Carson City Health Officer answers community questions regarding COVID, the Delta variant, masks, breakthroughs and more

Last week, Carson Now sourced questions from the community on questions they had regarding COVID-19, the Delta Variant, how masks work, and more.

Carson City Health Officer Dr. Colleen Lyons agreed to answer questions that would separate and clarify facts from misinformation.

The questions and answers are found below.

1) Can you explain in layman's terms how the vaccine works to fight against COVID-19? And, follow up, can it alter a person’s DNA?

Different types of vaccines work in different ways to offer protection. But with all types of vaccines, the body is left with a supply of immune “memory” cells that will remember how to fight that virus in the future. It typically takes a few weeks after vaccination for the body to produce these “memory” cells. Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the body had not yet built protection. Sometimes after vaccination, the process of building immunity can cause symptoms, such as fever. These symptoms are normal and are signs that the body is building immunity. The COVID-19 vaccines do not change or interact with your DNA in any way. Both mRNA (Pfizer and Moderna) and viral vector COVID-19 (Johnson) vaccines deliver instructions to our cells to start building protection against the virus that causes COVID-19. However, the material never enters the nucleus of the cell, which is where our DNA is kept.

2) Is the vaccine different from the antibodies of people who have recovered from COVID-19? Why or why not?

The CDC released a study on August 6th confirming COVID-19 vaccines provide better immunity than immunity gained from an actual COVID infection. Researchers found that, among hundreds of Kentucky residents with previous infections through June 2021, those who were unvaccinated had 2.34 times the odds of reinfection compared with those who were fully vaccinated. The research suggests that among people who have had COVID-19 infection previously, getting fully vaccinated provides additional protection against reinfection. COVID-19 vaccines help our bodies develop immunity to the virus that causes COVID-19 without us having to get the illness.

3) How do masks prevent the spread of COVID-19? Does data suggest that masks are effective, why or why not?

COVID-19 is mainly spread from person to person through respiratory droplets. Respiratory droplets travel into the air and can infect those who breath them in. Masks are barriers to prevent your respiratory droplets from reaching others. Given what we know about the Delta variant, vaccine effectiveness, and current vaccine coverage, layered prevention strategies, such as wearing masks and getting vaccinated, are needed to reduce the transmission of this variant. A case study from Missouri provided evidence on the benefits of wearing a cloth face covering. The study focused on two hair stylists who were both infected with and having symptoms of COVID-19. Their salon policy followed a local ordinance requiring cloth face coverings for all employees and patrons. The study found that none of the stylists’ 139 clients or secondary contacts became ill, and all 67 clients who volunteered to be tested showed no sign of infection. The study provides evidence that wearing a mask provides source control and prevents the spread of COVID-19.

4) If you test positive for COVID-19, should you get tested again after you recover? In general, how long is a person contagious after being diagnosed?

No, current guidance is to use time and symptom-based return to normal activities. For most individuals, after they test positive, they would need to isolate for 10 days from symptom onset and be fever free for 24 hours without the use of fever reducing medications; in some individuals that have a compromised immune system they may have to isolate for up to 20 days. For information on quarantining while symptomatic visit https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html

5) Does CCHHS still track flu numbers? Are these numbers available to the public and if so, where can they find them?

During influenza season, October to May, CCHHS utilizes syndromic surveillance to track influenza-like-illness (ILI) in the community. ILI is defined as fever (temperature of 100F (37.8C) or greater) and a cough and/or a sore throat without a known cause other than influenza. The syndromic surveillance system captures deidentified visits form urgent cares and emergency rooms. During influenza season we track the number of hospitalizations related to influenza. CCHHS publishes a report each week on our website related to ILI activity, reports can be found here http://gethealthycarsoncity.org/seasonalflu/

6) What does it mean that the vaccine isn’t FDA approved? Does that mean the FDA hasn’t done any testing on the vaccine?

All COVID-19 vaccines being given in the United States have received an Emergency Use Authorization EUA) from the FDA and have undergone the usual vigorous study and testing of all prior and current commonly used vaccines. The Pfizer COVID vaccine was the first vaccine to the achieve the full standard approval by the FDA on August 23rd, 2021. The CDC developed a post vaccine safety monitoring system, V-Safe, to collect information on post-vaccination symptoms and to monitor the health of individuals who have received the COVID-19 vaccine. If an individual received the vaccine and experienced complications from it, the information is reported to the CDC and FDA through the Vaccine Adverse Event Reporting System (VAERS). Both of these systems are ways which help look for any safety issues with the vaccine. The COVID-19 vaccines are the most closely watched vaccines in history for both immediate and long-term side-effects.

7) Can the government help pay for medical bills that are related to COVID-19? Who can those who have questions contact?

I am not aware of any specific programs to cover the cost of Covid infection care.

8) Is there a way to find out how many COVID-19 cases have been registered within each school district? How can parents, educators or students find out about outbreaks within their districts?

