Healthy, vaccinated adults don’t need to mask, UCSF doctor says

There’s still a moderate amount of the coronavirus circulating in Alameda County and a new variant is working its way through the country, but a doctor from the University of California, San Francisco, says people who have been vaccinated can drop the masks.

During a virtual update on the state of COVID-19 earlier this month, Monica Gandhi, professor of medicine and associate chief at UCSF’s Division of HIV, Infectious Diseases and Global Medicine at the Zuckerberg San Francisco General Hospital, said the data showed wearing high-quality masks, such as N95s, is effective — wearing a cloth mask is not — but that became immaterial when the vaccines became available.

“I do really trust the vaccines,” Gandhi said. “And I don’t think that after you’ve been vaccinated that you necessarily need to wear a mask.”

Peter Chin-Hong, professor of medicine in the Division of Infectious Diseases at UCSF Health, said he’s still wearing masks in crowded, indoor areas because masking during certain times of year and in certain contexts can protect against viruses other than COVID-19, too.

Gandhi said it is unlikely society will fully eradicate COVID-19, but that society can treat it like HIV.

“We had treatments and we moved on,” she said, “and it’s important to think about how important these biomedical advances are.”

Alameda County and XBB.1.5

In December, the area’s hospitals were highly impacted because of an early and active season of RSV combined with the flu season and COVID-19 transmission, but the situation has been improving since, Alameda County Health Officer Nicholas Moss told the Board of Supervisors on Jan. 10.

“We seem to be past the peak,” Moss said, though he added, “Some of our local hospitals, we know from conversations, remain highly burdened.”

A new variant, XBB.1.5, is spreading quickly across the East Coast, and Moss said it’s unclear how it will impact Alameda County at this point.

India and Singapore saw a surge in COVID-19 cases in the fall fueled by XBB.1.5, but Chin-Hong said the preliminary data didn’t show “a disproportionate number of folks going to the hospital compared to other sublineages.”

To boost or not to boost

Adults under 65 who aren’t medically vulnerable, for the most part, don’t need to get a booster, Gandhi said.

“Everyone’s sort of coalescing on the common understanding that older people need the booster the most, either yearly,” Gandhi said, “right now, in high circulation, maybe six months.”

In August, the World Health Organization’s Strategic Advisory Group of Experts on Immunization recommended a second booster for people who are older, pregnant, work in health care, have weaker immune system or are at higher risk of severe disease.

The group did a review of the scientific literature and found that the boosters restore the effectiveness of the vaccine, which wanes over time. The second booster saw its effectiveness against severe disease drop by 5% after one to four months and 8% after six months while the effectiveness against symptomatic disease dropped 24% and 29% in the same time frames.

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