Covid update July 1, 2021

Share this today!

There have been two very confusing issues recently regarding Covid 19 here in the US.

First off is mask wearing. Several different recommendations have been issued recently. The CDC position since mid-May has been that no mask is necessary in public if you have been vaccinated. The alternative recommendation coming from WHO and some local health departments such as Los Angeles County is you should continue to wear masks when out in public despite being vaccinated. This position is based on the concern that the Delta variant is so contagious that even being vaccinated may not protect you from either spreading it or getting it yourself (though the Pfizer and Moderna vaccines protect very well against it).

The reality is no one really knows, yet Dr. Walensky, the new head of the CDC, offered a compromise position yesterday stating that being unmasked remains ok unless the local health authorities in your area have recommended otherwise. Personally, I continue to wear a mask in public since I am not yet comfortable with the risk without one. Here in Arizona though, there is currently no formal recommendation overriding the CDC guideline to being unmasked if vaccinated. Of note is that having had Covid earlier on is not felt to be protective against the Delta variant and therefore masking is being recommended by some for this group.

The second issue is if a booster or additional dose of vaccine will be needed beyond what is already recommended. This conversation started back in Dec 2020 and like everything Covid related it is a frequently changing one.
In brief, the most recent data coming out is that the mRNA vaccines (specifically Pfizer and Moderna) seem to provide long term protection against both infection and death from Covid19. The adenovirus-based vaccines (Johnson and Johnson here in the US and Astra Zeneca in Europe and other parts of the world) protect against death from Covid19 yet may not be as protective against infection with the new variants (specifically the Delta variant).

There are some interesting studies just recently published showing that people who received a Pfizer vaccine a few months after receiving the Astra Zeneca vaccine had a significant increase in antibody levels against Covid19. This mixing of different formulations of Covid19 vaccines has been discussed for months in the medical literature. What is uncertain is if this will lead to fewer symptomatic infections or deaths. Also unknown is whether those who got a Johnson and Johnson vaccine should get a Pfizer or Moderna vaccine or if administering a third Pfizer or Moderna vaccine will provide even better protection or be necessary at all. Stay tuned for more on this subject. Right now, no additional shots are being recommended here in the US.

(The day after I released this message a study was publicized looking at a third and even fourth vaccine dose for those individuals who failed to make antibodies with the first two doses. This group mainly consisted of patients who were on chemotherapy for cancer or on other medications that suppressed the immune function. Although the number in the test group was small they did show that with a second series of two shots this group finally formed antibodies to the virus and thus were now probably protected. It will be interesting to see how these findings change what is done.)

The number of cases here in Arizona has been slowly increasing over the last 4 weeks. While nowhere near the numbers when things were really bad, the average daily number of new cases has increased from below 400 a day to an average of 540 a day over the last eight days. Hospitalizations for Covid 19 are fluctuating yet based on both numbers reported by the state and by TMC they are up a little.

Finally, I am giving my employees a four-day July 4th weekend so the office will be closed on Friday July 2 and Monday July 5. I will remain available by cell phone or through the answering service, yet hopefully everyone will have a joyful and healthy holiday celebration and not need to speak with me. I will be back in the office July 8 after just hanging out with my family at home. Take care.