NYC vaccine mandate, new OSHA guidance, and should we treat people recovered from COVID the same as those vaccinated?
August 17, 2021
COVID Recap
A new study shows Delta variant infectiousness peaks one to three days before onset of symptoms. (Science)
Starting today, NYC staff and customers 12 and older will be required to show proof they have received at least one dose of vaccine for indoor dining, fitness, and entertainment. Enforcement begins on September 13th. (NYC.gov)
The Biden administration is likely to advise all Americans to get a booster dose 8 months after their first mRNA shot. Those with the one-dose J&J shot will likely also need a booster, but we’re waiting on results from a two-dose trial later this month. (New York Times)
For adults 65–74 years old, effectiveness of full vaccination for preventing hospitalization was 96% for Pfizer-BioNTech and Moderna, and 84% for Janssen. The stats drop slightly over age 75. (MMWR)
It’s looking more and more like workplace vaccine mandates are becoming the norm. (WRAL)
Soon, we’ll likely be able to use antibody levels to know exactly how well protected someone is against COVID. (STAT)
Texas and Florida governors’ ban on mask mandates are facing mounting legal issues. (Washington Post)
Some COVID skeptics are requesting blood transfusions from unvaccinated people, which is both medically unnecessary and logistically unfeasible for blood donation centers, especially since about 60% of donors are fully vaccinated. (Kaiser Health News)
OSHA issued new guidance on employee COVID precautions which are mirroring CDC recommendations recommending masks for vaccinated people in high transmission areas and after exposure. (Reuters)
Today’s Health News
Ebola continues to be a concern, with the first new case in Ivory Coast in 25 years. (Al Jazeera)
RSV, another respiratory virus, is surging earlier than normal this year, raising concerns about a “double whammy” in children. (NPR)
One of Ben Franklin’s greatest regrets was delaying his son’s smallpox vaccine. (Washington Post)
A major recall of the most popular CPAP machine is creating challenges for patients and insurers. (Wall Street Journal)
Best Questions
We have someone who had COVID and recovered. At one point we considered them protected for 90 days and they didn’t have to quarantine if they were exposed. Is that still the case?
That’s correct. If someone has had COVID (confirmed by a positive test - either rapid or PCR), they do not need to quarantine after close contact for 90 days. If they haven’t been tested to confirm their COVID case, they do still need to quarantine after close contact. This is a good reason to go get tested if you’re sick, even if you’re fairly certain it’s COVID! We recommend requiring masks for 14 days for any recently COVID+ people who are exposed (just like vaccinated people).
Should we be treating someone who has had COVID the same as vaccinated people for the 90 days?
Generally, yes. While the CDC hasn’t said as much, we recommend requiring masks for 14 days for any recently COVID+ people who were exposed (just like vaccinated people). Natural immunity from COVID is less reliable than vaccination in terms of protection, and we have seen some rare instances of people getting reinfected within the 90 days. Even if someone has had COVID in the past 90 days, they should stay home if they have any symptoms return or new symptoms develop. The same is true for vaccinated people who have symptoms.
How soon after COVID can someone be vaccinated?
Someone can be vaccinated for COVID as soon as they meet the criteria for ending their self-isolation. The only exception is for people who received monoclonal antibody treatment while they were sick with COVID, in which case it’s recommended that they wait 90 days before getting vaccinated. Most people won’t receive that treatment, though, so for most, they can get vaccinated as soon as they are at Day 10, fever-free for 24 hours without fever-reducing medication, and their other symptoms are improving.
An employee lived with someone COVID+, developed symptoms, and was excluded - but never got tested. Now they’ve been exposed again. Should we exclude them again?
Unfortunately, if they never had a positive test, and they’re not vaccinated, we should exclude them. We just can’t be sure that they actually had COVID (even if it’s likely), and the research on protective antibody levels is still too early to say with confidence that they were previously infected and currently protected. At some point soon, we expect that we could accept an antibody test showing appropriate levels of protection and let someone work masked, but we’re still not there yet.
