LA County Recommends Indoor Masks, Regardless Of Vaccines

Speaker 1: 00:00 Health officials in Los Angeles county are urging people to wear masks indoors, regardless of their vaccination status. This reversal of the state's previous masking guidelines comes as the highly contagious Delta variant continues to spread throughout the state. The world health organization is making the same recommendation here to talk about the risks of the Delta. Variant is Dr. Christian. Ramers a specialist in infectious diseases who oversees clinical programs at family health centers of San Diego. And he sits on the counties vaccination clinic advisory group, Dr. Ramers welcome. Thank you, Jake, for having me. So how much of a threat does the Delta variant pose to San Diego's population? Given what we know about the counties, vaccination numbers, Speaker 2: 00:43 We're kind of splitting into two different groups of people. There's those that are fully vaccinated for which the Delta variant is really not much of a risk. The vaccine seems to hold up really well, especially the data that we have for the marinade vaccines, the Pfizer and the Medina that it basically can protect around 88% of the time from infection and about 96% of the time from hospitalization. So very close to the original members, but for those that are not vaccinated, this Delta variant, it's looking like it's probably twice as contagious as the original ancestral Wu Han strain. You tell Speaker 1: 01:14 Us about how the Delta variant is impacting people who can try. Speaker 2: 01:18 Well, there's a little less known about the severity of disease. There's kind of conflicting reports about it being more severe of an illness versus just being more contagious and effecting more people. So we haven't quite worked that out. It's possible that it is causing a little bit more disease. Those are just from anecdotal reports from India, where this was originally described that younger people were getting sicker in the hospital. You know, we need a little bit more information to make that conclusion for sure who is most Speaker 1: 01:43 At risk at this point? Speaker 2: 01:45 Well, it's pretty straightforward. It's people that have not been vaccinated. Um, and by my calculations that, you know, we've done a great job in San Diego getting to where we are, but there's still, uh, about a half a million people or more that are not vaccinated at all. And so those are going to be the vulnerable ones. We're going to have a, you know, kind of a tale of two populations of those that are protected. And I should say those, if you are fully vaccinated, even if you do get a case for the Delta variant, it looks like it's going to be just a very mild illness. That's what we've seen in Los Angeles. I just saw a report out of 123 cases there 113 or 91% of the Delta variant cases are occurring in unvaccinated people. Couple hospitalizations caused by that. And there were 10 cases and people who had been vaccinated and they did not need to go to the hospital. Any of them, that Speaker 1: 02:26 Number includes children under 12. So what advice would you give to San Diego parents about what is safe to do and not to do taking both the current infection rate and vaccination status into consideration with the Delta area? Speaker 2: 02:42 These vaccines are very carefully studied and we're not quite ready to use them on children younger than age 12. So what do you have? Will you have other mitigation strategies? You don't want to just go with one tool like COVID has taught us that multiple layers of prevention are the best. So if you can't be, for some reason, especially because of age, then this is where masks come in. We know masks are still very effective. And then all of those old non-pharmaceutical interventions such as distancing and fresh air and staying outside rather than indoors, we need to still remember all of those other things and not forget the lessons that we've learned over this past year. Officials Speaker 1: 03:17 In LA county are now urging people to wear their masks indoors. Just two weeks after governor Gavin, Newsome, reopened California and lifted the statewide mask mandate. What would prompt you to make a similar recommendation here in San Diego county? Speaker 2: 03:31 Yeah, we're shifting into kind of a new era here where instead of the government saying, this is a mandate and you have to do it, it's more of a recommendation. And that's what Los Angeles county officials are doing. And people are going to have to take more individual responsibility and make their own individual decisions. So again, indoors with poor air movement and a high concentration of people, that's a relatively risky situation, bars and restaurants, where people are really taking off the masks and eating those are, those are higher risk contacts, but if you're outdoors and fresh air, really, you don't need to. So I'd say people just need to make their own decisions and, you know, talk to their friends and look at good information on the internet. The more contact you have with more individuals outside of your household, especially if indoors, the riskier it is vaccination is one way to protect yourself. And a mask is another king Speaker 1: 04:16 Of vaccinations. A recent study published in nature magazine suggests the MRNs Pfizer and Madrona vaccines may protect for years against COVID-19 when both doses are completed. What does this tell us about the possible need for booster shots and further protection in the future? Speaker 2: 04:33 Yeah, this is very encouraging news, really pretty small study only in 41 people. And I think only about 10 or 15 had that had the lymph node biopsy is performed, but what they found were these very long lasting DeSales, the ones that make antibodies at relatively high concentrations, even several months after vaccination. So it's only a guess at this point, but the guest is that the protection is going to be around for awhile. You add that piece of information with the way that the MRNs vaccines are holding up against the variants. And it's really pretty good news for people that have been vaccinated. There was an announcement from a vaccine manufacturer that everyone's going to need boosters. And to be Frank, they're not the ones that decide it's the NIH. And it's the CDC, the advisory committee on immunization practices to really look at the data and see whether these are necessary. If I were to look at my crystal ball, I would say not everyone's going to need a booster, but for more vulnerable populations, such as those who are elderly, those with underlying conditions, particularly those who are immunocompromised might be the ones that will need boosters going forward. Well, the number Speaker 1: 05:32 Is small. There have been cases of fully vaccinated. People who have still died from COVID-19 related complications in San Diego, that number stands at three. Is this something that we should be concerned about? Speaker 2: 05:44 You know, the numbers are so small that we need to put it in perspective. Uh, I heard an expert say that you're more likely to be hit by a meteor than die of COVID after you've been vaccinated. I think out of those three, one of them actually wasn't technically fully vaccinated. So, and all of them had underlying conditions and were older individuals. So I don't think it's something we need to worry about. I think that we still have really good confidence in these vaccines ability to protect most people, not everybody, but most people. And then those that do get ill, the illness tends to be milder and of course nothing's a hundred percent. So there are some very, very rare exceptions to that rule. Speaker 1: 06:20 Is there anything else we should know about how the Delta variant could be spreading throughout our community? Speaker 2: 06:25 Well, remember that throughout all of last year, we're always about two to three weeks behind. Uh, and so, you know, June 15th is when we opened up the economy and all the restrictions kind of went away. So we really have to keep our eyes on the ball, keep our surveillance going and really not forget the lessons that we've learned in the last year. There are many places throughout the world that are having the worst surge as they ever have had in Latin America and in Africa and in Indonesia in particular. And all those places are just a plane ride away. Um, you know, so we're, we're not past everything we need to keep our vigilance keep using the tools that have worked for us and kept us safe over the last year. I've been speaking Speaker 1: 07:01 With Dr. Christian, Ramers a specialist in infectious diseases who oversees clinical programs at family health centers of San Diego and sits on the counties, vaccine clinical advisory group. Dr. Ramers. Thank you very much for joining us. Thank you so much. Speaker 3: 07:21 [inaudible].