July 2021 Howard Brown Health COVID-19 Safety FAQ

Howard Brown Health recently released a statement calling on public events organizers to implement strict COVID-19 safety measures to prevent further spread of the virus. Read the full statement here. Below are some frequently asked questions we have received from patients and community members.

If I’m vaccinated, why should I hesitate to attend an outdoor event?

The dominant Delta variant can be carried and spread by vaccinated and unvaccinated people. While symptoms are typically less pronounced among vaccinated people, they can still transmit the virus, risking severe illness to unvaccinated individuals. Until greater numbers of people locally and nationally receive vaccinations, large crowded gatherings pose severe risk to the public health and make future lockdowns harder to avert.

The CDC hasn’t made similar recommendations, how did Howard Brown make this decision?

Howard Brown certainly supports and follows CDC guidance and the science-based recommendations that are made by the CDC. However, the CDC has been very clear that local conditions need to guide decision-making to address specific local circumstances and needs. In accordance with CDC guidelines, outside gatherings are preferred to indoor ones. However, at large, crowded events like street festivals and parades, it will be extremely difficult to maintain physical distance. Also, asking for confirmation of vaccinated status of the events’ attendees is not possible because these events occupy the public way. More concerning are the many ancillary indoor activities that accompany these events. The indoor components are historically crowded and difficult to ensure physical distancing. For example, a recent COVID cluster occurred in Provincetown, resulting in hundreds of new positive infections.

I heard the recent spike in the UK and other countries wasn’t that big of a deal. Why should we care about it here?

Howard Brown is not aware of any COVID-19 spikes where infection rates subsided in less than three months. Right now, we are concerned about the trajectory of the increase here in the United States.  While we don’t know if infection rates will go down again in weeks or months, the concern isn’t the present wave. The main public health concern is severe illness, hospitalizations, and death in communities that are more vulnerable. The United Kingdom has a 55% vaccination rate. They peaked to 15% positivity, and that has trended down under restrictions, which are now being lifted because the trajectory is heading back down. The United Kingdom is two months in to the third wave, and even if it continues to drift down, the positivity rate will likely remain elevated for two more months.

How protected are vaccinated people living with HIV (PLWH) from the Delta variant?

In general, PLWH who are adhering to their treatment plan and have undetectable viral loads along with CD4 counts greater than 200 are not considered immunocompromised. Some researchers have increased this threshold to greater than 350 when studying COVID. There is no data to suggest that fully vaccinated PLWH with these higher CD4 counts would be any less protected from the Delta variant than the general population. Immunocompromised PWLH, however, may be at risk for reduced immune response from the vaccine.

If a vaccinated person has an asymptomatic infection, is there a risk of spreading it to others?

We know asymptomatic infections are as transmissible/contagious as symptomatic infections. The larger concern is around pre-symptomatic infections, or infections during the days right before someone becomes symptomatic.  We know pre-symptomatic infections have a risk of spreading. Again, vaccination protects against this!

What other precautions should vaccinated people consider?

Vaccinated people should follow all CDC and local government recommendations and adhere to rules and guidelines made by any private businesses they patron. Wear a mask, maintain social distancing, frequently wash hands, and take all precautions for COVID-19 safety. Vaccinated people should take these precautions including wearing masks indoors.

Is Howard Brown still providing in-person medical appointments at its clinics?

Yes. In-person care will continue at Howard Brown. We have no plans to close or limit in-person care provided as is dictated by our max capacity and spacing needs, particularly we have implemented safety measures and precautions at all of our sites (i.e. wearing masks, and our staff are vaccinated).  At this time, there is no reason to go “all virtual.”

Will Howard Brown vaccinate people at Market Days?

No. Our bodies need time to develop full immunity after receiving a vaccine. Unvaccinated people are at highest risk for severe disease, hospitalization, and death from COVID-19 and the Delta variant. A person receiving a vaccine at a large crowded event would still be vulnerable to severe disease and infection if they are exposed to the virus that same day. If someone is interested in being vaccinated, they should call Howard Brown at 773.388.1600 to make an appointment. While vaccinations are the best form of protection against COVID-19 and the best way to stem the pandemic, we adamantly discourage unvaccinated people from attending large, crowded, public events.

Does Howard Brown support mandatory vaccinations?

Howard Brown supports strategies – including vaccine requirements by employers, schools, entertainment venues, and others – that increase the percentage of vaccinated people within a community. However these strategies should integrate intersectional models and should ensure the burdens and benefits are shared equitably and don’t widen inequity.

Is Howard Brown mandating vaccination for its workforce?

The vast majority of the workforce has vaccinated voluntarily. Notwithstanding, we will mandate vaccinations for all workers in line with other infection control approaches for the prevention and control of the flu, tuberculosis, and other conditions.  

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