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In many ways, this week is a turning point in the battle against COVID-19.

Disneyland will reopen on Friday after being closed for more than a year.

Coronavirus cases in Los Angeles County are so low that the area is on the verge of going yellow – the most forgiving of California’s four-tier color-coded reopening system – which would trigger dramatic reopens.

And people fully vaccinated against COVID-19 can safely stop wearing masks in many outdoor environments, the United States Centers for Disease Control and Prevention said Tuesday.

But there are still reasons to be careful. As the situations in Oregon and India show, the coronavirus remains a threat.

What are some things that experts are still hesitant to do?

Earlier this month, Dr Robert Wachter, chairman of the medical department at UC San Francisco, told a webinar that he was comfortable having his hair cut and taking the plane to see his parents now that he was fully vaccinated. He also felt comfortable resuming a monthly poker game with fully vaccinated friends, he recently tweeted. But the 63-year-old was in no rush to go to an indoor restaurant and take off his mask.

“I am convinced that I will not be hospitalized and die. It feels good. But I don’t particularly want to have mild COVID because I don’t know for sure that it can’t turn into ‘long COVID’ or a long-term consequence that I don’t yet understand, ”Wachter said. during the seminar. .

“Long COVID” refers to a number of symptoms that have persisted for months in people who have survived infection with the coronavirus. They include fatigue, shortness of breath, trouble sleeping, fever, stomach problems, anxiety, depression, and difficulty concentrating or concentrating, what some people call “brain fog.” said Dr.Anthony Fauci, the U.S. government’s top infectious disease specialist. Report.

The severity of long COVID “can range from mild, annoying to actually quite disabling,” Fauci said.

Long-term COVID persists even after the virus has been essentially cleared from the body. Alarmingly, Fauci said, about 30% of patients enrolled in a study reported persistent symptoms of COVID long for as long as nine months.

What do other doctors think about eating inside?

Other fully vaccinated doctors have shown themselves comfortable returning to indoor restaurants, at least to places they are familiar with in California.

“Personally, I am 69 years old, I am vaccinated. I probably have a few more risk factors. I’m comfortable eating indoors in places I know, ”said Dr. George Rutherford, epidemiologist at UC San Francisco, in an interview.

During the webinar, Dr Peter Chin-Hong, professor of medicine and infectious disease specialist at UC San Francisco, said that if he went to an indoor restaurant, he would reduce his risk, for example by s ” sitting by a window or making sure to put on his mask when he goes to the bathroom.

Dr. Monica Gandhi, professor of medicine at UC San Francisco and medical director of the HIV clinic at Zuckerberg San Francisco General Hospital, said in the online forum that she was comfortable bringing her two children un vaccinated and two fully vaccinated parents – aged 87 and 80. – in a covered restaurant in San Francisco.

“I felt perfectly safe,” Gandhi said. Part of that was related to the extremely low amount of the virus circulating in San Francisco, so she felt that “I was probably not exposing my parents to COVID.”

But a doctor might make a different decision about indoor meals if, for example, they lived in Michigan, which is home to the highest rate of coronavirus cases in the country, Chin-Hong said. California has the lowest number of coronavirus cases per capita in the United States, while Michigan has the highest.

What about wedding receptions?

The mix of vaccinated and unvaccinated people during an event “is always a bit uncertain,” Rutherford said. Risks can be reduced by following guidelines issued by California, he said.

Wedding receptions, meetings and conferences are now allowed in California, with changes depending on the level of virus circulating in a county. In Los Angeles County, for example, which is in the second least restrictive level, or orange, outdoor receptions can be held with a maximum of 300 people if everyone tests negative for the virus or can present. proof of vaccination, or up to 100 people who do not need to verify vaccination or recent test records. Indoor receptions can be arranged if all guests show negative coronavirus tests or proof of vaccination, with the number of guests capped at 150.

The CDC and the California Department of Public Health are urging people to delay travel until they are fully immunized.

How about going to sports games or bigger conventions?

Rutherford said he believes California’s rules for watching live professional sports games are well thought out. “Just follow the rules,” he says.

And while Gov. Gavin Newsom has considered “completely reopening” the state’s economy on June 15 if the vaccine supply is sufficient and hospitalization rates remain low, there are important regulations to be expected.

For example, large-scale indoor events, such as conventions, would require vaccination testing or verification, Newsom’s office said.

The San Francisco convention center, the Moscone Center, has booked its first convention since the start of the pandemic: a convention of hand surgeons to be held from September 30 to October 2.

“They are all surgeons. They will all be vaccinated, ”Rutherford said.

California has a relatively low case rate. Will the state avoid a fourth wave?

“We just don’t know,” Rutherford said. Colorado, Washington, Oregon, Nevada and Arizona are among the states experiencing an increase in the number of cases.

There are several factors that help determine if a new wave will come, Rutherford said.

First, what proportion of the population has been vaccinated?

Second, are people still wearing masks and keeping themselves physically away?

Third, have any variants become more transmissible and difficult to control? One possible explanation for the surge in Michigan is how the highly contagious British variant (B.1.1.7) dominates there; he didn’t do so much in California or Arizona.

Fourth, are residents who are still unvaccinated living together in a way that would worsen an epidemic? A Times analysis found that only 35% of people living in the most disadvantaged areas of California received at least one dose of the vaccine, while 57% of people living in the more prosperous areas of the state received at least one dose of the vaccine. minus one dose.

Fifth, how soon will adolescents be eligible to receive the vaccine? Authorizing the Pfizer vaccine for children as young as 12 is something that will be needed to really slow transmission, Rutherford said.

And sixth, how much vaccine is available? A robust supply will help mitigate the threat of a fourth wave.

How vaccines can fail in rare cases

In Kentucky, an unvaccinated healthcare worker reportedly brought the coronavirus into a nursing home. An epidemic resulted, leaving 26 residents infected – 18 of whom were fully vaccinated – and 20 health workers, four of whom were fully vaccinated.

Three residents died – two who had received no vaccine doses and one who had been “fully immunized”, having received both doses of Pfizer vaccine more than 14 days before the outbreak was identified, according to the CDC.

One of the unvaccinated people who died had previously been infected with the coronavirus and survived before being re-infected. The death demonstrates the rare risk of reinfection and underscores the importance that everyone – including COVID-19 survivors – always receive the vaccine, according to the report.

Experts say the immunity provided by vaccinations is better than surviving COVID-19.

“Even if you’ve had an infection before, you really get an increase in antibody levels with the vaccination,” said Dr. Paul Simon, scientific director of the Los Angeles County Department of Public Health.

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