Optimistic outlook on future impacts of COVID, Delta

State Rep. Maria Horn (D-64) hosted two physicians from the Nuvance Health system, the parent company of Sharon Hospital, during an informational webinar on Thursday, Sept. 16, to update the community on COVID-19. 

They spoke on the novel coronavirus’ current impact on schools and hospitals, including breakthrough infections and vaccine mandates; and to clarified confusion surrounding boosters, vaccine efficacy and flu shots.

Horn was joined by Dr. Paul Nee, an infectious disease specialist at Danbury Hospital, and Dr. Suzanne Lefebvre, a pediatrician at Sharon Hospital who serves as medical advisor to both the Region One School District and the private Kent School.

Status of hospitals, schools

Nee and Lefebvre gave a snapshot of what is happening in hospitals and the schools. 

“So far we have gone through, in Connecticut, two surges and two waves,” of COVID-19, said Nee — the first one in the spring of 2020, and the second in the fall/winter of 2020 and 2021. Most recently, he said, “we have seen the Delta variant explode across the U.S. and with it an increase in hospitalizations.” But while infections are up, severe illness and hospitalizations are down.

Despite the new, highly transmissible variant’s presence, he said he does not expect to see a repeat performance. “We’ve seen ups and downs every week, but no surges like what we saw last spring and winter.” He attributed this to high vaccination rates in the state.

Horn noted, however, that while Connecticut’s vaccine rate is high, there continues to be disparity among populations that are not receiving the COVID-19 vaccination, including communities of color and the working class, and that efforts are being made to reach those demographics through education and outreach.

Speaking on COVID’s impact on schools, Lefebvre reported a “slight increase in cases” this year compared to last year, particularly among children — primarily through sports and contact with infected adults. But so far, she said, there has been no spread of coronavirus within the schools.

Lefebvre credited vaccinated students in the 12-15 age group and 16-17 age group for the low infection rate. “It’s impacting fewer kids within the classroom,” she noted. “In Region One we were grateful we were in school the entire year. The high school was in a hybrid model. But the remainder of our schools were in session until end of year,” said Region One’s medical adviser.

“It’s been a really cooperative region of parents and families in terms of following our protocols. That has paid off a lot this fall. Kids have more freedom in the schools, we are much more comfortable with field trips and things like that. So far, so good.”

Deadlines for vaccine mandates

The speakers agreed that there has been controversy surrounding vaccine mandates at state hospitals and within health-care settings. Despite initial resistance from some workers, “It’s now starting to go well,” said Nee.

“Many who were resistant have been vaccinated. “Unfortunately, we still have some people who don’t want to do that, but we have pushed all of our employees to make a decision in regard to that.” 

By Oct. 1, all workers in the Nuvance Health system, except for those with medical or religious exemptions, must complete their vaccine series.

The deadline for mandatory vaccines within the schools, added Lefevre, is tentatively set for Sept. 27, although a slight lag in the development of the paperwork for exemptions may delay that target date.

Breakthrough infections

There are misconceptions and concerns surrounding reports of breakthrough infections, the speakers all agreed. 

The takeaway? 

“Vaccines are working, and they are preventing people from getting hospitalized and keeping people from dying,” said Nee, who suggested people look at the big picture:   Of the 180 million people who have been vaccinated .001 percent have died.

 “The numbers are very, very small, and vaccines continue to protect us. An efficacy rate of 95 percent is unheard of in terms of vaccines, so we are very spoiled,” noted Nee. “The statistics are quite startling.” By comparison, he said, in a good year the efficacy of the flu vaccine might be 60- 65 percent. 

Boosters and flu shots

The takeaway from the physicians on these topics is that the jury is still out on whether booster shots are necessary, but that it is important to get a seasonal flu shot.

Nee said there is evidence that backs up a third vaccine for people with compromised immune systems, but data is still being gathered on the need for widespread booster shots. “For the immunocompromised it’s not a booster, it’s a third shot,” in the Moderna and Pfizer vaccine series, said Nee, a totally different scenario altogether.

The Nuvance Health physician said he was caught off-guard by a recent newsfeed announcing that the White House and U.S. Department of Health and Human Services would be recommending boosters beginning Sept. 20. 

“Being someone who follows this closely, I said, boy, where did this come from? We are still looking at and developing evidence for this.”

Already, 1 million people “jumped the gun,” and received a booster shot, said Nee. 

Breakthrough cases could be the result of waning vaccine efficacy, or it could be linked to the surge in the Delta variant, “which is different from the Wuhan or ancestral strain,” said Nee. 

But the evidence is lacking.  

“We are seeing two things happening at the same time. It’s not just, ‘Hey, we are seeing these breakthrough cases, we need to do a booster.’ We need to make sure it’s going to do what we intend it to do: prevent hospitalizations and death.”

As for flu shots, the medical experts’ advice is clear: Yes, you do need one. They also noted that despite misconceptions, people can receive their flu shot and COVID-19 vaccination at the same time. “There was a time when there was a period of waiting,” between the flu and COVID-19 inoculations, but no longer.

The panelists recommended that the best time to get a flu shot is around the end of October, before the holidays, to allow time for its efficacy to kick in. The vaccine will last through the winter months.  

“The flu is a virus that can really cause serious disease,” said Nee.

Looking ahead

Horn asked the two experts for their prediction of what to expect from COVID in the upcoming winter months. Nee said models tend to predict that COVID-19 will be active into November and December but will likely drop off after that.

 “We have a large number of vaccinated people in the state, and if we take everything we have learned in the last year with masking and social distancing, we can really keep a rein on this. It’s hard to predict. Will we have a new variant come on the scene? Maybe, maybe not. But we have to be ready for whatever comes our way.”