Coronavirus Today: Are the unvaxxed still dangerous?

Good evening. I’m Karen Kaplan, and it’s Tuesday, Nov. 8. I hope you found time to go to the polls or mail in your ballot. Here’s the latest on what’s happening with the coronavirus in California and beyond.

It’s been almost two years since the first COVID-19 vaccines first became available, and nearly one-third of Americans still haven’t completed their initial series of shots. One in 5 Americans haven’t rolled up their sleeves even once. This despite the fact that the shots are free, widely available and thoroughly tested, with more than 640 million doses administered in the U.S. alone.

Most importantly, the vaccines have a proven track record of reducing the risk of dying of COVID-19. According to the most recent data from the Centers for Disease Control and Prevention, people who were unvaccinated were six times more likely to die of COVID-19 compared with people who were fully vaccinated, and they were eight times more likely to die of the disease than people who were vaccinated and boosted.

That alone sounds like a pretty good incentive to get poked with a few needles. But plenty of other inducements have been added to the mix — free doughnuts, Apple AirPods, college scholarships and a $1.5-million cash jackpot.

Yet the ranks of the unvaccinated have barely budged, even after Novavax introduced a COVID-19 shot that uses the same tried-and-true technology as vaccines for tetanus, shingles and the flu. Vaccine mandates that might have forced some holdouts to get immunized are tied up in court and not being enforced.

Is there any point in continuing to try to change people’s minds? Are the 100 million or so Americans who never made it to “fully vaccinated” status even a threat to those around them at this stage of the pandemic?

Perhaps not.

“Clearly, the unvaccinated are a threat to themselves,” Dr. Jeffrey Shaman, an infectious disease specialist at Columbia University, told my colleague Melissa Healy. “The danger to the rest of us is a more debatable issue.”

Anti-vaccination demonstrators rally against COVID-19 vaccine mandates in Santa Monica in August 2021.

(Ringo Chiu / AFP via Getty Images)

The biggest reason why is that, even though only 68.5% of Americans are fully vaccinated, almost all of us have at least a little immunity by now. An analysis of blood samples from all 50 states, the District of Columbia and Puerto Rico estimated that 58% of U.S. residents had been infected by the coronavirus as of February. That percentage is surely even higher now courtesy of the BA.5 surge from the late spring and summer.

The number of people who’ve never had a coronavirus infection is dwindling by the day. Some of those coronavirus virgins may be unvaccinated, but in all likelihood, they’re few and far between.

From an immunity standpoint, is an unvaccinated person who has recovered from COVID-19 any different from a fully vaccinated person who’s never had COVID-19 or a booster shot? That depends on many variables, but in many cases, the answer is no.

Just under half of fully vaccinated Americans have not received a booster shot, and studies have shown that being fully vaccinated but not boosted offers very little protection against the Delta and Omicron variants. So in addition to the 100 million who are unvaccinated, that’s another 100 million-plus Americans we could categorize as “undervaccinated.”

Even among the unvaccinated and undervaccinated, an individual’s immunity levels vary widely based on how long it’s been since their last shot, how much time has passed since their last infection, how strongly their immune system reacted when they encountered the virus (or a vaccine decoy), and how quickly their immunity waned.

For those who’ve had both vaccine and infection, the sequence of events matters too. Getting the vaccine and then a breakthrough infection can result in strong protection against severe illness and death, but the reverse isn’t necessarily true.

Americans’ immunity is “kind of a patchwork,” said Harvard University epidemiologist Stephen Kissler. “It’s changing over time, and it’s changing over space. So it’s hard to say where any given community is at any given time.”

That means the threat posed by an unvaccinated person depends on where they are. But wherever they are, they’ll probably be giving the coronavirus a hand. An unvaccinated person with COVID-19 expels more virus particles than a vaccinated one, and that’s bound to help keep the pandemic going.

By the numbers

California cases and deaths as of 2:21 p.m. Tuesday:

Track California’s coronavirus spread and vaccination efforts — including the latest numbers and how they break down — with our graphics.

Are we in for a ‘tripledemic’?

The pandemic was only a few months old when people who were tasked with contemplating worst-case scenarios came up with a doozy — a hypothetical conflagration of COVID-19 and seasonal influenza that was quickly dubbed a “twindemic.”

“This could be one of the worst seasons we’ve had from a public health perspective, with COVID and flu coming together,” Dr. Robert Redfield said in August 2020, when he was director of the CDC.

He was partly right. That was the winter the Alpha variant first reported in the United Kingdom pushed hospitals to the brink and beyond. It was the deadliest period of the pandemic — but at least the flu didn’t make it any worse.

Things were much the same the following winter. The Omicron variant pushed infections to unprecedented levels, and so many people got sick that the death toll climbed higher than at any time before or since Alpha. Thankfully, flu activity was historically low. The CDC estimates there were about 5,000 flu deaths last year — a fraction of the typical toll.

Now it looks like our luck has run out.

The flu season got off to an unusually early start and is already complicating our lives. (Just ask Harry Styles and his legions of disappointed fans.) There are ominous signs that the recent decline in COVID-19 cases is about to reverse, especially as the long-dominant BA.5 strain gives way to newer Omicron subvariants like BQ.1 and BQ.1.1.

