This is a weekly Q and A column written by Dr. Lydia S. Segal in conjunction with Chaffee County Public Health. This column is focused on questions readers have about COVID-19 news and science. As Segal points out, ‘Everything I write today is valid for today. COVID-19 science news changes daily, and sometimes hourly.
QUESTION: How will my life change in 2021 in terms of COVID-19?
ANSWER: It is about the numbers. And the numbers are about how many people have been vaccinated, and how many have native immunity from having had COVID. Reaching herd immunity (meaning that about 85 percent of the population have been vaccinated or have had COVID-19) we can likely safely remove masks and stop social distancing outside and inside assuming the people you socialize with are fully immunized. Earlier projections had herd immunity with only 70 percent of the population being fully immune. However, the presence of the variants means more people will need to be vaccinated. Until we reach those numbers, we will not be living much differently than 2020.
Variants in the COVID-19 virus are taking hold throughout the United States.
QUESTION: How will life be different in 2021? And really, can we talk about 2022?
ANSWER: The CDC recently released guidance stating that travel is safe. It is expected that children and college students will likely go back to classroom schools. There may be a mandate that they are vaccinated to return to in-person schooling, depending on their age.
However, the second half of 2021 and 2022 is really too far off to say how life will be a new normal or a version of 2020. Mostly, this depends on the number of people who do get vaccinated, whether children age twelve and more can get vaccinated, and whether case numbers, hospitalizations, and deaths rise or go down.
QUESTION: Governor Polis recently loosened the mask and social distance mandates in counties that are rated ‘GREEN”. He also gave greater discretion on restrictions to local county public health leaders. Chaffee County is currently ‘BLUE’. When will the county go to GREEN?
ANSWER: This brings us back to numbers. The number of cases per 100,000 would need to decrease and the number of vaccinated would need to increase. The county is doing well and was running at over 70 percent of those over 65 years of age being vaccinated. Director of Chaffee County Public Andrea Carlstrom, stated with eligibility being opened to over 16 years of age, we are about 50 percent vaccinated. Now that [Gov.] Polis has opened up eligibility to everyone over 16, there will be a push to vaccinate the rest of the eligible in the county. There are currently available appointments both in Salida and Buena Vista. See the links below for more information.
QUESTION: Pfizer released data that said their vaccine has robust immunity for at least six months. What does that mean in terms of booster shots I hear about?
ANSWER: The newly released data is based on the original summer 2020 clinical trials. We are slightly more than six months out from those trials. Immunity tapers off gradually, not abruptly. At 6 months you are likely to still have very robust immunity as a result of vaccination. Nevertheless, disease specialists are conducting analyses of participant’s immune systems on an ongoing basis. Other similar vaccines, like those for SARS-CoV1 and MERS, showed that immunity lasted for at least several years, to more than a decade.
QUESTION: Will I need a booster in the future?
ANSWER: Just like the influenza virus vaccine that covers different variants, we will likely need boosters to protect against the SARS-CoV-2 variants that evolve. It is not clear yet whether it will be combined into the annual influenza vaccine. The variants from the UK and South America have been found in the county.
QUESTION: I have read the UK variant is spreading in the USA, can you discuss its impact on life this year?
ANSWER: The UK National Health Service databases show the UK variant is 50 percent more transmissible. This means it is more transmissible because of higher levels of viral shedding for longer periods of time. That translates into a longer period of infectivity, meaning if you are infected, you get to pass the virus on for a longer period of time. It does not necessarily mean you are sicker longer. The UK variant is also more lethal.
QUESTION: Can variants cause reinfections?
ANSWER: Based on the Novavax trial in South Africa, it appears that reinfection is possible with a different variant. Keep in mind that Novavax is still in clinical trial in the USA and shows promising early results. If and when it is approved, a review of the results will appear in this column.
QUESTION: Are the variants present in our community?
ANSWER: A test, called genotype assay testing, is done in state public health labs and at the CDC to look for the variants. This is not the typical test to see if you are positive for COVID. The percent of genotype testing done from all general COVID tests varies by country. In Australia and New Zealand they do genotype testing to about half of all positive COVID tests. In the UK it’s about seven percent and in the USA less than one percent. Given the low genotype testing in this country, it is difficult to assess the amount of variants and in which locations they exist.
QUESTION: What are the variants that are home grown that we need to be concerned with?
ANSWER: There are currently two main USA grown variants. They are NY(B.1.526) and California (B1.427 and B1.429). We don’t yet know the level of transmission and lethality of these variants.
QUESTION: How responsive are the vaccines to the variants?
ANSWER: Based on the most current limited literature, the vaccines compare favorably to the original SarsCov2 virus. Although there is a six fold decrease in antibodies to the South African variant by Moderna it is not known if there is still sufficient to ward off the viral variant. There is insufficient data on the Brazil variant or those that are USA homegrown.
Vaccine U.K.( B.1.1.7) South African ( B1.351) Brazil (P.1)
Pfizer same Same antibody response as original NA
Moderna good Six folder (fold) decrease in antibodies NA
J & J unknown Same antibody response as original NA
For more information about COVID, testing, and the vaccines, eligibility, and appointments, see the links below. Pharmacies are getting small shipments of vaccines. Information will be posted on this online medium and on the county public health and hospital web pages.
http://chaffeecounty.org/Public-Health-Coronavirus
https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/
Pharmacies with vaccine clinics: Buena Vista Drug, LaGree’s in Buena Vista and Valley-Wide Health, Safeway, Salida Pharmacy
By Lydia S. Segal, M.D., MPH
If you have questions you would like Dr. Segal to address in a future COVID Q and A column, please write to arkvalleyvoice@gmail.com
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