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Dr. Sara Cody: COVID-19 could be with us indefinitely

It's likely people will need periodic booster shots in the future, Santa Clara County health officer says

Santa Clara County Health Officer Dr. Sara Cody speaks during a press conference in San Jose on July 2, 2020. Photo by Magali Gauthier.

Living with — not vanquishing — the COVID-19 virus is likely to become the norm, with people getting booster shots to protect themselves much like they do an annual flu shot, Santa Clara County Health Officer Dr. Sara Cody told members of the Palo Alto Rotary Club on Monday afternoon.

Cody, who spoke for 45 minutes during a virtual meeting, touched on multiple aspects of the ongoing pandemic, including vaccinations for children, how the virus has changed to become more infectious, which groups are currently most vulnerable to hospitalization, and the impacts of the pandemic on public health and health care systems, especially their ability to confront the next major public health emergency.

With a current push to get booster shots in the arms of adults, Cody noted that the number of county residents who've gotten another dose has been low, but it is slowly rising. The boosters are now available to those ages 18 and older in the county.

Getting a booster shot after six months of the initial vaccine series (and after two months for those who got the Janssen/Johnson & Johnson vaccine) is important as people's immunity starts waning, she said.

Of the county's new COVID-19 cases, the rate among those who are fully vaccinated is 6.2 per 100,000 people — low, but not zero.

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It's likely that one booster shot isn't going to protect people indefinitely, either, she noted.

"If I had to guess and put money on it, I'd say (there will be) more boosters," she said, adding that people will end up living with the COVID-19 virus present in the world the same way they do influenza.

Asked if immunity among those who got COVID-19 and recovered is sufficient to ward off another recurrence, Cody said it is not, urging anyone who has had the disease to get vaccinated starting as soon as 10 days after recovery.

Are children less susceptible?

Cody also clarified how transmissible the virus is among children. Discussing the recent Food and Drug Administration approval of the Pfizer-BioNTech vaccine for children ages 5 to 11, Cody cautioned that it's a misconception to think children aren't as susceptible to getting COVID-19.

Part of the confusion for parents stems from changing viewpoints as researchers learn more about the virus.

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Health officials initially thought COVID-19 would spread much like the flu, starting with children who would then pass it to adults. Later, they believed children were less likely to catch the virus.

"Now it looks like kids are just as likely to get infected as adults," Cody said.

Nationwide there have been nearly 2 million cases among children. More than 8,000 children have been hospitalized, with one-third needing intensive care. At least 94 children have died.

In Santa Clara County, few children have been severely ill.

"The vast majority who required hospitalization had a chronic illness or complications that put them at risk," Cody said.

The initial infection isn't the only thing parents should consider, she said. Children can also get long COVID, a syndrome that can cause many long-term complications, including to the heart, lungs and brain. Scientists don't yet know if long COVID will affect learning or a child's future development.

Parents need to know that, in contrast to the risks of infection, shots are safe and effective. The children need a two-dose series for full protection, she added. It's also important for women who are pregnant, breastfeeding or who are trying to become pregnant to get vaccinated, she said.

The delta strain has added another level of urgency that people get vaccinated, Cody said. Delta is as transmissible as chicken pox and is more easily transmissible than other communicable viruses such as MERS, SARS, ebola, the common cold, seasonal flu and the 1918 influenza and smallpox. Delta is also many times more transmissible than the ancestral strain of SARS-CoV-2, she noted.

"Vaccines are the bedrock of protection," Cody said, and the county numbers seem to prove it.

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The average rate of new cases of COVID-19 in Santa Clara County is nearly 5.5 times lower for fully vaccinated people than for unvaccinated people. Courtesy Santa Clara County.

Unvaccinated Santa Clara County residents ages 12 and older have a substantially higher case rate — nearly five and a half times higher — than fully vaccinated residents, she noted. Once the numbers are adjusted for age, Cody thinks they could be higher.

Facing the backlash

Cody said her experiences with the COVID-19 pandemic have been sobering.

A highly vocal group of people, who are in the minority, has been spreading an enormous amount of misinformation in this country, she said. They have been loud and disruptive and "just angry" over everything from testing and contact tracing to masks to vaccines. Public health officers have become the targets in unprecedented ways, she said.

"Most of my colleagues in public health have experienced a level of vitriol that I have never experienced before," she said.

For two years, protesters have demonstrated against her decisions and at times it's gotten personal. One sign depicted Cody's head decked in a colorful coronavirus headdress.

"I thought it quite attractive," she said.

The situation hasn't always left room for levity. In September 2020, the Santa Clara County Sheriff's Office arrested a man with connections to the far-right "Boogaloo" group who allegedly wrote Cody 24 threatening and profane letters.