On top of that is the very real threat of a third infectious disease: respiratory syncytial virus, or RSV. It’s already sending young patients to emergency rooms (including Amy Schumer’s son) and prompted Orange County to declare a health emergency.

Forget about a twindemic. How about a “tripledemic”?

A magnified image of respiratory syncytial virus, or RSV. Along with the coronavirus and influenza, it may spark a “tripledemic” this winter.

(CDC)

It’s probably not a coincidence that both flu and RSV activity are unusually high. Our efforts to avoid the coronavirus the last two winters — by spending more time at home, for instance, or wearing masks when going out — also curtailed our exposure to other viruses. That will make us more vulnerable if we encounter them now, Luke Money and Rong-Gong Lin II report.

Such encounters certainly seem more likely, considering that so many Americans are comfortable going about life like it’s 2019. Even California, which has issued some of the strictest anti-COVID measures in the country, will experience its first pandemic winter without an indoor mask mandate (unless state health officials have a sudden change of heart).

The increased flu activity should not be taken lightly. The most recent report from the state health department says San Diego, Orange, Riverside, San Bernardino and Imperial counties all have “high” flu activity. Even in Los Angeles, “the amount of influenza we’re seeing is increasing sharply,” said county health officer Dr. Muntu Davis. “This is the earliest start of the flu season we’ve experienced in the past five years.”

And nationwide, “we’re seeing the highest influenza hospitalization rates going back a decade,” said Dr. José Romero, director of the CDC’s National Center for Immunization and Respiratory Diseases. The federal agency estimates that 730 Americans have died since the 2022-23 flu season began last month. Ten of those deaths were in California.

The RSV situation is looking dire as well. Statewide, the positivity rate for that virus is above 15%, the highest it’s been for this time of year since 2016. In Orange County, things are so bad that the two primary children’s hospitals are “operating at or beyond their capacity” for patients with respiratory illness, said Dr. Regina Chinsio-Kwong, the county’s health officer.

(If you don’t know much about RSV but you’re starting to think you’d better bone up on the disease, check out this explainer from my colleague Karen Garcia. It explains how RSV spreads, what symptoms to look out for and how to treat it, among other things.)

Chinsio-Kwong urged that people ages 2 and older “mask back up” when they’re indoors, even though COVID-19 community levels are currently considered “low” throughout the entire state.

In a tripledemic situation, the coronavirus is only one of the relevant threats.

California’s vaccination progress

See the latest on California’s vaccination progress with our tracker.

In other news ...

Under normal circumstances, a governor who ordered nearly 40 million people to shelter in place for an indefinite period of time and in effect shut down the world’s fifth-largest economy probably wouldn’t be cruising toward reelection with a commanding 20-percentage-point lead over his opponent. But anything can happen during this crazy pandemic, and Gov. Gavin Newsom is on track to win a second term before the night is out.

Election day feels like an opportune time to look back on Newsom’s COVID-19 response to remind ourselves just how uncertain things were in March 2020, when the initial lockdown order came down. My colleague Taryn Luna called it “the most consequential government action in modern state history.”

At the time, California had 675 confirmed infections and 16 deaths. But experts in his administration forecast that if nothing were done, more than half of California residents could contract the coronavirus in a matter of months and the state’s healthcare system would be overrun. So Newsom became the first governor to issue a stay-at-home order. Before long, others followed.

“It really started the national awareness and conversation about the public health interventions and public policy interventions that were needed at that time to flatten the curve and start our pandemic response,” Dr. Thomas Tsai of the Harvard T.H. Chan School of Public Health said a year later.

The bold action flattened the curve and saved lives. But the longer the lockdown lasted, the more unpopular it became. Millions of workers lost their jobs, and millions of students struggled with distance learning. People became restless. They wanted to meet friends at restaurants and visit elderly relatives in long-term-care facilities.

The Blueprint for a Safer Economy (remember those four color-coded tiers?) loosened restrictions on counties that had less coronavirus risk. But it wasn’t enough to prevent a recall election in 2021 that forced Newsom to justify his embrace of mask and vaccine mandates. He did so with gusto, contrasting his actions with those of then-President Trump. The recall attempt fell short by more than 3 million votes. We’ll have to wait and see how that compares with his margin of victory tonight.

In the meantime, the Walt Disney Co. is taking a step toward a post-pandemic future. The company told about a dozen of its TV shows last week that it was dropping its COVID-19 vaccine mandate for cast and crew members, according to people in the know. Disney is one of the first major studios to take that step for a large number of shows, though proof of vaccination may still be required on some projects.

Vaccine mandates have been controversial in Hollywood. Unions and producers agreed last year that they could be implemented, but Fran Drescher, president of SAG-AFTRA, has been a vocal critic. She praised Disney’s move in a video posted on Twitter.

“When cards must be presented to identify whether you are included or excluded, we stand at a tipping point of an America I no longer recognize,” said the former “Nanny” star, who has said she is vaccinated. “I must applaud Disney for taking the position not to vaccine mandate their sets any longer.”

