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Is everyone going to get COVID-19 at some point?

Breakthrough cases are expected but not always inevitable, experts say.

At this point, we know that the omicron coronavirus variant is more transmissible than previous versions of the virus — it's already been detected in all 50 states and we're seeing record case numbers in some parts of the country already. But does that mean everyone should prepare to get COVID-19 now?

Not yet, experts say. Many of us will likely be exposed, but whether or not you become infected with the virus depends on both public health policies and individual behaviors.

Expect to be exposed, but not necessarily infected.

Throughout the pandemic and especially now with the highly transmissible omicron variant taking over, we should expect to be exposed to the virus at some point, Dr. Bernard Camins, medical director for infection prevention at the Mount Sinai Health System, told TODAY.

"I've been telling this to anyone who would listen: It's not a matter of if you get exposed to the omicron variant or any other variant of the coronavirus, it's a matter of when," he said. It may not be this week or even in the next year, but eventually, "everyone will run into somebody with a COVID infection," Camins said.

But being exposed to the virus doesn't mean you'll get infected.

“I don’t think it’s a foregone conclusion that everybody will get COVID-19,” Dr. Otto Yang, professor of medicine in the division of infectious diseases and of microbiology, immunology and molecular genetics at the David Geffen School of Medicine at UCLA, told TODAY.

"It really depends on the public health response and what we do in terms of vaccination," he said, as well as prevention measures such as masking and social distancing.

Getting vaccinated and boosted will make the biggest difference.

Getting fully vaccinated and boosted will ultimately be the difference between getting exposed and getting infected — as well as the difference between a mild case of COVID-19 and a severe one.

“It’s looking very much like people who get a booster have protection against getting it,” Yang said. And introducing a booster that’s specific to omicron — or whatever concerning variant might be next — is one way to make vaccination even more effective against breakthrough infections, he explained.

“Certainly, your outcome is going to depend on your vaccination status ... We will see that those who are vaccinated and boosted will have less severe outcomes, less risk of mortality,” Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, told TODAY's Craig Melvin this week. “There are going to be breakthrough cases of omicron, but they will be certainly milder if you’re vaccinated and boosted.”

If you develop a breakthrough infection, don't panic.

It might be beneficial for even fully vaccinated people to mentally prepare to test positive at some point in the future, Camins said. If you do test positive at this point as a fully vaccinated person, you should be “concerned” but not “scared,” he said, advising people to get in touch with their doctor and monitor their symptoms. Keep in mind that most people are experiencing mild symptoms with omicron.

It's "always been a possibility" for even vaccinated people to get COVID-19, Yang said.

Coming to terms with that possibility — and the reality that getting COVID-19 now as a vaccinated person is not the same as it was in March 2020 — is part of adjusting to this phase of the pandemic.

We now have the vaccines, boosters, better (though still lacking) access to rapid tests, and, soon, oral antiviral medications we can take at home. Having all these tools doesn't mean COVID-19 isn't still dangerous or that people shouldn't take the precautions they can to protect themselves. But it does mean that many of us can take more calculated risks than we have previously in the pandemic.

For some experts, learning to live with COVID-19 means making this mindset shift. It also means knowing that the virus will likely be with us for a long time, hopefully in a less and less impactful way as time goes on. But even then, it will still kill some people every year like the seasonal flu, Camins said.

"I would prefer not to learn to live with COVID. I would prefer to get rid of it, and theoretically, it's possible," Yang said. "The scenario that I'm hoping will play out is that the numbers of COVID cases are reduced drastically to the point that there are small outbreaks here and there that are easily contained and most of the population is not being exposed." 

Whatever happens with omicron, it's clear that COVID-19 will be in our lives for a while longer. And while most of us will come in contact with the virus at some point or another, that doesn't mean we'll get infected or have severe symptoms.