July 2021 Howard Brown Health COVID-19 Security FAQs

July 30, 2021

Howard Brown Health recently released a statement calling on organizers of public events to implement strict COVID-19 security measures to prevent the 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 am vaccinated, why should I hesitate to attend an outdoor event?

The dominant Delta variant can be transported and spread by vaccinated and unvaccinated people. Although symptoms are usually less pronounced in people who have been vaccinated, they can still transmit the virus, risking serious illness for people who are not vaccinated. Until more people are vaccinated locally and nationally, large crowded gatherings pose a serious risk to public health and make future blockages more difficult to avoid.

The CDC did not make similar recommendations, how did Howard Brown make this decision?

Howard Brown certainly supports and follows the CDC guidelines and the scientific recommendations made by the CDC. However, the CDC has been very clear that local conditions must guide decision making to meet specific local circumstances and needs. In accordance with CDC guidelines, outdoor gatherings are preferred over indoor gatherings. However, during crowded events like street festivals and parades, it will be extremely difficult to maintain physical distance. Also, requesting confirmation of the vaccinated status of event participants is not possible because these events occupy public roads. Of greater concern are the many ancillary interior activities that accompany these events. Interior components are historically cluttered and difficult to provide physical distancing. For example, a recent COVID cluster performed in Provincetown, resulting in hundreds of new positive infections.

Heard that the recent spike in the UK and other countries was not that bad. Why bother here?

Howard Brown is not aware of any peak in COVID-19 where infection rates have declined 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 drop again in weeks or months, the concern is not the current wave. The main public health problem is serious illness, hospitalizations and deaths in the most vulnerable communities. The UK has a 55% vaccination rate. They peaked at 15% positivity, and that has tended to drop under the restrictions, which are now lifted as the trajectory goes back down. The UK is two months away from wave three, and even if it continues to decline, the positivity rate will likely remain high for another two months.

To what extent are people vaccinated living with HIV (PLHIV) against the Delta variant protected?

In general, PLHIV who stick to their treatment plan and have undetectable viral loads and a CD4 count greater than 200 are not considered immunosuppressed. Some researchers have increased this threshold to more than 350 when studying COVID. There is no data to suggest that fully vaccinated PLHIV with these higher CD4 counts would be less protected against the Delta variant than the general population. However, immunocompromised PWLH may present a risk of reduced immune response due to the vaccine.

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

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

What other precautions should vaccinees take into account?

People vaccinated should follow all CDC and local government recommendations and adhere to the rules and guidelines set by any private companies they sponsor. Wear a mask, maintain social distancing, wash your hands frequently, and take all COVID-19 safety precautions. People who have been vaccinated should take these precautions, including wearing masks indoors.

Does Howard Brown still offer in-person medical appointments at his clinics?

Yes. In-person care will continue at Howard Brown. We do not intend to close or limit in-person care provided as dictated by our maximum capacity and separation requirements, in particular we have implemented security measures and precautions at all of our locations ( i.e. wearing masks and our staff are vaccinated). At this time, there is no reason to go “all virtual”.

Howard Brown going to vaccinate people on market days?

No. Our bodies need time to develop full immunity after receiving a vaccine. Unvaccinated people are most at risk of serious illness, hospitalization and death from COVID-19 and the Delta variant. A person receiving a vaccine during a large, overcrowded event would still be vulnerable to serious illness and infection if exposed to the virus on the same day. If anyone wishes to be vaccinated, they should call Howard Brown at 773.388.1600 make an appointment. While vaccinations are the best form of protection against COVID-19 and the best way to stem the pandemic, we categorically discourage unvaccinated people from attending large, overcrowded 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 people vaccinated in a community. However, these strategies should incorporate intersectional models and should ensure that burdens and benefits are shared equitably and do not aggravate inequalities.

Howard Brown Imposing Vaccination on His Workforce?

The vast majority of the workforce has been vaccinated voluntarily. Nonetheless, we will make vaccination of all workers mandatory in accordance with other infection control approaches for the prevention and control of influenza, tuberculosis and other conditions.