Writings and Resources

I’m learning to live with COVID. Our government, social, and medical structures have left us on our own, but we can still rely on community care to survive this pandemic. Since it’s really, really hard to know what to do, I wanted to share my personal general guidelines at this stage of the pandemic, because COVID isn’t over. Long COVID rates are creeping up at an alarming rate, we’re seeing an increase in sudden strokes among young people, and COVID can be really serious even for healthy, fully vaxxed young people.

This is not comprehensive, it’s not fool-proof, and I am not a medical doctor nor a public health expert. I do things that other COVID-cautious people probably avoid. Some people may not be able to do all the things I do based on their job, available resources, or other constraints such as schools or daycare for their kids. Instead, this is just the list of precautions and rules of thumb I use day-to-day that I wanted to share because sometimes all we see are people saying that COVID is “over.”

I’m always happy to chat with people about figuring out the best options for themselves, or to further explain why I operate the way I do right now. Every choice I make is based on weighing my own physical and mental health, broader community needs, and public health guidance. When we all wear masks, wash our hands, and take infection seriously, we can make a big difference in the risk to the public.

For clarity, I’m grouping this into several categories: Reducing exposure, monitoring risk, and working with others.

Reducing exposure

1. I wear a high quality mask everywhere, and check to make sure it fits. I wear a Powecom KN95 any time I am indoors (except for in my own home and when visiting a home with other precautions in place) and when I am around other people outdoors. Research shows that this hugely reduces risk if your mask is high quality (N95 or better) and well-fitting (creating a seal around your face). As a caveat, I haven’t been fit-tested, and I sometimes take it off when I’m outdoors with no one around. Otherwise, grocery shopping, convenience store, coffee shop, farmer’s market – I’m always wearing a mask. I also do a poor man’s fit test where I will exhale sharply with my hands placed around the mask to feel whether air is escaping.
2. I prioritize clean air. COVID is airborne. While hand sanitizer and disinfectant wipes can make us feel squeaky clean, it doesn’t help us clean our air! When possible, I keep windows open and fans going to circulate air in my apartment, especially when others have been in our home (like a handyman or the Verizon guy). I do the same in hotel rooms when I travel. I try to choose areas with good airflow and few people when I choose to eat outside or when I’m out in public. The Coway Mighty air purifier is my new favorite travel companion, and otherwise chugs away at cleaning the air in our apartment. There are less expensive options, and Corsi-Rosenthal boxes are cool DIY projects that make a big difference to air quality in spaces like homes, classrooms, and offices. I haven’t yet gotten into CO2 monitors, but they’re becoming more popular and can show you how much of the air you’re breathing came from someone else’s lungs (yuck!).
3. I ask others to wear masks. This one is haaaaaaard, but it often goes better than I anticipate. Vet appointments with the cat, handyman or maintenance workers in the apartment, anyone I’m interacting with I try to ask to wear a mask. I bring extras with me, and more than once people have accepted kindly. Some people are happy to wear a mask, they’re just waiting for a nudge or maybe even a little peer pressure. More than once a person on the subway has given me and my KN95 a sideways glance before pulling a mask from their pocket and putting it on. Peer pressure works!
4. I don’t go to as many places as I’d like to go. I go lots of places I don’t need to. I travel for fun occasionally, and I like to go wander around Target sometimes, and I go get a bagel sometimes even though it’s often crowded in the bagel store. But during sustained surges like the one we’re in, I avoid hanging out with people regularly and I definitely don’t go to any of those places without a mask. I’m avoiding concerts, shows, and clubs for the most part. I’m slowly replacing grocery runs with delivery or pick-up orders to avoid spending time shopping indoors. It’s a bummer, but everywhere I go I can hear people coughing and these are risks that I’m fortunate enough to be able to easily reduce.

Monitoring risk

1. I test for COVID regularly. To me, “regularly” means a trip to our neighborhood test site for a rapid and a PCR 2 days before I travel or visit others, and 4-5 days after any outings. I use an at-home rapid test the day of any visits or travel, and whenever I’m feeling snifflier or headachier than usual. But I also note that at-home rapid tests have a very high false negative rate, so I always take them with a grain of salt.
2. I keep up with my local department of public health. I follow a few different health departments on Instagram and Twitter, as well as an account called the People’s CDC. These accounts tend to provide necessary information about current risk and available resources. It’s how I knew the bivalent booster was available in New Jersey and got my shot the first week it was rolled out!
3. I self-monitor for symptoms. This can be hard for those of us with health anxiety, but I’ve come up with a reasonable baseline that doesn’t require me to constantly worry. I take my temperature and use a pulse oximeter to check my oxygen a few times a week. I take note of headaches, sniffles, and changes in my breathing (and have figured out some patterns!). When things seem out of the ordinary, I do a rapid test or go for a PCR, because I know too many people whose “allergies” turned out to be COVID.
4. I take quarantine and isolation seriously. If I’m a “close contact” of someone with COVID, I cancel plans, monitor for symptoms daily, and use both rapid and PCR tests 4 – 7 days after exposure. If I were to get COVID (either a positive test or symptoms), I have an isolation plan that includes staying in my apartment for at least 10 days, wearing a mask when in common areas of the apartment, using paper plates and plastic silverware, moving the air purifier to my isolation space, and way more rest than I’d ever willingly engage in. (I’m again very fortunate to have the luxury of prioritizing rest and isolation when needed.)

