Reasonable precautions?
November 7, 2021 8:04 AM   Subscribe

Partner has to make Scotland - England return rail trip. He is double vaxxed but almost six months ago. I am double vaxxed but 5 months ago. Boosters will not be available in time. When he returns should I isolate in case he has caught breakthrough covid or is that over the top?

Assume he will be masking and making the main trip by sleeper with his own compartment apart from 1hr 30 trip on normal train to eventual destination (and same back) staying with people who are isolating, vaxxed and not going out. But I know people in England don't mask as much as people in Scotland because of different regulations. I could go and stay somewhere else for five days after his return to avoid him till he can take a test but I'm not totally well and this would be inconvenient. We both have an underlying condition which would have put us at risk if we caught covid unvaxxed and are middle aged, so risk doesn't seem trivial or am I wrong? How risky do you think this is at the present time?
posted by Flitcraft to Health & Fitness (10 answers total)
You have to do what you feel is best for you. Anecdotal, know someone whose husband caught the Delta variant (fully vaxxed, works in education), and she did not. He was low for a few days, then tired easily, but is now back at work.

I have diabetes, so am eligible for the booster, which I will get soon at my local Walgreens. Right now here in Maine, it's for 65 and older, or if you have an underlying condition. I also wash my hands a lot and wear a mask when appropriate.
posted by Marie Mon Dieu at 8:12 AM on November 7, 2021

We both have an underlying condition which would have put us at risk if we caught covid unvaxxed

You are not unvaccinated, by your own words.

Your medical situation is your own, your risk tolerance is your own, and we are not your physician. I think this is more of a personal question than something we can really help with. Further, your perception of risk often is more important than actual risk - it doesn't help you if you are taking reasonable risks, but feel continuously panicked and anxious about them.

What the UK government says is: "You are not required to self-isolate if you live in the same household as someone with COVID-19 and any of the following apply: you are fully vaccinated". What you're asking about is several orders of magnitude more conservative than that - living in the same household as someone who is vaccinated, went on a trip mostly isolated, stayed with people who are isolated, and (presumably) will have no COVID diagnosis or symptoms.

Vaccines work! They decrease chance of transmission - and the impact of that is squared (mathematically) for you because they will *both* decrease the chance of transmission from other people to him *and* from him to you. If you catch COVID while vaccinated, you have a significantly lower chance of developing symptoms. If you develop symptoms while vaccinated, you have a significantly lower chance of going to the hospital. If you end up needing to go to the hospital while vaccinated, you have a significantly lower chance of dying.

Feel free to meet your partner when he returns, at your own home.
posted by saeculorum at 8:16 AM on November 7, 2021 [16 favorites]

Pfizer comes in ten-dose vials and they don't last more than a day after being brought out of deep freeze. Most places that administer Pfizer will therefore be discarding anywhere from zero to nine doses at the end of each day. You might try ringing around to see if any of your local places would let you have, without official booster authorization paperwork and at the end of their day, a dose that they would otherwise be forced to discard.
posted by flabdablet at 8:25 AM on November 7, 2021 [2 favorites]

FWIW, it's true that people in England don't mask as much as in Scotland but nonetheless, the differences in COVID numbers in England and Scotland haven't been orders of magnitude different - your partner might be twice or even three times as likely to encounter someone infected with COVID-19 in England as he is in Scotland but he's not 10x or 100x as likely (I don't know what the exact numbers are today, or what they will be for the time period your partner is traveling).

Let's be conservative and say he is four or five times more likely to get exposed in England/on the journey than in Scotland, and thus five times more likely to get COVID while on the trip than he would be if he stayed home. That would still only mean he's about as likely to get COVID during any given week in England as he is in any given month in Scotland.
posted by mskyle at 8:35 AM on November 7, 2021

I'm in the UK, ask for the booster anyway, from Monday it's more available UK-wide.

I really don't know about South England vs Scotland for infection rates. I do know that vectors among friends and colleagues have children passing it along school classes but that the adults already being vaccinated stops the infection from taking hold or being passed on. You shouldn't need to isolate because of the double jab and you can ask for the booster asap.
posted by k3ninho at 9:58 AM on November 7, 2021

I would not isolate, but I would have Partner do a daily rapid test for 5 days upon returning.
posted by Winnie the Proust at 11:00 AM on November 7, 2021 [4 favorites]

Response by poster: This is something I don't think I understand properly - can't someone be infectious before the rapid test shows if they have covid? I thought it took five days or so to show? I'd like to know more about how rapid testing helps as that might be a way forward? Thanks!
posted by Flitcraft at 11:39 AM on November 7, 2021

I would worry less about isolating yourself from him, and yet more interested to hear that you're willing to isolate yourselves from everyone else. I'm an epidemiologist, not your doctor, but if isolating to any degree is something you can do, it is never going to be anything other than a step in the direction of supporting safety.
posted by late afternoon dreaming hotel at 11:44 AM on November 7, 2021 [1 favorite]

My understanding is that the rapid test is very good at picking up the COVID virus when it is at high enough levels to be infectious. There is a period before when a person has the virus in the body but the viral load is too load to be detected (but climbing) but also low enough that it is is not likely to be infectious. So, a negative test in the first few days is not a quarantee that he doesn't have COVID but makes it make less likely that he would give to you if he does. (And this is all probabilities - no completely certainty but less risk)
posted by metahawk at 12:47 PM on November 7, 2021 [3 favorites]

Metahawk has it.

Michael Mina has been one of the leading proponents of rapid testing as a way of controlling the spread of Covid. He says that rapid tests will show you as positive when you are infectious. By contrast, PCA tests will often show you as positive before you are infectious (good) and long after you are contagious (not so good).

Note that rapid tests are designed to be used serially. A single test result doesn't mean you're home free. You should continue to test (daily, or the frequency shown on the packaging). That's why in the US they are sold in two-packs.
posted by Winnie the Proust at 6:52 AM on November 9, 2021 [1 favorite]

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