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Health director: FDA's vaccine approval fuels optimism that pandemic's days are numbered

By Mike Pettinella

News that a Food and Drug Administration advisory panel has approved COVID-19 vaccines developed by Pfizer and BioNTech SE for emergency use provides “light at the end of the tunnel,” the public health director for Genesee and Orleans counties said today.

“Hopefully, this will start a new chapter (in this pandemic) – a kind of beginning of the end for us,” Paul Pettit said, adding that the vaccine will be dispersed in phases, starting with individuals at the highest risk. “We do see the light at the end of the tunnel. It will take a bit of time, so we ask folks to be patient.”

Pettit said local health departments have been working for months on the distribution plan, but emphasized that New York State has the final say as to who gets the vaccine and when.

“The state is kind of driving the boat on this and how it is going to happen,” he said. “Obviously, we’re working with our community partners and our healthcare providers to get pharmacies, and primary care physician offices signed up to deliver the vaccine.”

He said the vaccine – which is given in two doses about three weeks apart – will first be administered to nursing home residents and staff and healthcare workers who are at greater risk. After that, the groups will be divided into other health professionals and high-risk individuals, healthy seniors who meet the age requirements, those with underlying health conditions, other essential service workers and, finally, the general public.

At the outset, the vaccine will be sent to “closed pods,” Pettit said.

“Doses will be sent right to the nursing homes or the healthcare providers that are eligible for it. As we get into January, February and March, it will be more available to the community, again, depending upon your risk level,” he said.

Pettit said the health department will oversee mass vaccination clinics, likely at Genesee Community College, Genesee County Building 2 on West Main Street Road or the Genesee County Fairgrounds, with the campaign – due to the volume of need – expected to run into April and May.

He said about 11,000 doses are being delivered to the Finger Lakes Region as early as next week, and will go to the people designated in the first phase.

The vaccine will be administered at no charge, Pettit said.

“We’ve been told that there will be no co-pays,” he said. “There will be a lot more information coming out, but for the general public, you should not expect the vaccine to be available at least into January.”

Pettit commented on other aspects of the virus.

On the Possible Side Effects of Vaccination

“Everybody’s different so people respond differently to vaccines. We do hear that when people get a flu shot – it’s not a live virus – but sometimes people do have some mild reactions to the shot.

“Again, there may be some mild side effects … but the phase three trials that have been done over the last three to four months have not reported out any significant issues that we have been made aware. The FDA just this morning approved the emergency use authorization that the vaccine is safe and we’re going to be strongly encouraging folks to receive the vaccine. That’s the best way to get us out of this pandemic is to start getting our folks protected.”

On the Primary Causes of the Spread in Genesee and Orleans Counties

“As we continue to look at the data in both counties, the biggest identifying factor that we can find in the majority, but not all, of the cases is usually tied back to some level of gatherings or workers working symptomatic. Those seem to be the two biggest reasons we have seen for at least the index cases and secondary spread, and what happens from there, they go home from the gathering or work and they take it to their family members and/or their extended family members and friends.

“So, you start to get this secondary and tertiary spread, which seems to be perpetuating some of the problem here in our counties. One thing I will say, on the gathering side, a lot of the cases we’ve seen are not necessarily from gatherings of 50 people – the public can be up to 50, private it is supposed to be 10 per the governor’s order.

“But the reality is that it only takes one positive person in that setting to spread it very easily, actually, to potentially all the others that are in that gathering if they’re not distancing and masking. So, gathering size at all levels – five, eight 10, 20 people – we’re still seeing significant spread within those groups if you have positive people.

“It does seem to be that private gatherings are the underlying factor in these new cases and, again, the other one is workers coming to work symptomatic. It’s difficult this time of year because people are dealing with coughs, sniffles and other types of colds, and they’re going to work like they normally would in an average year – and unfortunately a percentage of these are COVID cases and they’re spreading it to their coworkers.”

