As a boosted, vaccinated infectious diseases physician I remained careful outside of work. I always wore a mask outside of my home. I even wore a mask while I am driving alone in my car because I needed it for my next encounter and it kept me warm.

So how did I get SARS-CoV-2 infection? The same way most people do, from household exposure [1]. One week before my SARS-CoV-2 diagnosis of December 20, 2021, my daughter went to see an old friend, in from out-of-town. The out –of –town friend was at an apartment where several friends were present. Seventy-two hours later my daughter had a scratchy throat, which she attributed to being tired; then some nasal congestion. The nasal congestion triggered our wearing masks at home, but it was too late. We had already had dinner together. Forty-eight hours later I had the same scratchy throat, which evolved into an intermittent cough for three days and then all dissipated by day four. I completed ten days of isolation during which time I watched the case rate of incident SARS-CoV-2 infection soar [2].

I hope that the SARS-CoV-2 infection that I experienced will become the new COVID-19 illness, but thus far that is not a universal finding. Although data indicate a milder course with Omicron when population immunity is high [3], and early data suggest vaccinated persons may be less likely to transmit SARS-CoV-2 [4], we are still months away from understanding the full clinical spectrum of this variant, and the protection that will be conferred by natural infection, coupled with up-to-date vaccine immunity, against this and future variants [5,6].

Omicron has clearly changed my perspective. As a vaccinated boosted physician, I now can pose a serious infectious risk to an unvaccinated person. Until now I always thought of the unvaccinated person as the one posing the risk. The unvaccinated remain at extraordinarily high risk of infection, and dependent upon co-morbidities may be at high risk of severe disease.

It is now up to us, the healthcare community, not only to protect the unvaccinated by moving each person toward vaccination, but also in the interim we will need to see ourselves and our vaccinated community as potential vehicles of SARS-CoV-2 transmission. During this time there is an urgent need for ongoing layered approaches to infection control as well as to promote testing. We cannot rely upon a positive test to jump start our infection control measures. We need to remain vigilant and act at the first signs of infection, including the scratchy throat.

I have no conflicts of interest to disclose.