COVID-19 - Dr. Jim Halverson

COVID-19 - Dr. Jim Halverson

Ask Dr. Halverson: To mask, or not to mask, that will be the question

web 4 17 Halverson photo
By Dr. Jim Halverson
Centers for Disease Control Director Rochelle Walensky announced on May 13 that fully vaccinated people no longer need to wear a mask or physically distance IN ANY SETTING, except where required by federal, state, local, tribal or territorial laws, rules and regulations, including local business and workplace guidance.
The guidelines apply to non-healthcare settings. California is expected to adopt these recommendations when reopening regulations go into effect on June 15. Ventura County and Ojai will likely quickly follow the state guidelines.
What do these new guidelines mean for our daily activities and social opportunities? Please take some time to look over the CDC graphic on “Choosing Safer Activities” that accompany this column. Are you surprised by some of the opportunities that are considered safe for fully vaccinated people? I am. For example, I just don’t think I will attend our Ojai Fourth of July parade without wearing a mask, although the chart says that I could.
Here are the facts I hope you will consider when deciding to wear a mask after June 15. Please remember that you must be fully vaccinated for these suggestions to apply. People are considered fully vaccinated for COVID-19 two weeks after they have received the second dose in a two-dose series (Pfizer-BioNTech or Moderna), or two weeks after they have received a single dose vaccine (Johnson & Johnson). 


1. Currently authorized vaccines are highly effective at protecting vaccinated people against symptomatic and severe COVID-19 infections.
Since vaccinations began in December, the CDC and many state and county public health organizations have been tracking “breakthrough” infections, defined as the detection of SARS-CoV-2 RNA or antigen in a respiratory specimen (such as a nasal swab) collected from a person 14 days or greater after they have completed all recommended doses of a U.S. FDA-authorized COVID-19 vaccine. On May 21, Los Angeles County’s Public Health director said the county has identified just 933 breakthrough cases out of nearly 3.3 million fully vaccinated people. 
This equates to 1 case per 3,000 people. Of the 933, 71 had been hospitalized and 12 deaths reported. She noted that of the 12 people who died, “four had severely weakened immune systems” from prior medical conditions or medications, highlighting the need for such people to continue taking precautions even after being fully vaccinated.


2. A growing body of evidence suggests that fully vaccinated people are less likely to have asymptomatic infection or transmit SARS-COV-2 to others.
If you are exposed and have been fully vaccinated, you should have a very effective immune response to the virus, effectively eliminating it from your airways very quickly. Others around you who are fully vaccinated should be at very low risk of getting infected from you.


3. How is my health? 
This is important for two reasons. First, if you are at high risk for severe COVID-19 infection, are you comfortable being unmasked in the setting you will be going to? Second, people with significant underlying health conditions are not as likely to get as robust an immune response to the vaccines as those who are in good health. Unfortunately, this cannot be measured by antibody testing alone as other protective immune system components are helped by vaccination also. If you are on immunosuppressive medications or have significant underlying health issues, please discuss the need to continue wearing a mask with your healthcare provider after vaccination.


4. How is the health of the people I will be around?
Consider wearing a mask if you are visiting someone in poor health who would be at higher risk for severe COVID-19.


5. Is the event I am attending inside or outside?
Events outside or in well-ventilated indoor spaces have much lower risk of significant exposure to the coronavirus.


6. Do I currently have any symptoms that are consistent with COVID-19?
These guidelines apply to people WITHOUT symptoms. If you are symptomatic, get tested and quarantine at home until you have the results.
Ultimately, time will tell if these guidelines are truly safe. Current case numbers of COVID-19 nationally are continuing to drop, now averaging less than 30,000 cases per day. More importantly, California now has one of the lowest rates of infection in the country. If case rates in California increase significantly after the guidelines go into effect, then masking guidelines should once again become stricter. If case rates remain low, I will gradually become more comfortable with not wearing a mask in more social settings. For me, it will continue to be a daily decision in the foreseeable future.
Stay properly informed. Follow your local, state and federal COVID-19 regulations. Stay hopeful. Stay safe. Be well.

— Dr. Jim Halverson is a longtime Ojai physician who writes a weekly column on COVID-19 for the Ojai Valley News.