Feb
20
2021

2-19-21 Covid19 update

Share this today!

Now that more people are being immunized, I am getting more questions about what activities may be ok to do again. Patients are wondering if going to the gym or eating out can now be done without risk of infection. To answer that question, I need to elaborate on what is going on this week.

In Houston Texas, a small group of people were found with extremely high viral loads and relatively mild disease. This group subsequently infected many individuals supporting a current theory known as the 20/80 rule. It is believed that 20% (or less) of the population causes most infections, and consequently the continuation of the pandemic.

In this Houston group the current predominant strain (D614G) was isolated, yet it is believed that by the end of March or early April this strain will be surpassed by the UK/British variant strain B.1.1.7. Thankfully, the British variant remains sensitive to the Pfizer and Moderna vaccines.

However, there are additional variants which are not. The South African strain (B.1.351) is the most concerning, as that is spreading rapidly through the world and is less responsive to the Pfizer and Moderna vaccines (although they do offer some protection).

With more genomic sequencing of the virus, additional mutant strains are now being identified, and so far, seven additional variants unique to the US have been found. At this time, it is unclear how significant these US variants are, although one (from Southern California) has been isolated here in Arizona in addition to the British variant. So far, no cases caused by the South African variant have been identified in Arizona.

One hypothesized worry about vaccines is that someone immunized can still be an asymptomatic carrier of the virus and pass it on to someone else (remember the 20/80 rule). Variant strains not as well covered by the current vaccines could make this transmission more likely. Indeed, it is theoretically possible that an immunized individual could infect another immunized individual with a resistant strain.

So, even though someone may be immunized, they are not necessarily completely protected. Hence, the continuing advice of staying socially distanced and wearing masks when around others. Eventually, when over 70% of the population is either immunized or has natural immunity, these concerns will most likely ease, yet it will be at least another 3-4 months before that occurs.

Therefore, it is ok to go to a gym if you continue to wear a mask when there with others. Eating in a restaurant is a bit trickier, since obviously you need to remain unmasked, yet if done in a larger room with few people this is probably ok. Eating outdoors or a similar open-air environment would be preferable. Getting together with family who have all been immunized or have recovered from an infection is also probably ok yet remember that most of the spread of the last few months occurred in small family get togethers.

The most frustrating aspect of Covid is the unknown. We continue to understand the virus better as time goes on, so it is likely that some of what we believe today may be disproven in the future. Nonetheless, we are limited by what we know and need to advise accordingly in order to bring this pandemic to a quicker end.

I will be back next week with another update. Take care.