Dr. Robin’s Covid-19 Updates

Dr. Covid, Party Pooper

Navigating a Partially-Vaccinated World

Photo by Austrian National Library on Unsplash

I have an old pal named Julia who lives in a nearby state. I don’t get to see her very often but I was going to be in her town for a few hours last Thursday so we made arrangements to meet up.

She’s going through (like so many other people) a terrible divorce situation, a hideous mess, and I was glad to have the chance to see her in person.

I’m completely vaccinated but she’s not. How to meet up safely?

We thought about going for a walk but the forecast was for temps in the 30s. We wondered if we might be safe to eat a restaurant meal because she was pretty sure she had Covid in March 2020 when she had been super sick and in bed for two weeks.

This was in the early days when there weren’t many cases or tests, and they didn’t run a Covid test on her. But her flu and strep tests were negative so her doctor said it was probably Covid.

I really wanted to eat in a restaurant with Julia.

Still, there wasn’t any proof she’d really had Covid and to make matters worse a (notoriously unreliable) antibody test in May had been negative.

Besides, even if she did have Covid, we still don’t know exactly how long immunity lasts after infection — at least 90 days and probably a year or two — but we just don’t know yet.

So I texted, “Walk: yes, food: no.”

Julia wrote, “This is what happens when you’re friends with Dr Covid.”

I texted back, “LOL, so true, my real name is “Dr Covid, Party Pooper.” And we made plans for a bundled-up walk.

But then Thursday morning she texted me again and said she had a developed a nasty chest cold overnight. “If I feel better later do you think we can meet up anyways?” She added, “My Protestant work ethic hates it when I cancel plans.”

I wrote back and said, “No darling, we have to cancel, you’re full of germies.” She told me she was getting Covid tested after lunch so we hopped on the phone and had a nice chat, some about Covid, but mostly about our kids. She has two little boys, I have two big boys, we had a lot to talk about even though in my role as “Dr. Covid, Party Pooper” I had insisted we only talk on the phone and not in person.

And then the next day Julia told me her Covid test was positive. WHUT??!!

When you are friends with Dr Covid, sometimes you get to be a Life Lesson.

Question One: Did I dodge a bullet or what? Yes ma’am, I feel like I did.

Would I have caught Covid from Julia if we had met up while she had her ‘nasty-chest-cold-that-turned-out-to-be-Covid’?

I’m vaccinated, so while it’s certainly possible I could catch Covid from her, the chances of it happening are thankfully pretty small. How small? Well, we’ve all heard the “95% efficacy” of the mRNA vaccines. That doesn’t mean I had a 5% chance of catching Covid from my actively infected and infectious friend.

What it means is that in the Moderna/Pfizer trials, when you compared a group of people who were vaccinated to a group of people who were not vaccinated, for every ONE HUNDRED unvaccinated individuals who developed symptomatic Covid only FIVE PEOPLE in the vaccine group got it. So my chances of getting Covid from Julia were super reduced but not zero (and not 5%).

  • Would I have caught it from her on a walk? Highly unlikely.
  • Could I have caught it from her if we’d eaten indoors? Higher chance.
  • Could the unvaccinated server at the restaurant have caught it from her? Absolutely.

So, yes, I do feel like I dodged a bullet. As did the unvaccinated server.

Question Two: Did she get reinfected? We’ll never know. Her illness in March is Covid-suspicious although numbers were low then and there’s no proof.

Still, it’s certainly possible for a person to be reinfected and it may be becoming more common.

Reinfections happened occasionally in 2020. But even though this often made headlines, in reality they didn’t really happen all that often.

But now in 2021 we’re seeing more reinfections — maybe because of variants, maybe because of declining immunity, maybe especially with the B.1.1.7 variant (the one originally seen in England) or P.1 (first seen in Brazil) popping up everywhere they test for it.

Question Three: How did Julia get Covid? On Thursday, this was a mystery; she worked from home and had only gone to the grocery story once in the proceeding five days.

On Thursday night, when one of her kids admitted he hadn’t felt well for a couple of days and got a positive Covid test, the mystery was solved.

It turned out her vaccinated soon-to-be-ex husband had taken their unvaccinated sons on a spring break trip the week before. The three of them were mindful about Covid hygiene but travel inevitably exposes everybody to more people at airports and the hotel pool and restaurants and etc.

The riskiest of these activities is eating indoors. You have your mask off, you’re indoors, you’re laughing, you’re talking, you’re spewing little spittle droplets. (One thing the pandemic has made clear is that we are ALL always spitting a little when we talk, not just Uncle Maskless and King George in Hamilton.)

So somewhere towards the end of his vacation, Kid One had inhaled some coronavirus droplets. He wasn’t vaccinated so wasn’t protected. And when he came hurtling into the house and gave Julia a big hug, all excited to see Mom for the first time in a week — boom, the die was cast.

Question Four: Was Julia infected by a variant? Quite possibly, but we can’t know yet. The PCR Covid test she had only checks for SARS-Co-V2 infection — it doesn’t tell you which variant it is. Variant testing via “sequencing” is only done on a tiny fraction of cases. You can’t request it. We may well never know. (Grrrrr).

Question Five: What are the chances her other son (also unvaccinated) will also get sick? Kid Two’s chances of getting sick have been around 15% (ie, not every household contact gets infected) but with some of the variants this seems now to be much higher.

Question Six: Should Julia get vaccinated and if so when? Yes, she should get vaccinated. The CDC at first said you should wait 90 days but now they basically say “Wait til you feel better, are no long infectious, and then go get the shot(s).”

Question Seven: Why wasn’t she vaccinated? She wasn’t vaccinated because she was waiting her turn. She felt safe to wait because she thought she had already had Covid and she isn’t high risk and she stays mostly at home and she wasn’t exposed to anybody except her family. She felt safe. She WAS safe.

Until her soon-to-be-ex husband took their unvaccinated kids on a trip.

People who are unvaccinated should not let down their guard, should not take off their masks, should not be eating and drinking indoors, and should not be traveling.

The bottom line is we — especially the unvaccinated — are just not out of the woods yet.

We still have to be nimble and work hard to keep each other safe, even when it means being our own personal version of a party pooper. Hopefully just for a little while longer!

{Robin Schoenthaler, MD is a Boston-based cancer doctor who has been writing weekly straightforward fact-based no-blame-no-rumors-all-science-all-the-time essays about Covid-19 since March 2020.}

Covid-Translator. Cancer doc: ~Three decades at MGH. Writer and storyteller: Moth Grand Slam Champion. Mom. www.DrRobin.org, @robinshome, robinshome2@gmail.com

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