Coping with our Autumnal Covid Uptick

Robin Schoenthaler, MD
6 min readOct 5, 2023

And Getting Vaccinated for Our Upcoming Viral Winter Wonderland

Photo by Clément Falize on Unsplash

I’m a Boston-based cancer doctor and I’ve been writing weekly fact-based-no-blame-no-rumors-all-science-all-the-time essays about Covid-19 since March 2020. If you liked this and some of my other essays below, you can support both Medium and me here .

It’s been a busy month for vaccine scientists leaving us with a bunch of ways to cope with our upcoming Viral Winter Wonderland.

It’s kind of amazing. Five years ago the only vaccine to help you cope with winter bugs was the flu jab. Now there are THREE vaccines:

a) flu

b) Covid and

c) a virus that’s always been around but most people never heard of til the last couple of years, RSV.

a) The flu vaccine is available now for a flu season which usually starts in mid-October and is already popping up here and there. The flu virus changes composition every year and so the vaccine is designed to fight the “most likely” flu bugs to bug us this winter which are usually the ones that gave them fits in the southern hemisphere in their preceding winter.

And let us always remember: the number one effect of the flu shot is decreasing serious disease.

So if you get a flu vaccine but you get the flu anyways and are unhappy and sick at home, do you say, “My flu shot didn’t work!”? No, you say, “Thank heavens I got my flu shot. I was miserable, but it kept me out of the hospital!”

b) Then there’s RSV, which stands for Respiratory Syncytial Virus. Usually it’s a mild respiratory illness (our old-fashioned “cold”) but last winter it put thousands of kids and some older adults in the hospital, more than we usually see.

This year they’ve actually invented TWO RSV shots, one for pregnant women and high-risk adults over 60 and another one for little ones. The goal again is to prevent severe disease.

So, again, if you get an RSV vaccine for your kid but they get RSV anyways and get nasty sick with a wicked bad cold, do you say, “Shoot, that dang RSV vaccine didn’t work!”? No, you say, “Thank heavens we got her that shot! RSV was miserable, but she didn’t get pneumonia!”

You can get the flu, RSV and Covid vaccines all at once or you can space them out. One arm or two arms, there’s science either way. It’s hard for me to believe it a huge big deal which arms you use, the main thing is getting these vaccines in some place.

c) And then there’s the newly approved, semi-available Covid vaccine.

This roll-out has been quite bumpy.

All the previous vaccines were sent out by a big gigantic government machine whose entire purpose was to get vaccines into our arms asap. It was literally like a military campaign and overall, it really worked pretty well.

This rollout on the other hand is largely influenced by market forces and commercial interests and there’s no central administrative arm so it’s definitely been more of a mess.

First off, it’s not in every office or pharmacy, and they run out in the blink of an eye so cancellations are common. Secondly, it’s not yet always coded to be covered by insurance. Allegedly they’re fixing that soon.

Remember how when the first vaccines came out and we called 47 pharmacies 10,000 times a day and kept auto-refreshing sign-ups?

Well, you could do that again this time or you could recall how all roll-outs do eventually roll-out and you could just hang on, Sloopy, until the time comes, hopefully soon, when it becomes more widely available and insurance snafus are handled and if you sign up for an appointment they won’t cancel you and it’s easy and stress-free.

For me, choosing to wait a week or two until it’s easy and stress-free (with precautions in between) is part of my Covid-will-be-here-forever coping style.

Because Covid IS going to be around forever. It lives in animals, it’s out in nature, it’s passed when we are asymptomatic and hence clueless, it mutates too often for us to develop a 1000% effective vaccine. We can’t mask or mandate this bug away.

It is NEVER not going to be part of our lives, just like most cold viruses. Some viruses are with us for all of history and all of our lifetimes. This is going to be one of them.

So we need coping mechanisms. Covid-will-be-here-forever coping mechanisms.

Our institutional coping mechanisms in March 2020 overall made sense, for then. We didn’t know anything about Covid and we didn’t have any protection whatsoever. We were genuinely afraid we were going to overwhelm all the hospitals and kill all the health care workers.

So we down shut everything, mandated masks, closed schools, restricted travel, etc etc and without question saved a bunch of lives in the process.

But that not going to happen now. Now we have the vaccines and treatments we were waiting for (yay, Paxlovid) and unless there’s a really bad mutation — like a wildly contagious inevitably fatal virus — I don’t think the government is going to intervene or even begin to consider statewide masking, or shuttering school districts, or restricting travel, or anything except free testing.

So the coping mechanisms are now mostly up to you. The current variants are definitely contagious and our immunity has waned and lots of us are catching it. We may well get Covid this time, even if we’re a Novid Kid and have never had it before, or even if we’ve a Multi-Covid Mama and have had it a couple of times already.

So how do you cope? It’s back to basics. You reduce your risk of catching it by wearing a mask, especially inside, in tight quarters, in situations where people are exchanging bodily vapors (eating, singing). You can try to eat outside or in well-ventilated room with machines or windows. You can eat right, sleep right, the usual things your mom taught you might keep you healthy. You stay home when sick and you wash your hands.

And then you get the newer vaccine when you can, you talk to your doctor about a plan to get Paxlovid or Remdesivir if you get it anyways, and you stock up your cabinets with cold remedies and chicken noodle soup and keep the Netflix subscription up to date so you can binge watch Downton Abbey again.

And you might do want to do this a little more conscientiously until you can get the vaccine (which gives maximum protection two weeks later). And you can do all this stuff in triplicate if you’re going to visit immunocompromised Aunt Petunia or planning a precious trip.

For most people now, Covid is a nuisance, a great big fat disruption to the usual running of their life. But for some it’s super serious (hat-tip to two immunocompromised friends who ended up hospitalized last week with Covid pneumonia; they’re both better now but it was nasty).

Since we don’t know if we’re going to fall into the irritant category (most likely) or calamity category (rare but real), we should all go get another vaccine and take our known and reasonable precautions.

Bottom line: time to buckle up for our little autumnal uptick, brace for a winter season and pull out the coping mechanisms again.

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Robin Schoenthaler, MD

Covid-Translator. Cancer doc: ~Three decades at MGH. Writer and storyteller: Moth Grand Slam Champion. Mom. www.DrRobin.org, @robinshome, robinshome2@gmail.com