calendar June 28, 2021 in Public Health

COVID Precautions: Vaccines and Protect Vulnerable People

Although the coronavirus is “never going to go away,” the good news is that “it’s as safe (now) as it’s going to get at this point,” infectious disease expert Dr. Tim Babinchak told SEPA leaders on a Zoom call June 24. “And as more people get vaccinated, it will get safer.”

During his presentation, Dr. Babinchak said that:

  • Everyone should get vaccinated as soon as possible. So far vaccines are effective against variants, including the rapidly spreading Delta variant.
  • The currently vulnerable population is adults who cannot or will not get the vaccine – including healthy people under age 25 – and children, who may be able to be vaccinated before school starts in the fall.
  • Wearing masks and physically distancing indoors is safest for people who are not vaccinated, especially if singing.
  • These precautions can be dropped in outdoor settings, although vulnerable people may wish to mask and distance.
  • It is safer if those administering Communion are vaccinated.
  • Serving food and beverages at coffee hours poses no exceptional threats, and it is safer if servers are vaccinated.
  • Common sense precautions still apply: Do not come to church if you are sick. Wash your hands before you come.
  • People who self-identify as vulnerable should take personal responsibility to take proper precautions for the protection of the community.

Following are highlights of the conversation.

 

Can we go back to “normal” now?

“This virus isn’t going away. It’s never going to go away. It’s just going to reach a steady state that we’re going to have to deal and live with much as we deal with influenza virus. So my major activities are toward getting information out to get as many people vaccinated as possible, and by doing so, we have the best chance of limiting that spread.”

 

How important is being vaccinated?

“Vaccine is clearly the key.” Older Americans have greater than 80% vaccination rate. Rates drop in younger age groups, with the lowest in the under-25 group. The risks for COVID-19 exist in the unvaccinated population. “The vaccines are 90 to 95% effective even against these variants. When I say effective, what I mean there is that the vaccine is very good at preventing severe illness that will result in hospitalization or death. It doesn’t mean that you can’t get sick. It doesn’t mean that you can’t get the virus, but … any illness is more likely to be mild.”

 

How serious is the Delta variant?

“In the past month, it’s gone from less than 3% to now at least 20% of the virus that continues to circulate” mostly among unvaccinated people. [Delta appears to be both more infectious and cause more serious illness in vulnerable and unvaccinated people.] What happens in the coming months will determine if different strategies are needed.

 

Will we need boosters or re-vaccination?

“We only have experience for as long as we’ve had vaccines,” approximately a year since clinical trials started. “So we know that immunity lasts at least a year. And from everything that we’ve seen so far, there doesn’t seem to a need for a booster at one year. … That’s all being followed very carefully because we may get a variant that is not vaccine susceptible.”

 

Do congregations still need to take precautions?

“Unfortunately, I don’t think that we’re ever going to get out of this situation because we’re always going to have people who are unprotected, just as we have people who don’t get flu shots. … The question is, how then do we manage and deal with the risks that those folks are now assuming on their own, essentially?. And my recommendations are really not a lot different than they were, when we did this a month ago. And that is as long as there are people at risk, each congregation, is going to need to take its own temperature and determine how much of that risk they’re willing to accept within their congregation.”

 

Is indoor worship safe?

“Transmission is greatest in enclosed places where you spend a lot of time with individuals who could potentially be sick and in the various activities that they’re doing. … My recommendation is you can ask and you need to have people be willing to self-identify and take some responsibility on their own.”

Congregations could reduce physical distancing for individuals or family groups that are vaccinated from six feet to three feet. Congregations can ask those who are still vulnerable or unvaccinated to continue to wear masks and social distance. “Understand that as, as being part of that community, you’re being asked to take into consideration your fellow parishioners.”

“For the most part, indoor activities should still be social distanced and masked to the extent possible, particularly those who self-identify themselves at risk.” These precautions are key in reducing the development of new variants.

 

What about outdoor worship?

Masks are not necessary outdoors, even for spoken responses. [Ecumenical guidance still suggests maintaining physical distance between people from different households.]

 

What about singing?

“Singing is still by far the riskiest behavior that our congregations are going to undertake. and again, that is to the vulnerable, the unvaccinated, for the most part.” Dr. Babinchak displayed a chart — see page 4 of this study — showing that singing, even softly, emits more of the particles that spread as aerosols — smaller than 5𝛍m – than speaking, whispering, or breathing through the nose or mouth.

To make singing indoors safer, wear two-ply masks and maintain distancing within the church, especially for those who are vulnerable. “Most of our services are for less than an hour, and that length of time exposure with ventilation (is) not an issue.” For most public buildings, eight air exchanges per hour is considered adequate. Exchanging air every 7-8 minutes prevents the longer exposure that puts people at risk. Consult an HVAC contractor to determine the adequacy of air exchange in your building.

“You can sing without masks outdoors” because ambient airflow disperses virus particles.

 

How should we clean/disinfect our indoor spaces?

“Normal cleaning procedures that you have in place are sufficient.” Spaces do not need extraordinary cleaning before returning indoors or between services, provided they are spaced out. “The important part is still not so much the surfaces in the church as people are washing their hands before they come in the church. And that’s the key, stressing the usual things that we stressed before COVID ever existed. Don’t come if you’re sick, please wash your hands and please be considerate of others.”

 

Do you have recommendations for distributing communion?

No special procedures are needed except that “those who are delivering the sacrament should be vaccinated. … That is the best way to protect the congregation.” Given this caveat, individual cups or a common cup are acceptable, provided the cup is wiped off between communicants. Communion rails do not have to be cleaned between tables. In general, the brief exposure during communion is not highly dangerous.

 

Can we resume sharing food and beverages at coffee hour?

Congregations could consider this, factoring in their local situation. “It just has not been the case where we’re seeing these large outbreaks in the delivery of food service, either in individual restaurants or in grocery stores, or in, in other retail type establishment.” Congregations can decide whether food servers must be vaccinated.

 

“It’s as safe (now) as it’s going to get at this point. And as more people get vaccinated, it will get safer in that regard. And that’s why I wanted to stress the good news. We don’t have any evidence that this virus (makes us) any more unsafe than we were a year ago, with the exception of those who are unvaccinated. Now, for me, the shift needs to be back to (taking) personal responsibility — if you know you are vulnerable, you have the personal responsibility of not putting others at risk in those particular situations.”