CCHHS is working with the schools in the Quad-County Region to help track and identify outbreaks. Reports of outbreaks will be managed by the schools and school districts. The State of Nevada Department of Health and Human Services created a COVID-19 school dashboard showing the number of cases in students and staff in the schools. It can be found here..

9) Does CCHHS track the numbers of those who are positive who have received the vaccine? If so, how many positive cases of vaccinated individuals have been recorded in the Quad-Counties?
If we are able to talk to a case, we do ask them about their COVID vaccination status. If they state that they are vaccinated, we validate they have actuality have had the COVID vaccination in the Nevada Immunization registry. Since May of 2021, we are providing weekly updates to the State on individuals who have been hospitalized that have been vaccinated. The current breakthrough rate in the Quad-County Region as of August 21, 2021 is 4.8 percent.

What We Know about Vaccine Breakthrough Infections:
- Breakthrough infections are expected. COVID-19 vaccines are effective at preventing most infections. However, like most vaccines, they are not 100 percent effective.
- Fully vaccinated people with a breakthrough infection are less likely to develop serious illness than those who are unvaccinated and get COVID-19.
Even when fully vaccinated people develop symptoms, they tend to be less severe symptoms than in unvaccinated people. This means they are much less likely to be hospitalized or die than people who are not vaccinated.
People who get vaccine breakthrough infections can be contagious.
- Each person’s immune system is as different as our individual faces and personalities.

10) In your opinion, what is the cause behind the continued rise of positive cases despite the fact that community members are being vaccinated?

Yes, individuals in our community are choosing to get vaccinated, however according the State dashboard only 43.03 percent of Nevada is fully vaccinated, that leaves 57 percent of our population at an increased risk of becoming infected with COVID-19. The majority of current cases are among unvaccinated people and children. Unfortunately. the Delta variant is also much more infectious than the original COVID-19 virus. For every one person infected with the original COVID virus, there were an average of two more cases associated with the spread from that one person. Currently, the Delta variant is associated with 8-9 more cases spreading from each person infected. As our community engages in more activities (shopping, eating out, going to concerts, traveling, etc.) we have more contacts in a day. That is why the CDC recommends everyone wear a mask in indoor settings and large crowded outdoor settings to decrease the spread of virus from people who are infected, some without symptoms, especially at the onset of infection.

11) How long do people need to wait to receive a booster shot? Will individuals be contacted when they are eligible to receive a booster?

Currently, there are no recommendations for “booster” shots. The CDC recommended those with moderate to severely compromised immune systems receive a third dose of the Pfizer or Moderna COVID-19 vaccine. This third dose is different than a booster shot. The third dose is given to improve the immune response in those who are immunocompromised because the initial 2-dose series may not have built enough immunity in their body. A booster dose is given to individuals who built enough immunity with the initial series but that immunity has waned over time. The CDC has announced plans for booster doses, but at this time there is no official recommendation and CCHHS is not authorized to administer a booster dose to the general population. Individuals will not be contacted by CCHHS regarding recommended booster shots. CCHHS will continue to provide general information to the public regarding the recommendations for vaccinations and any possible boosters, like the Flu shot. Some doctor offices or pharmacies may send reminders to individual patients if you received your original vaccination with them.

12) If you are unvaccinated and contract COVID-19 and recover, can you contract it again? If so, how long on average are you protected from contracting it?

Based on what we know from similar viruses, some reinfection are expected. The Delta Variant causes more infections and spreads faster than the original virus that causes COVID-19 and it might causes more severe illness than previous strains in unvaccinated people. The CDC is still studying reinfection of unvaccinated individuals to determine how soon after the first infection reinfection can occur. Currently, the CDC says that a person who has had COVID-19 within the previous 3 months is not as likely to contract the virus and therefore will not need to quarantine after exposure. But they are still working to determine if immunity is 3 months or longer.

13) What is the Delta Variant? Has the original strain of COVID-19 disappeared?

Viruses constantly mutate (change genetic structure randomly and accidentally). Occasionally those genetic changes result in variants that have an increased chance of survival, by being more infectious for example, as is the case with the Delta variant. When a variant is better at survival it out competes the other variants and the original virus that causes COVID-19 and becomes the dominant virus infecting people.

14) How can CCHHS determine whether or not a person has contracted the Delta Variant versus the original strain of COVID-19?

Presently, the vast majority of cases, approx. 98 percent plus are the Delta variant in region 9. In Nevada 89.6 percent of sequenced results are the Delta variant.

15) How can the community find out how many positive cases are due to the Delta Variant?

The Nevada State lab, and some commercial labs, random analysis of positive Covid tests to determine the variant. The CDC and NSPHL publish reports of variants circulating in the community at any particular time.

16) If a COVID-19 booster and a flu shot are due at the same time, is it okay to get them together at the same time?

Yes. You can get your flu shot and the COVID-19 shot at the same time.