On the Pertinent Current Data Regarding Positivity Rate

“Right now, positivity-wise, in Genesee County we are, as of yesterday, at about at 8 percent positivity rate over a 14-day average, and over a seven-day average, we are trending down from our peak, which was 9 percent a week ago. We’re down at about 7.2 percent right now for positivity rate. So, that continues to trend down in the right direction, which is a great thing. We’ve been working hard to get that number to trend in the right direction.

“It’s still high. If you recall, three months ago we were down at .5 to 1 percent positivity rate and now we’re right around 8 percent. It’s definitely a lot more active in the community.”

On the Projected Thanksgiving Bump in Positive Cases

“Obviously, there was a lot of talk about a Thanksgiving bump, but our numbers going into Thanksgiving were very high. So, if anything our numbers have started to trend down slightly.

“I think that there were gatherings that occurred over the holiday and we did our best to try to educate and encourage people to have smaller gatherings this year, and minimize contact with those in your immediate family and household, and to look at the risk factors for every individual that’s gathering. If they have underlying health conditions? If they’re in higher risk categories?

“I wouldn’t say there was a significant bump. Our numbers have stayed very consistent to what they were through the whole month of November.”

On the Process of Contact Tracing

“When we find out about a positive case, we do a case investigation. As part of that case investigation, we talk to the individual about their close contacts – that’s really what we’re looking for. With COVID, we go back 48 hours from either symptom onsets, or if they’re asymptomatic, from the test date. So, we’re looking for any close contacts.

“When we say close we’re talking about within six feet or less for more than 10 minutes or if they happen to be in the same space with the positive for more than an hour. That’s called proximate contact, so there’s a couple of different things that we look at, and it’s all based on risk potential. That would be more of a scenario like in a classroom setting or in the restaurant/dining setting … using an hour threshold in a common space with a positive case.

“Once those are determined, they get identified and put under mandatory quarantine, and it’s 14 days from their last exposure to the positive (person). The Center for Disease Control has made some recommendations to change the quarantine down to either seven days with a negative test or 10 days without a test. NYS has not decided yet whether they’re going to follow the CDC’s recommendation on this. As of right now, we are still using 14 days as the quarantine period.”

On Health Alerts that Target Local Businesses, Primarily Restaurants

“We’ve said since day one, going back to March, if we get scenarios where we can’t identify close contacts in a public space, we would have to put out an announcement – a health alert – to let people know that may be in that space, that they may have been exposed to a confirmed positive case.

“What has happened quite a bit lately is – and this is mainly reflective of increased activity -- all through summer and early fall, our infection rate was .5 percent – one case a day, a couple cases a day. Right now, with an 8 to 9 percent positivity rate, there are a lot of positives in our community. What’s happening, particularly in restaurants and other businesses, you have people who come in, sit down and eat their dinner, they’re spending an hour, hour and a half eating.

“Going back to proximate contact, people are sitting down without their masks on so we have to look at everybody in that room or dining area as a potential contact because of proximate contact and time exposure. We don’t know who these people are … the only way to notify these people is to put out a health alert that if you ate at X establishment at X time and on X date, you may have been exposed to a confirmed positive case.

“Obviously, it would be up to the person to read that alert and say, ‘Wait, that was me, and I need to monitor for symptoms or go get tested.’

“As far as big box stores, such as Walmart, Tops, we get a lot of those questions, it’s really the nature of the interaction. When you shop at these types of stores, you’re very transient and you’re not spending more than 10 minutes closer than six feet. Most people are wearing masks, so the risk exposure is totally different because of the transient nature and the large size of these buildings.

“We have had confirmed positive employees at these bigger stores and we have put coworkers on quarantine because they’re spending time in the break room or the back, those types of things. But the exposure to people shopping – going up and down aisles – the risk and the time exposure isn’t there like it is at an establishment where you’re spending an hour with no mask on.”

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