More broadly, she said, health care and public health workforces are exhausted by this pandemic and the constant battle against hostility and disinformation. It will take resources — including financial — to rebuild a robust public health system for when the next pandemic strikes.

Cody has great concerns regarding the future should another global health crisis emerge.

"It's the decay in public trust and government that troubles me," she said. People might be less willing to listen to their leaders, she said.

As the Thanksgiving holiday approaches, Cody said people need to use good sense regarding whether to gather with family and what precautions to take. Cases are again on the rise. The county never completely got out of the summer's surge, she said.

If people do plan to gather, they should probably do a rapid at-home COVID-19 test before getting together. If they are sick, they shouldn't attend a gathering. Unlike last season when there was a huge spike in winter cases, Cody isn't imploring people this year to stay home. With vaccines readily available and other precautions such as masking and social distancing well-publicized, Cody said it's up to individuals to assess the risk.

"It's like driving in the winter. We don't tell people not to drive in the winter," she said. But if one has an old car or would be traveling in deep snow or a blizzard, they might consider limiting their travel or not going out at all.

"You adjust your risk to the circumstances," she said.

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Dr. Sara Cody: COVID-19 could be with us indefinitely

It's likely people will need periodic booster shots in the future, Santa Clara County health officer says

by / Palo Alto Weekly

Uploaded: Mon, Nov 15, 2021, 9:29 pm

Living with — not vanquishing — the COVID-19 virus is likely to become the norm, with people getting booster shots to protect themselves much like they do an annual flu shot, Santa Clara County Health Officer Dr. Sara Cody told members of the Palo Alto Rotary Club on Monday afternoon.

Cody, who spoke for 45 minutes during a virtual meeting, touched on multiple aspects of the ongoing pandemic, including vaccinations for children, how the virus has changed to become more infectious, which groups are currently most vulnerable to hospitalization, and the impacts of the pandemic on public health and health care systems, especially their ability to confront the next major public health emergency.

With a current push to get booster shots in the arms of adults, Cody noted that the number of county residents who've gotten another dose has been low, but it is slowly rising. The boosters are now available to those ages 18 and older in the county.

Getting a booster shot after six months of the initial vaccine series (and after two months for those who got the Janssen/Johnson & Johnson vaccine) is important as people's immunity starts waning, she said.

Of the county's new COVID-19 cases, the rate among those who are fully vaccinated is 6.2 per 100,000 people — low, but not zero.

It's likely that one booster shot isn't going to protect people indefinitely, either, she noted.

"If I had to guess and put money on it, I'd say (there will be) more boosters," she said, adding that people will end up living with the COVID-19 virus present in the world the same way they do influenza.

Asked if immunity among those who got COVID-19 and recovered is sufficient to ward off another recurrence, Cody said it is not, urging anyone who has had the disease to get vaccinated starting as soon as 10 days after recovery.

Cody also clarified how transmissible the virus is among children. Discussing the recent Food and Drug Administration approval of the Pfizer-BioNTech vaccine for children ages 5 to 11, Cody cautioned that it's a misconception to think children aren't as susceptible to getting COVID-19.

Part of the confusion for parents stems from changing viewpoints as researchers learn more about the virus.

Health officials initially thought COVID-19 would spread much like the flu, starting with children who would then pass it to adults. Later, they believed children were less likely to catch the virus.

"Now it looks like kids are just as likely to get infected as adults," Cody said.

Nationwide there have been nearly 2 million cases among children. More than 8,000 children have been hospitalized, with one-third needing intensive care. At least 94 children have died.

In Santa Clara County, few children have been severely ill.

"The vast majority who required hospitalization had a chronic illness or complications that put them at risk," Cody said.

The initial infection isn't the only thing parents should consider, she said. Children can also get long COVID, a syndrome that can cause many long-term complications, including to the heart, lungs and brain. Scientists don't yet know if long COVID will affect learning or a child's future development.

Parents need to know that, in contrast to the risks of infection, shots are safe and effective. The children need a two-dose series for full protection, she added. It's also important for women who are pregnant, breastfeeding or who are trying to become pregnant to get vaccinated, she said.

The delta strain has added another level of urgency that people get vaccinated, Cody said. Delta is as transmissible as chicken pox and is more easily transmissible than other communicable viruses such as MERS, SARS, ebola, the common cold, seasonal flu and the 1918 influenza and smallpox. Delta is also many times more transmissible than the ancestral strain of SARS-CoV-2, she noted.

"Vaccines are the bedrock of protection," Cody said, and the county numbers seem to prove it.

Unvaccinated Santa Clara County residents ages 12 and older have a substantially higher case rate — nearly five and a half times higher — than fully vaccinated residents, she noted. Once the numbers are adjusted for age, Cody thinks they could be higher.

Cody said her experiences with the COVID-19 pandemic have been sobering.

