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Frank A. Bures: Activity advice after vaccination

Frank A. Bures: Activity advice after vaccination

From the COLLECTION: Recent Healthful Hints columns by Dr. Bures series
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So, you got your vaccination. Now what can you do safely?

Like everything with this virus and pandemic, there is not yet a straightforward answer. And the answers can keep changing in this biologically fluid environment. We all wish we could get back to “normal,” whatever that is.

The CDC’s “Interim Public Health Recommendations for Fully Vaccinated People” on their website (under the vaccines heading) is a good starting point. Being vaccinated means you can begin to engage in low-risk activities without a mask. You have a shield or force field around you, but it isn’t impenetrable.

The summary of the CDC “allowed” list starts with:

    Visit inside a home or private setting with other fully vaccinated people without a mask or physical distancing. (A California doctor who is a frequent expert commentator on TV said that, when he and his wife first had another vaccinated couple over to their house, he felt like he was somehow breaking the law!)

    Visit inside a home or private setting without a mask or distancing, with one household of unvaccinated people who are not at risk for severe illness. (Right there is a gray area because who is a risk for severe illness can be arbitrary.)

    Refrain from quarantine or testing following exposure to someone infected if they are asymptomatic. (How can you know who is infected without symptoms?)

    Resume travel, and refrain from testing before or after travel or self-quarantine after travel. This refers to domestic travel primarily.

    Travel internationally without a pre-travel test, depending on destination, and no post travel quarantining in the U.S. Overseas trip have some rules, which are country dependent.

As of April 2 the CDC says to continue to take precautions in public, like wearing a well-fitting mask and distancing. Take the standard precautions if visiting a gathering of people from multiple households. The same goes for hanging around people at “high” risk for severe COVID illness (whomever that might be, again a gray topic). Avoid medium and large-sized in-person gatherings, especially unmasked in close quarters. Most medical people feel dining indoors and hanging around in bars are still high-risk activities (especially in states that allow “packing heat”/ guns openly).

In one article Leana Wen, M.D., emergency room physician and health policy scholar at George Washington University and former health commissioner of Baltimore, says, “While the vaccines’ efficacy is very good, nothing is 100% safe, and nothing is 100% risky. With that in mind we should choose the activities that are the most essential and of highest value to us.”

Gregory Poland, MD, director of Mayo Clinic’s Vaccine Research Group, said that “while the CDC guidance represents a step towards normalcy, there are key things it doesn’t address, such as the durability of the vaccine immunity, effect of vaccines on variants, specific guidelines for patients who are immuno-compromised (like cancer patients), and how a new ‘surge’ should influence how we make choices.” These are all constantly being studied as more data are generated. He said he is not ready to dine indoors, unless diners are six feet apart, and the room has good ventilation. (Isn’t it silly to say, “eat out” indoors?)

Dr. Anthony Fauci, now a household name, says going into crowded places like bars and restaurants where people aren’t wearing masks are still off limits for him. Paul Offit, M.D., another vaccine expert from Children’s Hospital of Philadelphia echoed Dr. Poland about six-foot distancing and ventilation. Dr. Wen says, “There’s no clear right or wrong here. It depends on the individual’s own risk tolerance, importance of the activity to them, and their own health.” The same is true for places of worship, whether a church, synagogue or mosque, or working out in a gymnasium.

But returning to normal won’t be easy, like flipping a switch. We have been isolated and imprisoned physically and mentally for a year. I am personally aware of two folks who are paralyzed by the thought of contact with almost anyone. The L.A. Times just published an article titled “For some of us, returning to pre-COVID life is turning out to be harder than we expected.” The Minneapolis 4/21/21 edition ran a Washington Post article, “A guide to easing back into normal.” It said, “After more than a year of staying 6 feet apart, the thought of transitioning to a new normal comes with mixed emotions for some people. People might feel that their social skills are rusty, or feel anxious about doing activities they carried out before.”

I heard it said the Scandinavians want to return to their usual ten feet distancing, because six feet is way too close … and, is normal really a one-word oxymoron?

Dr. Bures, a semi-retired dermatologist, since 1978 has worked Winona, La Crosse, Viroqua, and Red Wing. He also plays clarinet in the Winona Municipal Band and a couple dixieland groups. And he does enjoys a good pun.


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