What are people asking about COVID-19 – and what do doctors wish patients knew?

In the first days of the COVID-19 pandemic, the world was full of questions.

Dr. Jeffrey Hsu recalls the fear of the unknown as he and other health professionals confronted a virus they didn't understand, much less know how to treat.

"It was quite scary," said Hsu, a cardiologist and an assistant professor-in-residence at the David Geffen School of Medicine at the University of California, Los Angeles. "We were bracing ourselves for the worst."

Five years after the World Health Organization declared a pandemic, the questions have waned, at least among patients, said Dr. Won Lee, medical director of Boston Medical Center's Home Care Program.

"I think a lot of people are fatigued by the news and the headlines that they have been receiving for many years," said Lee, who is part of a medical team that helps homebound older adults.

COVID-19 and the virus that causes it, SARS-CoV-2, might not be as headline-grabbing as they once were. But even though deaths from the virus are far below their early 2021 peak of more than 25,000 a week in the United States, COVID-19, which is directly blamed for more than 1.2 million U.S. deaths since 2020, hasn't gone away.

"We're still seeing waves of infection with SARS-CoV-2 pop up, and we're still seeing patients who do get severely ill," Hsu said. "So that's still happening. Definitely at a much smaller scale than it was before, but it's still there." So far this year, COVID-19 has been listed as the cause of death for 5,694 people in the United States, according to the latest numbers through Feb. 22 from the National Center for Health Statistics.

Here are answers to what doctors say are some of the most common questions they still get about COVID-19 – and a few questions they wish they were hearing more often.

Do I really need another vaccination?

It's the most common question Lee gets from patients and families, and one Dr. Susan Fuchs, an attending physician in the emergency department at the Ann and Robert H. Lurie Children's Hospital, hears variations of.

Some people ask her, "Is a vaccine worth it?" The answer is yes, said Fuchs, who also is a professor of pediatrics at the Feinberg School of Medicine at Northwestern University in Chicago.

Fuchs acknowledged that the vaccines don't stop every case – she's been vaccinated and had COVID-19 twice herself. But vaccines protect against severe illness, hospitalization and death, according to the Centers for Disease Control and Prevention, which recommends vaccination for everybody 6 months or older.

Are COVID-19 vaccines safe?

Fuchs wishes more people would come to her with their worries about vaccine safety and side effects. Most people, she said, endure little more than a sore arm or a low-grade fever. Other common side effects include muscle pain, joint pain, fatigue, headache or chills.

"There are minor side effects with most vaccines," Fuchs said. "But it's better than getting the actual illness."

The approved vaccines are still being monitored, she said. And "right now, we're saying it's a safe vaccine – no matter which one you get from whichever company."

Who has the answers about boosters or other concerns?

Fuchs said that while people don't ask about the emergence of different COVID-19 variants the way they once did, people can easily become confused about how often they need their vaccination updated.

Her advice: "Go to your family doctor."

Lee said it's easy for people to feel overwhelmed when there are "so many different sources coming at you all at once." She regularly hears from patients or family members who have a concern they've heard from friends or at church or read online that they want to check with her. "I absolutely love and welcome those conversations," she said.

Will I ever get better?

Most of the patients Hsu interacts with have long COVID, an assortment of symptoms that continue four weeks or more after the initial infection. People who have it ask him, "Is this going to shorten my life? Do people get better?"

Researchers don't have all the answers to that, Hsu said. But large numbers of people – many of them previously young, active and healthy – "are now effectively disabled because of long COVID."

Some people with long COVID – maybe a third – have gotten better, he said, but "I think the majority of people are still dealing with ongoing symptoms and are nowhere near back toward their baseline."

Researchers are learning how the virus can persist in the body for years, Hsu said, and they've seen hints that abnormal blood clotting may be at the root of some problems.

He's hopeful that treatments will be found, but at the moment, the answers about long COVID remind him of how doctors felt at the start of the pandemic. "We want to help, but we don't have effective therapies to help just yet."

He wishes more people were asking questions about how to limit the spread of the virus. People who have had a mild case of COVID-19 might not be as afraid of getting reinfected, Hsu said.

But risks of heart disease, stroke, high blood pressure and other conditions increase after an infection, he said. And each infection could become severe or lead to long COVID.

He emphasized how serious long COVID can be. Some of his patients are formerly high-energy, highly accomplished people who now are so drained that they can't get out of bed to come to his clinic. "I can only see them virtually, and it's just devastating."

How can I protect myself and the people around me?

Like Hsu, Lee said she wished she heard this question more often.

"Even before COVID, this would come up with the flu shot," Lee said. "Young, healthy people would say, 'Well, you know, I don't really get too sick from the flu. I don't really have to worry about it.' And my plea was always, 'Well, think about your grandmother or your neighbor, or the person who you work with,'" or someone who cares for a child with a disability at home.

According to the CDC, age is the strongest risk factor for severe COVID-19, and the risk grows higher the older someone gets. Other high-risk groups include people with underlying conditions such as heart disease, people on dialysis and those with suppressed immune systems.

Staying up to date with vaccinations is one important way to protect them, Hsu said.

"I'm not one who just blindly says everyone should get a vaccine," he said. "I do understand everyone has their own approach to weighing the risks and benefits of the vaccine. My concern is that the risks of the vaccine are real but have been overstated by influential voices on social media."

Beyond vaccines, Lee said that advice from the pandemic's peak on limiting the spread of the virus holds up. "If you're sick, stay home. If somebody is sick, don't let them come visit you."

She acknowledged the importance of staying socially connected, especially for older people. "I do want people to visit their older adults in their lives and spend time with them and pick up the phone and talk with them, because I think the flip side to people being too cautious or too scared about getting someone sick is the social isolation."

But, she added, "I want them to do it safely, when everyone's feeling good."

COVID-19 and the flu are similar in that some people might dismiss them if they've had only mild cases in the past, Lee said. But both can be deadly. And even when they aren't fatal, a case of either that requires hospitalization can have many unintended consequences, especially for older adults, sometimes leading to lasting disability.

"That's something a lot of people don't consider," Lee said, "and it's not something most people want to face."

Fuchs said parents should not send their children back to school until they have been fever-free for 24 hours without medication. And she still wears a mask at work because she doesn't want to spread COVID-19 from patient to patient.

Hsu's recommendation is "if it's clear that cases are rising, then it may be a good time to be more mindful about wearing a mask in public" and to make sure large gatherings are held either outdoors or in a well-ventilated area.

"I also think it's really important to take care of ourselves and our bodies better," Hsu said, with a healthy diet, regular exercise and medical checkups. "I do think that these measures can make us more resilient to an infection."

Lee seconded Hsu's advice for getting up to date with any routine health screenings that might have been delayed during the pandemic. That can be a good time to raise whatever COVID-19 concerns someone might have, she said.

"It's stressful to try to make sense of all the things that you hear or read," Lee said, but there's an easy way to avoid that stress over health concerns. "Pick up the phone and make an appointment."