Ask the doctors: Are we headed into another surge?

Update Nov. 18: All adults 18 years or older are eligible to receive a booster shot, either six months out from their second dose of the Moderna or Pfizer vaccine, or two months out from the Johnson & Johnson shot. Read more here.

It appears we're on a COVID upswing in Massachusetts.

Over the weekend, the commonwealth marked 24 new COVID deaths, and more than 5,200 new infections.

That number — 5,200 — marks a more than 1,200 case increase from the previous weekend, which itself marked an 800 case increase over the weekend before that. ICU beds are filling across the state, exacerbated by staffing shortages. And after months of reporting few cases of the coronavirus, there are now outbreaks in some of the state's jails and prisons.

Even as kids ages 5 through 11 get their shots, many adults qualify for boosters, and now there's talk of a COVID-19 pill, we seem to be headed in the wrong direction.

We take listener calls with Dr. Davidson Hamer, infectious diseases physician at Boston Medical Center and a professor of infectious diseases and medicine at the Boston University School of Medicine, and Dr. Gabriela Andujar Vazquez, an infectious disease physician, associate hospital epidemiologist and medical director of the COVID-19 Vaccination Program at Tufts Medical Center.

On case increases and the approaching winter: 

Dr. Davidson Hamer: "The numbers in Massachusetts have been relatively flat, but not decreasing for a while. In the last week or two, there's been a rise — not a big surge, but definitely an increase. And so we're going in the wrong direction, but we're going there, I would say, more slowly than other parts of the region. If you look at Vermont and Maine, for example, they have had a surge in cases in the last month. And yet these are two states that have very high levels of vaccine coverage. With people spending more time indoors and people basically starting to have more in-person events, whether it be, you know, at work or outside, you know, there's just greater number of exposures and the delta variant, is the predominant variant still circulating, is highly transmissible. So, you know, I think the next month or two could be tough.

Dr. Gabriela Andujar Vazquez: "I'm worried, but I'm cautiously worried, you know, and a little bit optimistic in a couple of things because ... [in winter] we expect the number of cases to increase in a certain proportion when compared to summer months. But then I'm hopeful that because of the vaccine availability now and the number of vaccinations we have across the state, that the severe illness, hospitalizations and deaths will not be as high or severe as we experienced last winter when we did not have a vaccine available."

On who qualifies for a COVID booster shot right now

Dr. Davidson Hamer: "The recommendations are for people 65 and older, and then anyone younger than 65 who is in an occupation or a living situation that increases their risk. So that could be homeless, prisoners, health care providers, or other people who have a lot of sort of outward contact with individuals. That's the CDC guidance. The reality is that a lot of people said, 'You know, I'm at risk. I'm going to go out and get a booster now.' And boosters are readily available. I don't think people are checking too carefully to say, 'Oh, you don't qualify.' It's not that restrictive. So if you feel like this would be something you'd like to do, I would not discourage it. My gut feeling is that within a month or two, maybe a little bit longer than that, they're going to liberalize the booster recommendations to everybody."

[Editor's Note: If you had the Johnson & Johnson shot as your first dose more than two months ago and are over the age of 18, you qualify for a booster shot.]

On why people with comorbidities quality for a booster shot

Dr. Gabriela Andujar Vazquez: "There's underlying medical conditions that we think may put the individual at risk of having severe illness. And so even if they're fully vaccinated with the primary series, we think that they would benefit from that booster to improve the vaccine-mediated protection. It's a very long list — there's obesity, there are regular things that we see all the time like high blood pressure, diabetes, there's mental illnesses. There's a different list of medical conditions that would qualify for a booster shot."

On when a pregnant person should get a COVID booster shot:

Dr. Gabriela Andujar Vazquez: "... in pregnancy, we have so much data now that contracting COVID has a lot of severe effects on not only mom, but baby, too. So I think I would try to maximize vaccine protection against COVID without compromising safety. We know that it's safe to get the vaccine, including [the] primary series and booster. So I would probably, in pregnancy, try to get, as soon as they're able to, that booster, as long as it's within the time-frame that's recommended — right after the six months of that second [mRNA] dose."

On if a kid gets the first dose of the vaccine for children (ages 5-11), and then turns 12 before their second dose, what should parents do?

Dr. Gabriela Andujar Vazquez: "I would encourage to get your child the vaccine as soon as possible, and more is not necessarily better. They should receive what is the age-appropriate dose. So if your child is 11 at the first dose, they receive the 10 microgram dose one, and if they turn 12 by their second dose, then they'll receive the 30 micrograms dose. But in the clinical trials, children were within those age groups, too, and they received a lower dose and they had a good vaccine-mediated immune response. So I think that as soon as they can get their vaccine, they should get the age-appropriate dose."

On if we should feel comfortable getting together with family for Thanksgiving:

Dr. Gabriela Andujar Vazquez: "Yes. I think that if I compare what our advice was last year to now, we do have the vaccine that's safe, effective and it still provides strong protection... And I think that to make your activity safer, you want to make sure that the majority of the people in that activity are vaccinated and that we follow certain safety measures depending on who is in the activity and and/or risk for infection and severe illness."