods of time compared to those who have not been vaccinated. The studies do show that people, even those who have been vaccinated and then become infected, can still have that virus in their nose for seven days.

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