A highly vocal group of people, who are in the minority, has been spreading an enormous amount of misinformation in this country, she said. They have been loud and disruptive and "just angry" over everything from testing and contact tracing to masks to vaccines. Public health officers have become the targets in unprecedented ways, she said.

"Most of my colleagues in public health have experienced a level of vitriol that I have never experienced before," she said.

For two years, protesters have demonstrated against her decisions and at times it's gotten personal. One sign depicted Cody's head decked in a colorful coronavirus headdress.

"I thought it quite attractive," she said.

The situation hasn't always left room for levity. In September 2020, the Santa Clara County Sheriff's Office arrested a man with connections to the far-right "Boogaloo" group who allegedly wrote Cody 24 threatening and profane letters.

More broadly, she said, health care and public health workforces are exhausted by this pandemic and the constant battle against hostility and disinformation. It will take resources — including financial — to rebuild a robust public health system for when the next pandemic strikes.

Cody has great concerns regarding the future should another global health crisis emerge.

"It's the decay in public trust and government that troubles me," she said. People might be less willing to listen to their leaders, she said.

As the Thanksgiving holiday approaches, Cody said people need to use good sense regarding whether to gather with family and what precautions to take. Cases are again on the rise. The county never completely got out of the summer's surge, she said.

If people do plan to gather, they should probably do a rapid at-home COVID-19 test before getting together. If they are sick, they shouldn't attend a gathering. Unlike last season when there was a huge spike in winter cases, Cody isn't imploring people this year to stay home. With vaccines readily available and other precautions such as masking and social distancing well-publicized, Cody said it's up to individuals to assess the risk.

"It's like driving in the winter. We don't tell people not to drive in the winter," she said. But if one has an old car or would be traveling in deep snow or a blizzard, they might consider limiting their travel or not going out at all.

"You adjust your risk to the circumstances," she said.

Comments

Bystander
Registered user
Another Palo Alto neighborhood
on Nov 16, 2021 at 8:43 am
Bystander, Another Palo Alto neighborhood
Registered user
on Nov 16, 2021 at 8:43 am

She is now saying what many of us have been saying for quite some time. We are going to have to learn to live with this. We will make some adjustments of course, but we will have to return to living our lives with this added risk. Some of the adjustments will differ according to our values and our priorities, but being forced into a life of fear is not one of them for most of us.

She said very little about other health issues and their effects. Things like being obese being a factor in how an individual copes with Covid is being underplayed. Also whether issues such as cancer, parkinsons, etc. may make a person's body find it harder to fight the virus.

She also said very little about how the pandemic has affected mental health. Some are finding the adjustments to less interactions with family, friends, social activities, etc. isolating and making it harder to find peace of mind when missing close interaction with loved ones or with activities that are loved. Returning to getting together with people and taking part in much loved activities have to be weighed in with the pros and cons of life.

Lastly compliance certificates, aka vaccine passports, is making for a two tier society. Doing weekly Covid tests and carrying proof of negative test or proof of vaccination is turning us into a card carrying society which is not an American value. Somebody is making a lot of money out of these tests. And expecting a 17 year old restaurant worker to demand to see id from someone old enough to be their grandparent is not a value society should demand.


Jason Beck
Registered user
Woodside
on Nov 16, 2021 at 8:54 am
Jason Beck, Woodside
Registered user
on Nov 16, 2021 at 8:54 am

This is not rocket science as the SARS Covid-2 virus will continue to mutate.

All we can do is get fully vaccinated, wear a face mask when/if applicable, avoid large public gatherings where thousands may or may not be vaccinated, and initiate further (aka harsher) travel bans from 3rd world countries with low vax rates...including refugees and immigrants seeking asylum.


mauricio
Registered user
Embarcadero Oaks/Leland
on Nov 16, 2021 at 9:49 am
mauricio, Embarcadero Oaks/Leland
Registered user
on Nov 16, 2021 at 9:49 am

"carrying proof of negative test or proof of vaccination is turning us into a card carrying society which is not an American value"

I'm sure you want everybody arriving in the US to show their passport to the immigration official. When I enter my health club I need to show or scan my membership card. In Costco you also need to scan your member card. I need to show my credit card to pay my restaurant bill, etc, etc.

It is only when life and death matter are concerned, when selfish individuals refuse a vaccination to avoid the spread of a deadly virus that the "card carrying society" argument is brought up by the anti science crowd.


Bystander
Registered user
Another Palo Alto neighborhood
on Nov 16, 2021 at 12:37 pm
Bystander, Another Palo Alto neighborhood
Registered user
on Nov 16, 2021 at 12:37 pm

Jason. I disagree. I have no problem with passports at immigration or membership at Costco or gyms. In fact, most of those are done by uniformed officials at airports, or by a high tech reader at gyms. Costco still looks for a membership card, but not a drivers license.

