“ Updates on COVID and vaccine boosters” 

(information as of Aug 23, 2021)

Dr. Suzuki is a Covid19-designated physician & He can answer your COVID related questions.  

Q.  I heard Covid-19 numbers are up again in the hospital. Is that true?

Yes it’s true. In early July 2021, Covid patients in our hospital were down to a few patients. Now we are closer to 100. We are starting to cancel elective (non urgent) surgeries to save our beds and resources. Now, we also require the visitors and the hospital workers to show the proof of vaccination. 

Q. What’s the state of COVID infection in LA county right now?

In LA county, our vaccination rate is 65% (at least one dose) and we are averaging 33 new cases per 100,000 residents. In brief, we would like you to be careful and take all the prevention measures, but we are doing okay compared to the other struggling states, due to our higher vaccination rates.

Our COVID infection patient number is worse than it was in June, but it is no where near the peak, around the last Xmas when we had 180 new cases per 100,000 people. Our 7 day average infection rate is 1.03 — so it is still spreading slowly in Los Angeles. Our hospitalized patient numbers have been holding steady for the last two weeks and the vast majority (99%) of our COVID patients in the hospital are unvaccinated people.

Q. What’s the deal with FDA full-approval of the vaccines?

Today (Aug 23, 2021) FDA has granted a full authorization of Pfeizer vaccine, meaning that after weighing all the data based on over 200 million doses given, FDA determined that Pfeizer vaccine is SAFE and EFFECTIVE against preventing COVID19 infection and complications, and endorsed just like any other vaccines for flu, shingles, polio and others. 

Q. I didn’t get around to get the COVID vaccine. Should I still get one? Is it really safe?

Yes. Covid vaccines are very safe and very effective. As of last week, about 200 million Americans have received at least one dose of a Covid-19 vaccine, including about 168 million people who have been fully vaccinated by Johnson & Johnson’s single-dose vaccine or the two-dose series made by Pfizer and Moderna. About 71.6 percent of adults in the US have received at least one shot. 

The ingredients of Pfeizer vaccines are quite simple, mRNA (virus spike protein) and the absorbable container, which is made of lipids (PEGs, as in toothpaste), salts (as in table salt) and sugar (Sucrose). Note that you CANNOT get COVID from the vaccine itself, as it does not contain the actual virus.   The vaccine teaches our immune system what to watch out for, so that when your body recognizes the virus, it attacks the virus right away, preventing infection in most cases, and preventing severe disease (and hospitalization and death) in over 99% of cases. 

Q. But you can get infected even after full vaccination? Then what’s the point?

Yes, It’s called breakthrough infections and it’s quite rare, about 0.5% of vaccinated people in LA (see figure). First, the vaccines can prevent infection, but more importantly the vaccines prevent severe disease and death, and they are really good at that. 

Let me show you two recent real-life cases in July 2021:

1. Fourth of July event in Provincetown MA: this was a huge annual event with 60,000 people gathering and partying up. It was a rainy weekend, and it created many indoor gathering situations and a cluster of infections. The results were 965 COVID infections… but resulted in 7 hospitalizations and no death. 

2. San Francisco General and UCSF hospitals in July: we recently had a mini outbreak in the hospital in downtown SF… which resulted in 183 infections, two hospitalizations and no death. 

The common thread was 3/4 of these people were vaccinated and well protected. The full vaccination renders COVID (fairly) harmless, bringing the rates down to 0.004% of hospitalization and 0.001% of deaths recorded by CDC. This is much less deadly than seasonal flu numbers.

Q. I already had a covid infection. I don’t need a vaccine right?

Yes you do. We have been checking the antibodies of previously infected people, and their antibody levels may be unreliable. The current guideline is to give a vaccine to previously infected people, which resulted in super high antibodies to protect you, even higher than two vaccines and no previous infection. 

Q. I’m fully vaccinated now. What’s going on with the booster shot?

For certain individuals with compromised immune systems, we recommend that they make an appointment and receive a third shot right now. Examples are;  people with cancer treatment or transplant patients, or active treatment with steroids or other immune suppressing medications. FYI, you do NOT need a doctor's note to get a third vaccine shot, as it is a self-attestation basis. Now you can make an appointment specifically as a third shot.

For the rest of us, with healthy immune function, CDC will recommend a 3rd shot of mRNA vaccines (Pferzer and Moderma) as it will boost the antibody level by at least ten-fold. It is recommended that you get the same vaccine as the previous 2 shots, starting on September 20th and ideally before the winter season, when we can expect another surge in COVID cases.

Q. Does this mean we have to get a shot every 8 months?

We don’t have the data on that, but it’s unlikely. Many vaccines (examples: Tetanus, H Flu and Polio etc) are given as a series of 3 shots, and the protections are enhanced and very long lasting after the third shot (see the illustration - source: NY times & @peterHotez MD PhD).

Q. I’ve got the one-dose Johnson & Johnson vaccine. What about me?

Since J&J vaccine was developed and introduced much later, we still don’t have enough data or formal CDC recommendation yet… but it is forthcoming. I will update you later on this blog. 

Q. What about masks? Do we still need it?

Mask is an inexpensive but effective tool that protects you against the virus, as well as keeping a person from spreading the virus. In LA county, we are back with the mask mandate which will protect you and others, including large outdoor venues like Dodger stadium and Hollywood Bowl, mandating to use a mask except when you are eating and drinking at your seat.

Q. Are we ever going to be done with COVID pandemic?

As the virus spreads from person to person, it continues to replicate and mutates. Unfortunately, Covid virus isn’t going away completely and we expect it to be endemic; meaning we have to learn to live with it, just like flu or cold. I grew up in Tokyo Japan, where many people wear masks routinely during winter (flu/cold season) and spring (hey fever season). I can see it being the new habit here in Los Angeles to keep you safe from COVID, flu and cold. 

Q. Is it safe for us to be running together? 

YES. If you are fully vaccinated, it is considered safe to be running outdoors with others. I still recommend that you wear a mask indoors, like grocery stores or shopping malls, and at large venues like Dodger stadium. If you are still unvaccinated, I highly recommend that you get that shot. It’s safe, effective, it saves your life, and it prevents your friends and family from catching the virus. Thank you!! —> www.vaccines.gov

And www.myturn.ca.gov

(Sources: CDC.gov, New York Times) 

Dr. Suzuki is a Boston marathon qualifier/finisher and an Ironman finisher. He is a foot and ankle surgeon, an attending staff of the Cedars-Sinai Medical Center. He welcomes your running or health-related questions via email (Kazu.Suzuki@cshs.org), which may be featured in our weekly emails and in our website. 

(Disclaimer: This article is for your information only; it is NOT meant to be a substitute for a proper diagnosis and medical care by your own doctor.)