By Bernard J. Wolfson, KHN
As you surely know, this country’s covid vaccination effort has been plagued by major birth pangs: registration snafus, poor communication, faulty data and a scant supply of vaccine — all exacerbated by inequitable allocation, alleged political favoritism and unseemly jockeying for shots.
Still, over 100 million shots have gone into arms, and more than 38 million people, 11.5% of the nation’s population, have been fully vaccinated. One in 5 U.S. residents have had at least one dose.
The vaccine rollout is finally ramping up — just as the deadly winter surge has ended, dramatically reducing infection rates, hospitalizations and deaths. President Joe Biden has promised enough vaccine for every adult in the country by the end of May and dangled the hope of a return to semi-normalcy by July 4.
We’ll see if that happens. Unfortunately, ill-advised behavior, or a mutant strain of the covid virus — or both — could still ignite another surge. And we’re not entirely certain to what extent vaccination prevents you from infecting unvaccinated people, or for how long it protects against covid.
Bottom line: Optimism is warranted, but all of us — even the vaccinated — still need to be careful.
In case you missed it, the Centers for Disease Control and Prevention issued new public health guidelines last week that offered a small glimpse of what the not-so-distant future might hold if enough people are vaccinated. The most striking point was that it’s OK for vaccinated individuals to meet indoors with unvaccinated members of another household, without masks, as long as nobody in that household is at risk for severe covid.
That’s big news if you’ve not seen your children or grandchildren in person for a while. If you are fully vaccinated, it’s now likely safe to visit with them indoors without masks, regardless of their vaccination status. You can even hug them.
As long as they don’t live too far away, that is: The CDC still frowns on long-distance travel.
If everybody in your group is vaccinated, so much the better. In that case, hosting a maskless dinner party inside your home, for example, is “likely a low risk,” according to the new guidance.
But Dr. George Rutherford, a professor of epidemiology at the University of California-San Francisco, warns not to interpret this new freedom too liberally: “People say, ‘Oh, we can have a wedding reception for 50 people at a hotel as long as they are all vaccinated.’ I say, ‘What about the people serving you — are they all vaccinated? And the band?’”
Public health experts and the CDC agree that if you are vaccinated and in the company of people who aren’t — or if you don’t know their status — you should continue the safeguards of masking and maintaining your distance.
“What I tell people who are vaccinated is, ‘You should assume you are one of the 5 or 6% for whom the vaccination will fail, and that everyone around you is a super spreader,” Rutherford says.
That means you should probably tap your inner brakes before going to a movie, working out in a gym, boarding an airplane or dining indoors at a restaurant.
Dr. Walter Orenstein, associate director of the Emory Vaccine Center and professor of infectious diseases at Emory University School of Medicine, points to a possible side benefit of the new CDC approach. “It may enhance vaccine uptake if it shows people that once you get vaccinated you have more freedom to do things,” he says.
Orenstein, like most public health experts, acknowledges that we still have an incomplete picture of covid and how the vaccines will work in the real world. Officials must set guidelines based on the best data available at the time, he says. “If, in fact, there is a marked spike in cases as a result, they will have to revise them.”
For now, Orenstein says, he is incorporating the new guidelines into his personal life. “We hadn’t had people over to our house in ages, and last night we had a couple over,” he says. They were all vaccinated, and they didn’t wear masks.
Others are wary of easing up too soon, even if they’ve been vaccinated.
“I feel a real sense of relief, but it hasn’t changed my behavior,” says Sam Sandmire, a 65-year-old retired gymnastics coach in Boise, Idaho, who’s had two doses of the Moderna vaccine. “I still mask up and will continue to mask up and social distance until the science shows that I can’t infect others.”
Andy Mosley, 74, says he is not entirely convinced by the new CDC statement. “The information that we could start hanging out with each other again was laced with a lot of qualifiers,” says Mosley, a resident of Temecula, California, who’s also had two shots of the Moderna vaccine. “That tells me they are not really sure about it.”
But he may alter his behavior in one instance. He has not seen his daughter, a chef who lives in San Francisco, since October 2019. She is scheduled for surgery soon and may need his help. “Because she’s been immunized and I’ve been immunized and her roommate has been immunized, I would feel safe going up there,” Mosley says. “So that would be a change. But I would drive; I wouldn’t fly.”
Many others, including state and local politicians, are less cautious. Texas recently did away with its mask mandate. Florida has remained largely open for business through much of the pandemic.
In California, 13 counties accounting for nearly half the state’s population have reopened gyms, movie theaters and indoor restaurant dining — albeit at reduced levels. That includes Los Angeles County, one of the hardest-hit regions in the U.S. during the winter surge. And Gov. Gavin Newsom has suggested that California’s four-level color-coded system for phased reopening could soon add a “green” tier — meaning pretty much back to normal.
However, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, says localities that open too soon “are going to be in big trouble shortly” because of a new surge he expects to be triggered by a fast-spreading covid strain first detected in the United Kingdom, which is projected to become the dominant strain in the U.S. sometime this month.
For now, stick with masking and physical distancing in most social and commercial encounters. Get vaccinated as soon as it’s your turn and try to persuade the people in your lives to do the same. The more people vaccinated, the greater the protection for the community.
In the near future, we may all have extra incentive to get vaccinated: Proof of vaccination could be required for air travel, sports events, concerts and other mass public gatherings. This is being considered in some parts of the U.S. and is already happening in some countries.
Israel, for example, has begun issuing six-month vaccination “passports” that would allow entry to sporting events, restaurants and other public venues. That has “created this kind of push for people who otherwise might not be that interested in getting vaccinated to get vaccinated,” Rutherford says.