Working with others

1. I try to communicate expectations up front and go with the strictest safety requirements requested. Most people who know me, know my boundaries: I avoid eating indoors, I wear masks around others, I ask that others self-test before we get together. I also ask others what would make them feel safe and comfortable, and I always defer to the strictest requests. If one person is okay just meeting up but another prefers masks and self-tests, then we go with the masks and self-tests! I’m really grateful to have respectful and considerate family and friends who ask about and respect my COVID boundaries.
2. I’m getting better at saying “no” and managing disappointment. I often worry that I’ll disappoint others or be embarrassed if I feel a need to cancel or change plans. We have such a “tough it out” culture that it can feel self-indulgent to say, “No, I woke up with a scratchy throat today so I’m going to need to cancel our meet-up.” Or “Thank you so much for the offer of those concert tickets, but I don’t feel comfortable being in large crowds right now.”
3. I try to have empathy and compassion for people who take more risks than I do, as well as those who take fewer risks than I do. I’m really, really lucky to be able to stay home. So many people can’t do that. But so many immunocompromised people aren’t safe visiting others and aren’t able to leave their homes at all. I try to keep in mind that everyone is doing their best in a difficult situation. Many people don’t know that COVID rates are still extremely high!
4. I avoid scaremongers and overly technical social media accounts. Anyone who accuses others of being alarmist or says “we need to learn to live with COVID!” is getting booted from my social media feed. But anyone who says that we’re all totally doomed doesn’t have a place there either. I can’t properly interpret technical epidemiological info, so I avoid accounts that only share that type of information. I try to focus on public health experts who speak in plain language and provide references and resources to back up their recommendations.
5. I seek out and support the most vulnerable members of our community. Lots of people are seeking and providing mutual aid, ranging from raising money for folks who can’t work due to Long COVID to providing high-quality masks to members of the community. We’re only as strong as our weakest link, so I look to the people engaging “on the ground” to what they need in terms of resources and support.

Coda: “Lifting” my restrictions

I’ve been asked a few times, “So: When are you going to let up on all this?” It’s a great question, so here are a few things I look for:

• Transmission levels. The CDC maps are misleading and inaccurate, so I look to resources shared by other organizations such as the People’s CDC. When levels of community transmission are high in my area, I avoid things like massages/manicures, concerts, and big gatherings of friends. Last spring, during that brief lull between forever waves, I went for massages and caught up on doctor’s appointments (still all masked) because I felt okay spending more time indoors with lower rates of transmission.
• Mask requirements. When most people around are wearing masks, I’m more comfortable doing things like going to shows or taking public transit (and I understand that many people can’t make that decision around public transit). In the total absence of mask requirements, I am very uncomfortable being in public spaces – including doctor’s and dentist’s offices.
• Public health guidance. This one’s tricky, because there’s a lot of misinformation and disinformation coming from the CDC and the White House in particular. The CDC’s guidelines around masking and isolating are misleading at best, and the president just said “COVID is over” while hundreds of people are dying from it every day. However, there are a lot of people and agencies sharing useful information and resources, so I look to them to help inform how strict my precautions should be.
• The guidance of the disabled community. Disabled and immunocompromised people have been sounding the alarm about COVID, Long COVID, and the slow collapse of our medical infrastructure due to a “let ‘er rip” approach. They are often especially tuned-in because they have to be for their survival. When the leaders and communities I follow on social media are concerned, I’m concerned. When they’re hopeful and enthusiastic about resuming certain activities, I follow their lead!

Resources that inform my decision-making

This Twitter thread (link to Twitter thread on masks) summarizes some available masks and respirators, explaining how and why some work better than others.

The People’s CDC (link to the People’s CDC website) is a coalition that provides guidance, recommendations, and summaries about COVID risk and resources.

Clean Air Crew (link to Clean Air Crew website) has resources and information about ventilation, filtration, and masks to help people improve the quality of their air. They also have guides on creating your own box fan filter (link to DIY box fan filter instructions), also known as the Corsi-Rosenthal Box.

On Twitter, I follow activists and advocates including Brianne Benness (@bennessb), Alice Wong (@SFdirewolf) and Imani Barbarin (@Imani_Barbarin) who share resources, anecdotes, and support.

This Atlantic article by Ed Yong (link to Atlantic article on Long COVID) discusses the challenges related to accessing medical care related to Long COVID.

This Wall Street Journal article (link to Wall Street Journal article on at-home tests) discusses questions of accuracy in at-home COVID rapid tests.