A Christmas covid surge is looking more likely, again. But getting sick isn’t inevitable.

Public health experts fear we’re headed into yet another post-holiday covid surge, based on how numbers are trending.

Past observations that viruses sometimes interfere with one another, a bad cold season knocking down flu rates for example, might give epidemiologists some hope against a steeper covid surge this winter, said virologist Andrew Pekosz, of the Johns Hopkins Bloomberg School of Public Health. “That might be what we are seeing in the adult population, with more flu and less covid,” he said, but that “viral interference” phenomenon doesn’t seem to be playing out this year in children.

“We don’t have to have a big winter surge. But right now, we are on track to,” said epidemiologist Eleanor Murray of the Boston University School of Public Health.

So if covid is surging ahead of the holidays, what is the best way to protect yourselves and your loved ones?

Vaccinate and boost

“My perspective as an immunologist is, ‘Get the friggin vaccines and boosters for flu and covid!!!’ ” said University of Arizona immunologist Deepta Bhattacharya by email. “The shots will help — please get them!”

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The advent of the omicron subvariants, and this winter’s surge, likely signals that winter coronavirus seasons are ahead of us for the foreseeable future, added Bhattacharya. That means covid season will need the same approach as every flu season, with annual booster shots timed to the newest dominant variety of SARS-CoV-2.

From an evolutionary standpoint, coronavirus has now come to behave more like its kindred coronaviruses that cause colds, throwing off lineage bugs of a dominant strain, rather than wholesale new variants as it did in the first years of the pandemic. The virus has gone from evolving solely to be more infectious, as the first alpha variant was, to now evolving to evade the immunity that humanity has acquired through vaccination and past infection, a different landscape for mutations that sees many of these diverse subvariants converging on specific changes meant to defeat immune system defenses.

There are also hope that newer vaccines aimed broadly against those unchanging fundamental parts of the entire coronavirus family will also prove out, said Bhattacharya. “But those are years away.”

Test if you have symptoms

At-home covid tests still are good at detecting even the omicron subvariants, said epidemiologist Keri Althoff of the Johns Hopkins Bloomberg School of Public Health, in case there is any dispute around the holiday table. If you have symptoms and test, and it’s negative, it’s wise to wait another 24 to 48 hours to test again to be sure, she added, particularly if you have symptoms particular to covid, like the loss of taste or smell.

“As hard as it may be, normalize those last-minute holiday cancellations if someone is not feeling well,” she said. “Common sense reduces the likelihood of one of these viruses entering your household.”

Because effective antiviral medications for both flu and covid only work early in an infection, their prescription as soon as symptoms appear — rather than later in an overworked emergency room — is crucial.

“We all know from the last two years that when hospitals fill with sick patients and hospital workers start getting sick themselves, that is not an ideal situation for people seeking care,” said Althoff.

Masking still works