UCSF’s Bob Wachter was traveling with his wife when she tested positive for COVID. Here’s how they handled it – San Francisco Chronicle

After more than two years of diligently following COVID-19 safety measures, avoiding high-risk situations, and sharing pointers with his legion of social media followers, Dr. Bob Wachter, UCSFs chair of medicine, found the pandemic hitting close to home over the weekend.

His wife, journalist and author Katie Hafner, tested positive for the coronavirus on Sunday morning, Wachter said. She had recently returned from a teaching at a weeklong writers workshop with about 50 other people. The couple both 64 years old, double vaccinated and double boosted had then flown to Palm Springs to visit with some older friends when she started feeling ill.

She felt mostly guilty, which is a fairly common feeling for people that have been very careful, Wachter, who had tested negative as of Monday afternoon, told The Chronicle. She felt less bad about her own clinical status and illness and more worried about whether she could infect these friends that we were visiting, or that she could infect me.

With the high attack rate of the BA.2 omicron subvariant and its sublineages, such as BA.2.12.1, Wachter said his odds of catching the virus after staying with his wife in a hotel room the night before her positive were about 50%.

One would assume that a bed sharer would have a higher rate than, say, the kids or roommate, Wachter tweeted. On the other hand, she tested neg. on our 1st day together, so I probably was only exposed to her while infectious for ~12 hrs.

The couple canceled their flight home Sunday evening. Although Wachter thought the chances of exposing other passengers were relatively low, he said, we knew it was the wrong thing to do.

With airline mask requirements now dropped, We knew that most people sitting near her would be maskless.

They instead made the nine-hour drive to San Francisco in a rental car, both wearing well-fitted N95 masks and keeping the windows open the entire time.

Wachter said given the typical 3-5 day incubation period, he wouldnt know if he was infected before Wednesday.

In 23 tweets, Wachter reviewed the couples precautions, their options after her positive test and what went into their decisions. Vaccines and treatment make COVID less worrisome today than in earlier pandemic phases, he said.

My mindset is that the state of COVID today is probably about what it's going to be for the foreseeable future, he told The Chronicle Monday. We are all going to have to negotiate some version of normal that works for us. For many people, that's going to be a state that involves taking more risks than you were willing to take a year ago.

With coronavirus infections and hospitalizations again climbing across California, especially in San Francisco and the Bay Area, Wachter earlier this month said he was resuming rigorous masking .

On Twitter, he shared a photo of Hafner hermetically sealed on their flight, with an N95 mask and fleece hood nearly completely covering her head and face. With their older friends in Palm Springs, given their age and medical comorbidities, Katie was very careful - masking when indoors with them, testing at SFO before boarding the flight for Palm Springs, then testing each morning (she was negative on Saturday), he said in the thread. When we ate with them, we ate outdoors only.

Wachter said their hosts tested negative Monday morning and will test every day for the next 3-5 days.

Id give them a 5-10% chance of turning positive, tweeted the doctor, who has been at the forefront of the COVID pandemic since early 2020.

His wife now is taking the treatment drug Paxlovid to reduce her chances of a severe outcome, Wachter said, noting that she feels crummy. But the key fact is that her vaccines, boosters, and Paxlovid bring her odds of a truly bad outcome (hospitalization, ICU, and death) down to near zero.

He said he himself would not start Paxlovid because it has not been shown to prevent infection for close contacts of an infected person.

As for his wifes guilt about carrying COVID to their friends home, Wachter said, I told her this level of COVID risk is the way the world will be for many years, and making choices like teaching at this course is something we need to learn to live with.

Earlier this year, during the winter omicron surge, Wachters 28-year-old son was infected after watching a movie with a friend.

In his Twitter thread, Wachter compared todays COVID risks with earlier in the pandemic.

There is good evidence that being fully vaccinated halves the odds, and at least theoretical reasons to believe that early use of Paxlovid might also help, he said. If I turn positive in the next few days, my odds will be similarly favorable. So - though getting COVID still sucks - theres a lot to be grateful for.

However, Wachter noted Monday that long COVID and other possible impacts of the virus on the heart, brain and lungs still weigh heavily in his decision making process.

I still think it may turn out to be that the most harmful legacy of COVID is if it meaningfully increases your chances of long term noninfectious complications like heart attacks or diabetes. It's still in my calculus when I ask myself how important this activity is and is it worth it for me to do this, and is it worth it not to have my mask on?

Aidin Vaziri (he/him) is a San Francisco Chronicle staff writer. Email: avaziri@sfchronicle.com

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UCSF's Bob Wachter was traveling with his wife when she tested positive for COVID. Here's how they handled it - San Francisco Chronicle