I do object to a 17 year old child demanding to see my proof of vaccination as well as my drivers license. That is not the job of a child on minimum wage. If I had a 17 year old demanding to see this at the local McDs I would not be happy and be very concerned about their safety.

I am vaccinated. I will happily show my ID to officials to enter the country or by police if stopped for speeding or similar. I am happy to show my Costco card or my gym membership and have them scanned. After all, these documents do not have personal information. I am wary of anyone other than uniformed officials in non official manners needing to see my ID showing my address, date of birth, etc. Anyone could be standing at a door with a scanner of some sort and we should not be obliged to show this important document to someone who could be using the information for any type of nefarious action.

If you can't see a difference then I believe you are mistaken. My drivers license shows personal information which should not be seen by anyone to buy a burger or see a movie.


PattiP.
Registered user
Professorville
on Nov 16, 2021 at 10:01 pm
PattiP., Professorville
Registered user
on Nov 16, 2021 at 10:01 pm

Bystander, If you look at your vaccination card (which you say you have) you would see that it has no personal information other than the fact that you are vaccinated. People charged with verifying your identity have only a moment to verify that the name and the photo is the same; they don't have the time to look or memorize your address. But if you feel better, cover your address and age with a piece of masking tape. As for your age...well your face tells the story there, so not exactly private information. And who cares about the age of the person verifying that your vax card matches your identity? Ridiculous argument. But feel free to ask that an older manager verify that you are vaxed if you want to enter these places.


Jennifer
Registered user
another community
on Nov 17, 2021 at 7:37 am
Jennifer, another community
Registered user
on Nov 17, 2021 at 7:37 am

This is something we'll have to learn to live with. Just like the flu and pneumonia.

As far as the vaccine mandates, I understand both sides. Both sides have valid arguments.


mauricio
Registered user
Embarcadero Oaks/Leland
on Nov 17, 2021 at 8:08 am
mauricio, Embarcadero Oaks/Leland
Registered user
on Nov 17, 2021 at 8:08 am

My vaccination card doesn't even have my address on it, only the serial number of the injection and the place of vaccination. It contains no more information than a gym card. It doesn't even matter anyway, because unvaccinated people shouldn't even be allowed to enter public areas like stores, airports, restaurants, gyms, health care clinics, etc. Every person, unless excused by a physician must get vaccinated, end of story. If there had been an outbreak of the smallpox virus and one third of the population refused to get vaccinated would we allow them to roam the streets and enter public areas?

Unvaccinated people are selfish and endanger the public. They can, and do, infect other people, some of whom end up losing their lives. The excuse of personal information breach is ridiculous at a time when we carry other cards more than ever and have to show them more frequently than ever.


PA Community Advocate
Registered user
Another Palo Alto neighborhood
on Nov 18, 2021 at 9:09 am
PA Community Advocate, Another Palo Alto neighborhood
Registered user
on Nov 18, 2021 at 9:09 am

When people point to controlled experiments and real-world data that disproves the value of your policies, that’s not misinformation. It’s called science.

Sadly our bureaucrats with undeserved and unbounded power due to questionable emergency authorization don’t want to admit this.


Bystander
Registered user
Another Palo Alto neighborhood
on Nov 18, 2021 at 12:20 pm
Bystander, Another Palo Alto neighborhood
Registered user
on Nov 18, 2021 at 12:20 pm

Mauricio, unfortunately it is not just the vaccination card that is required. To prevent people borrowing a friend's card, or even buying a fake card, all these places requiring proof of vaccination also require ID also. So it is a two part process, showing vaccinatio card as well as license.

This is where the big problem lies.


Neal
Registered user
Community Center
on Nov 18, 2021 at 4:37 pm
Neal, Community Center
Registered user
on Nov 18, 2021 at 4:37 pm

I really don't understand the issue regarding 17 year olds. They are more than capable of verifying vaccination status. This isn't rocket science. How much more comfortable would you feel if the person was 18 years old? Sounds like a red herring to me.


Jennifer
Registered user
another community
on Nov 18, 2021 at 7:03 pm
Jennifer, another community
Registered user
on Nov 18, 2021 at 7:03 pm

I understand the issue with 17 and 16 year old teenagers. They're minors, and they lack life experience. With all the "mask abuse" including people getting shot and killed, the same could happen with vaccine mandates. Health records are more personal than masks. An abusive man could abuse (take a punch) at a kid, especially if it leads to an argument. If you don't think this could happen, especially since it's become political to some. You're naive at best and ignorant at worst. Wise up. A mature adult employee knows how to handle asking for an ID. A kid might not.

I also understand county health orders, and why vaccines mandates are in place. We're still dealing with the pandemic. If this hadn't become political, I believe it would be a smoother ride for all of us.


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