It’s not that bad if you are in a single house or have decent neighbors. My extended family had them from some holidays hotel and one professional extermination was enough. (That being said, I live in Europe - hollow walls are a rarity)

I heard it’s a huge problem if you are living near some slob that is a neverending source of the infestation. If one has a neighbor that sacrificed his body and soul to the bedbug god and refuses to let exterminators in, then indeed, the only possible choice is to GTFO.