Jason writes:

Hi. We are scheduled to host a catered party in a few weeks on Long Island. Out of 130 or so guests we have a handful who are unvaccinated. I’m assuming we need to require masks for them and kids who also aren’t vaccinated? Can they test out of a mask requirement? Would we do a rapid or PCR or both? And how long before the party?  

Just curious if recommendations have changed at all?

Thanks 
Jason

Tom writes:

Dear Dr. Griffin, 

I know the guidance from the FDA and CDC at this point is that boosters are not needed to prevent disease. However, it seems like they could help prevent infection as a third dose appears to elevate neutralizing antibodies to 100X (if you take the Pfizer data at face value*). While we don’t know if neutralizing antibodies are a correlative of protection from severe disease, it does seem to correlate with protection from infection based on small data from NEJM paper out of Israel. https://www.nejm.org/doi/full/10.1056/NEJMoa2109072  

As a father of 2 young children, I am finding it hard not to go and “find” a 3rd dose. I am not worried about getting COVID19, but instead a mild case that allows me to transmit the virus to my children. I still wear masks in areas where I can’t verify the vaccination status of others. But I am worried that this might not be enough. For instance, do we need to go back to the days of masking around everyone not in our immediate family such as my parents and in-laws. To me, I would like to see boosters or an expedition of the vaccines to those <12 .

I am not looking for you to comment on whether I should get a third dose, but rather on how the FDA full approval might change the ability of physicians to prescribe a third dose? Would full approval allow doctors to write off-label prescriptions based on the needs and risks of their patients? 

Keep up the good work 

Best, 
Tom 

Keels writes:

I’m a primary care doctor here in steamy Jacksonville FL (feels like a sauna whatever the temperature these days). 

We’re having a terrible time with SARSCoV2 and COVID-19 disease here in Jacksonville, FL.  

What, if anything, is the role of UVC light to potentially sterilize the air? I know you did some papers on this in 2020 – I’m hoping that there’s more information out now.  Memory might fail me as I write this email in my car before I go into the clinic for another very long day but there was something about a particular wavelength 245(?) that was effective and most of the others were not. I’m not worried about surfaces but I wonder about the air.

If UVC room light can be helpful especially in places where mask mandates are prohibited (like our schools!!! EGAD!) Or ignored, could UVC light be another mitigating measure? Expensive, probably impractical (and i do wonder about long term exposure to skin) but at least it’s passive.

I even emailed Consumer Reports a while back asking them to do some reviews of UVC products purported to inactivate Coronavirus but to my knowledge they have not gotten to it.  

I’ve emailed this question in to you before so apologies if you have answered it. I try to keep up with all of TWiVs but I have had to spend some of my precious podcast time listening to things about diabetes and heart attacks and diverticulitis and cancer since those conditions have not gone away. 

I don’t mean to turn you into a research librarian for me but if you cannot address it on the air if you can point me towards some literature I’ll try to read it on my own.

I’ve been a faithful listener since 2020 led me to you. Even went back and listened to TWIV number one about West Nile virus (that was awesome). Got a bumper magnet and a T shirt and friends are sometimes tired of me talking about what I heard on TWIV.  And my daughters are tired of me telling them to listen to your speaker introductions-I love hearing the stories of how these scientists came to where they are. Inspiring for me and my young adult daughters.

Again, thank you thank you thank you for all that you do.  

— Keels

Jennifer writes:

Dear Dr. Griffin,

I am writing with great appreciation for your weekly clinical updates on COVID and know your time is limited so will get right to my questions:

I have heard rumblings that with delta on the scene, cloth masks are not to be trusted for protection and that N95/KN95s or double masking with a surgical mask under a cloth mask are the only way to go. What are your thoughts on this? I have been able to find N95/KN95s to fit myself, my spouse, and my older child, but have not found good options that fit children. Furthermore, most of the masked children I encounter are wearing cloth masks, which may be loose, usually lack nose wires, etc. With return to school around the bend for us, and with a district mask policy in place, do we proceed with the idea that any mask is better than no mask (leaving folks feeling falsely protected?) or is there/should there be new guidance about what type of mask actually reduces spread from the wearer and/or increases protection to the wearer? From a resource use perspective (reusable/washable, and cost less), I would love it if the cloth masks were a valuable NPI, but if they’re not, I would like to find ways to move us all to safer products/practices.

Something else that delta has likely changed is what qualifies as a close contact. For quite a while now, folks have been using “within 6 feet for a total of at least 15 minutes over a 24-hour period” as a rule of thumb to identify close contacts. With the high viral loads being measured in delta+ people, it seems that a close contact would now be someone who is further than 6 feet away and/or for fewer than a total of 15 minutes in 24 hours. Has anyone had a go at revising the “close contact” definition? Even if the original definition was a loose guideline at best, I found it very helpful to make quick assessments about daily interactions. I no longer feel like I can rely on that rubric to assess the relative risk/safety of a given interaction/series of interactions. This has relevance all over, but especially in schools as they reopen for the new school year and districts implement contact tracing.

With best wishes,

Jennifer