The company declined to comment on the matter. Other protocols for masking and testing on set will remain in place.

Elsewhere on the vaccine front, Pfizer released data showing that people 55 and older who got the company’s new Omicron-targeting booster produced four times as many antibodies as people who got a booster dose of the original vaccine. What’s more, their antibody levels were 13 times higher than they’d been before they got the bivalent booster — an indication of what people miss if they skip the shot.

The results are among the early findings from the company’s ongoing study of its new boosters, which rolled out in early September. It’s still too soon to know how those antibody levels translate into real-world immunity, or how long that protection will last.

In more sobering news, a report from the CDC’s National Center for Health Statistics says that alcohol-related deaths in the U.S. rose 26% in the first year of the pandemic. These include deaths from more than a dozen causes, including alcoholic liver disease, alcohol poisoning, and mental and behavioral disorders tied to drinking.

Alcohol-related deaths were on the rise before the pandemic, increasing by no more than 7% per year in the first two decades of the century. The sudden spike in 2020 was the highest in at least 40 years.

Deaths rose for both men and women that year, though they were 2½ times more common among men. Americans ages 55 to 64 had the highest alcohol-related mortality rate.

Our last stop is China, where frustration with the Communist Party’s “zero-COVID” policy continues to grow.

Last week, a man accused health workers of impeding his efforts to get his 3-year-old son to a hospital after a gas leak in his home. The family’s residential compound was subject to a quarantine, and one of the health workers told the father he would need to produce a negative coronavirus test before help could be offered. Unable to call an ambulance, the man wound up taking his son to a hospital in a taxi. Unfortunately, doctors there were unable to revive the boy.

The father’s account was shared on the social media site Sina Weibo, and the response was sympathetic. The quarantines are supposed to “protect life and health, not to confront those who need to be rescued with obstacles!” one commenter said.

Officials in Lanzhou said the boy’s death caused them “deep sorrow and regret.” They said the health workers who offered resistance instead of help would be “dealt with seriously.”

Public reaction to the toddler’s death helped fuel speculation that the national government would relax its COVID rules. Stock markets in China even rallied last week as investors grasped for any sign that life might be normalized. But at a news conference Saturday, health officials said they would stick with zero-COVID “unswervingly.” Now most analysts say big changes aren’t likely to come until next year.

Your questions answered

Today’s question comes from readers who want to know: Will I have to remove my mask during jury duty?

Probably not — and if you do, it won’t be for very long.

“There are no known instances in which a juror would be required to remove their mask while within a courthouse,” according to a spokesperson for the Superior Court of Los Angeles County. (If you live in the county, this is the court that’s most likely to send you a jury summons.)

The L.A. County Department of Public Health no longer requires masks to be worn inside all government buildings (that’s reserved for healthcare facilities and places such as nursing homes). But the Superior Court would still like to see them on jurors’ faces. Indeed, it “strongly” recommends that everyone inside its courthouses wear a snugly fitting medical mask or respirator.

The federal courthouses here are taking a more relaxed approach to masks since all counties in the Central District of California currently have low COVID-19 community levels.

“Individuals may wear masks but masks are not required unless the presiding judge requires masks in the courtroom,” said Sara Tse, chief deputy of operations for the central district. “Even if a judge does not require masks, that would not preclude a juror from wearing a mask because CDC guidance provides that people may choose to mask at any time.”

Don’t let that stance trick you into thinking the federal courts aren’t taking masks seriously. During the summer, when COVID-19 community levels in Los Angeles and Orange counties were high, masks were not recommended there; they were required.

Tse said “it is possible that there might be circumstances under which jurors might be asked to temporarily remove their masks.” For instance, a judge might make such a request during the jury selection process when asking a prospective juror to answer a question.

If you have a concern about your upcoming jury service at the federal court, you can contact the jury department at (213) 894-3644 from 2:30 to 4:30 p.m. Monday through Friday, or send an email to jury@cacd.uscourts.gov.

You can learn more about the Superior Court’s COVID-19 safety precautions on the court’s jury page.

We want to hear from you. Email us your coronavirus questions, and we’ll do our best to answer them. Wondering if your question’s already been answered? Check out our archive here.

The pandemic in pictures

(Robert Gauthier / Los Angeles Times)

Neither rain nor a pandemic kept Southern California voters from casting their ballots in today’s midterm elections, which will determine who will become the new mayor of Los Angeles and whether the balance of power in Congress will swing from Democrats to Republicans.

In the photo above, poll workers at Ted Watkins Memorial Park in South Los Angeles applauded Timoteo Antonio Ramirez after he exercised his right to vote. Ramirez responded with a thumbs-up.

Voters elsewhere in the city were in a less celebratory mood.

“Quite frankly, I’m terrified our world is coming to an end,” said Jaclyn Zeccola as she left her polling place at the Elysian Masonic Temple in Los Feliz with her 3-year-old son. “We’re very lucky we live in a liberal area. But I think I’m voting in the hopes that the tide will turn nationally to where we are — where we recognize the rights that are being taken away from so many people.”