In recent weeks, Colorado’s COVID-19 situation has gotten worse. New reported cases recently reached the highest level since the end of April, hospitalizations are on the rise, and the state’s health director indicated last week that stricter pandemic-related regulations could be coming soon.
While all of that is cause for some concern, especially with colder months and more time inside on the horizon, Dr. James Neid, an infectious disease specialist at the Medical Center of Aurora, thinks we have all the necessary tools to reverse course. “Cases continue to go up in unvaccinated people, but breakthrough cases are rare and mild,” he says. “So the roof is not blowing off. I am hoping a continued uptick in vaccination rates and masking can help blunt this surge caused by the Delta variant.”
But until cases drop again, some questions remain. Should you change what sort of social activities you engage in? What role will booster shots play in keeping the pandemic under control? And what will it actually take to end the pandemic? To help understand this confusing stage of the pandemic, Dr. Neid answered those questions and more.
Health guidelines: Should you change how you approach social situations given the continued prevalence of the Delta variant?
Neid says that the best thing to do in social situations if you are vaccinated is to continue following guidelines from the Centers for Disease Control and Prevention (CDC), which say you should wear a mask indoors in areas of substantial or high transmission. What exactly qualifies as an area of substantial transmission can vary depending on a number of factors, including whether you are in a part of the state with a high case count or not.
“What should drive your decision is what you know, and what you don’t know about your surroundings,” he says. “If you don’t know much, I err on the side of putting on a mask.”
If you are unvaccinated, however, Neid says your approach should be very different. “You should be very afraid of Delta,” he says about people who have not been inoculated. “You should limit your public exposure and you should be masked.”
Immunity: If you are fully vaccinated, how concerned should you be about fading immunity and breakthrough cases?
“We know with almost every infectious disease, and COVID is not an exception, immunity will wane overtime,” Neid says. “I just haven’t personally seen a lot of data that says, you know, at eight months your clock is ticking to where you are not protected anymore. That is still being worked out.”
The worry about fading immunity should be the greatest for anyone over the age of 65 or immunocompromised people who struggle to produce antibodies, according to Neid. But overall, he says that breakthrough cases are still extremely rare in people who are vaccinated here in Colorado. Anecdotally, he also hasn’t seen a prevalence of breakthrough cases for people who have received one particular vaccine type.
“It is still the overwhelming message that if you are vaccinated, you are highly, highly protected against severe illness, hospitalization, and death,” he says. “We are certainly waiting day-by-day to see if things are changing. But we haven’t seen any sort of change here in Colorado.”
Booster shots: Should I be rushing out to get an additional dose of the vaccine right now?
Neid says that booster shots have proven to be safe, and they will augment the breadth of your immune response. But healthy people still appear to be well protected against the disease with regular vaccination status. The CDC has also stated that the goal is not for people to start receiving booster shots immediately, but rather at some point this fall.
“I’ve kind of fallen back to: If you are at high risk from getting COVID in the first place, you should be on the earlier list to get a booster shot,” Neid says. “ I think it is logical to discern between risk groups in terms of suggesting booster shots. But right now, getting shots to unvaccinated people is still what will be most helpful for the pandemic.”
Neid also said that more info needs to be gathered to decide how safe and effective it is to mix different vaccine types (i.e., taking a booster shot of Moderna after originally getting the Johnson & Johnson vaccine).
Back to school: How concerned should we all be about how much virus will be circulating in classrooms with kids returning to school?
According to Neid, the widespread return to school could end up presenting many challenges. “Kids represent an important remaining reservoir for COVID, and I think the disease will naturally try and figure them out,” he says. “That’s preventable with distance learning, which no one wants to go back to. But I think problems will hopefully be mitigated with mask wearing. At the bare minimum, that is a very smart idea.”
Neid expects those challenges to be very different for students 12 and older, who are eligible to receive vaccines, than for younger students. “If you have a high school class, and 50 percent of them are vaccinated, the potential for disruption is going to be much less,” he says. “At the same time, the socialization part for the younger kids is interesting. They appear to be pretty good at wearing masks. They tend to do what you ask them and don’t question it, which is helpful in this case.”
Neid also anticipates that vaccines will be approved for kids younger than 12 at some point in the late fall.
Endings: How long could we be stuck in this same pattern with variants of concern popping up?
“If the Delta variant doesn’t inspire more vaccinations, then the virus could create new variants of concern and find a new biological strategy,” Neid says. “As long as there is a suitable reservoir [for the disease] out there in the community, whether that is children or unvaccinated adults, we could continue to see the same pattern.”
Neid thinks the next few months will be especially important for determining the longevity of the pandemic. “This is kind of our last chance for a burst here before we head back indoors and give the virus the upper hand again,” he says. “It’s kind of like a call to arms. While we still have warm weather, let’s drive up the vaccine rates. That is really going to have broad implications for the next variant of concern.”