With vaccine surge, can we safely return to pre-COVID life?

In many ways, this week is a turning point in the battle against COVID-19.

Disneyland will reopen Friday after being closed for more than a year.

Coronavirus cases in Los Angeles are so low that the area is about to move to the yellow tier, the most forgiving of California’s four-category color-coded reopening system, prompting dramatic reopens.

And people who are fully vaccinated against COVID-19 can safely stop wearing masks in many outdoor settings, the U.S. Centers for Disease Control and Prevention said Tuesday. English).

But there are still reasons to be cautious. As the situations in Oregon and India show, the coronavirus remains a threat.

What are some of the issues that experts remain wary of?

Earlier this month, Dr. Robert Wachter, chair of the UC San Francisco Department of Medicine, commented in an online seminar that he felt comfortable cutting his hair and flying to see his parents now that he is fully vaccinated. He also felt comfortable resuming a monthly poker game with fully vaccinated friends, he recently tweeted. But the 63-year-old hasn’t really wanted to go to an indoor restaurant and remove his mask there.

“I am sure that they are not going to hospitalize me and die. That feels good. But I don’t particularly want to have mild COVID because I’m not sure that that can’t turn into a lasting illness or some long-term consequence that I don’t yet understand, ”Wachter said at the seminar.

“Prolonged COVID” refers to a series of symptoms that have persisted for months in people who have survived coronavirus infection. They include fatigue, shortness of breath, sleep disturbances, fever, stomach problems, anxiety, depression and difficulty concentrating – what some people call “brain fog,” noted Dr. Anthony Fauci, the government’s leading infectious disease expert. USA.

The severity of prolonged COVID “can range from mild, annoying to quite disabling,” Fauci said.

The disease persists for a long time even after the virus has been cleared from the body. Alarmingly, Fauci said, about 30% of patients enrolled in a study reported persistent COVID symptoms lasting up to nine months.

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What do other doctors think about eating indoors?

Other fully vaccinated doctors have felt comfortable returning to indoor restaurants, at least in places they know well in California.

“Personally, I am 69 years old, I am vaccinated. You probably have some additional risk factors. I feel comfortable eating indoors in the places I know, ”Dr. George Rutherford, an epidemiologist at UC San Francisco, said in an interview.

In the webinar, Dr. Peter Chin-Hong, UC San Francisco professor of medicine and infectious disease specialist, said that if you went to a restaurant indoors, you would reduce your risk, for example, by sitting near a window. or making sure to put on the mask when you go to the bathroom.

Dr. Monica Gandhi, UC San Francisco professor of medicine and medical director of the HIV Clinic at Zuckerberg San Francisco General Hospital, said on the online forum that she felt comfortable bringing her two unvaccinated children and two parents Fully vaccinated, 87- and 80-year-olds, to an indoor restaurant in San Francisco.

“I felt perfectly safe,” explained Gandhi. Part of that had to do with the extraordinarily low amount of virus circulating in San Francisco, so he felt that “I was probably not exposing my parents to COVID.”

But a doctor might make a different decision about indoor dining if, for example, they lived in Michigan, home to the highest rate of coronavirus cases in the country, Chin-Hong said. California has the lowest number of coronavirus cases per capita in the United States, while Michigan has the highest.

What about wedding receptions?

The mix of vaccinated and unvaccinated people in an event “is always a little questionable,” Rutherford said. Risks can be reduced by following guidelines issued by California, he noted.

Wedding receptions, meetings and conferences are now allowed in the state, with modifications depending on the level of viral load circulating in a county. In Los Angeles, for example, which is in the second least restrictive category, orange, outdoor receptions can be held with a maximum of 300 people if they all test negative for the virus or can show proof of vaccination, or up to 100 individuals They do not need to verify inoculations or recent test records. Indoor receptions can be held if all guests show negative coronavirus tests or vaccination, with a limit of 150 guests.

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The CDC and the California Department of Public Health urge people to delay their travels until they are fully vaccinated.

How about going to bigger sports games or conventions?

Rutherford said he believes California’s rules for watching live professional sports games are well thought out. “Just follow the rules,” he said.

And while Governor Gavin Newsom has discussed a “full reopening” of the state’s economy on June 15 if vaccine supply is ample and hospitalization rates remain low, some major regulations are expected.

For example, large-scale indoor events, such as conventions, would require proof or verification of vaccination, the governor’s office noted.

The San Francisco convention center, the Moscone Center, has booked its first convention since the pandemic began: a surgeons’ event to be held from September 30 to October 2.

“They are all surgeons. Everyone will be vaccinated, ”Rutherford said.

California has a relatively low case rate. Will the state avoid a fourth wave?

“We just don’t know,” Rutherford said. Colorado, Washington, Oregon, Nevada, and Arizona are among the states experiencing an increase in the number of cases.

There are several factors that help determine if a new wave will come, he stressed.

First, what proportion of the population has been vaccinated?

Second, do people still wear masks and stay physically distant?

Third, have variants emerged that are more transmissible and difficult to control? One possible explanation for the surge in Michigan is how the highly contagious British variant (B.1.1.7) is dominating there; and how it has not done so much in California or Arizona.

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Fourth, are residents who continue to live unvaccinated clustered in a way that would make an outbreak worse? A Times analysis found that only 35% of people living in California’s most deprived areas have received at least one dose of vaccine, while 57% of individuals living in the most affluent areas of the state have received at least one dose of the vaccine. minus one injection.

Fifth, how soon will adolescents be eligible to receive the antigen? Licensing Pfizer’s vaccine for children 12 and under is something that will be necessary to really slow transmission, Rutherford said.

And sixth, how many doses are available? A solid supply will help alleviate the threat of a fourth wave.

How vaccines can fail in rare cases

In Kentucky, an unvaccinated healthcare worker is believed to have brought the coronavirus to a nursing home. An outbreak occurred that left 26 residents infected, including 18 who were fully vaccinated, as well as 20 healthcare workers, four of whom were fully inoculated.

Three residents died: two who had not received any doses and one who had been “fully vaccinated” and who had received both doses of the Pfizer vaccine more than 14 days before the outbreak was identified, according to the CDC.

One of the uninoculated people who died had previously been infected with the coronavirus. That death demonstrates the rare risk of reinfection and underscores the importance of everyone, including COVID-19 survivors, receiving the vaccine in the same way, according to the report.

Experts say the immunity provided by antigens is better than surviving COVID-19.

“Even if you’ve had a previous infection, you really get a spike in antibody levels from the vaccine,” said Dr. Paul Simon, chief science officer for the Los Angeles Department of Public Health.

If you want to read this article in Spanish, click here.

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