Paul Pettit

Press release:

Paul Pettit, MSL, CPH, Health Director of the Genesee and Orleans County Health Departments in New York, has been newly elected to the National Association of County and City Health Officials’ Board of Directors for a three-year term as a Director for Region 2, representing local health departments in NJ, NY, PR, and the USVI. NACCHO is the voice of the country’s nearly 3,000 local health departments. Mr. Pettit’s term began on July 1, 2022.      

“Being elected to serve on the NACCHO board is a very humbling and exciting opportunity. I’ve had the privilege to serve as a local public health director for over 14 years in the communities where I live,” said Paul Pettit. “Local public health is where we see the true impact of our work and have the direct interaction with our residents.  Serving on the board will allow me to represent my colleagues in Region 2 and work collaboratively with my fellow board members and the staff of NACCHO to continue the advocacy work for funding and services that will directly impact and improve the lives of those in our communities.” 

“I am very pleased that Paul Pettit’s colleagues around the country have voted to have him join our board,” said NACCHO Chief Executive Officer Lori Tremmel Freeman. “He is a past president of the New York State Association of County Health Officials and is especially active in public health policy and advocacy. We greatly appreciate the experience and insight he will bring to our organization’s leadership.”

About Mr. Pettit
Mr. Pettit has a bachelor’s degree from the University of Rochester in Environmental Health, a Master of Science degree in Strategic Leadership from Roberts Wesleyan College and a certificate in Public Health from the University at Albany. 

Mr. Pettit has worked in public health for over 23 years, starting as an environmental health technician and advancing to the public health director role for Orleans County in January 2008. In 2012, he also became the public health director for Genesee County through a collaborative cross-jurisdictional sharing (CJS) arrangement between the two counties. This unique CJS partnership was supported and developed with assistance from the Center for Sharing Public Health Services. 

In addition to serving on many local, regional and state Board of Directors, Mr. Pettit is a Past President of the New York State Association of County Health Officials (NYSACHO), he was recently appointed to the New York State Rural Health Council, and he is very active in statewide public health and policy advocacy. Mr. Pettit is also an adjunct professor, teaching various public health classes at both SUNY Brockport and the University at Buffalo.

The voices of local health officials pleading with the powers that be in Albany to boost support for county programming are finally being heard.

That’s what Paul Pettit, public health director for Genesee and Orleans counties, communicated to members of the Genesee County Legislature’s Human Services Committee today as he presented his department’s annual report.

“Ever since I’ve been in my position, we’ve been seeking an increase in Article 6 funding,” said Pettit, (pictured at right) speaking about the section of the Public Health Law that authorizes funding for core services delivered by local health departments. “But, if anything, that has deteriorated over the years as they’ve (state lawmakers) have made more things ineligible.”

Things seem to be changing for the better, Pettit said, as a result of his review of Gov. Kathy Hochul’s proposed 2022-23 state budget.

“As this is our main funding stream … we continue to advocate for (increased funding) on an annual basis,” he said. “Now, (for) the first time the (governor) actually proposed increases in Article 6 funding in her executive budget.

“Again, this is fairly unique. It's never been in the executive budget; we've always lobbied the legislative side for when they put their packages together and it never makes it to the end. So, we are very happy to see that it is in on the front end. And it's fairly significant.”

Pettit said that Article 6 funding for full service health departments (such as Genesee-Orleans) is set to increase from $650,000 to $750,000, and money for “fringe reimbursement” also will go up.

“Public health through Article 6 has never received fringe reimbursement on any of our costs,” he advised. “It's all been local or written off on different grants. We’ve always advocated for it, but it's never been realized. So, the biggest thing in here is that it included up to 50 percent fringe reimbursed on any eligible expenses.”

Fifty percent translates to about $230,000 more to the county health department – bringing the total of state funding through Article 6 to around $1.1 million. Pettit said that kind of money will enable his department to implement key programs, such as lead immunization.

While not official yet, Pettit said he has attended advocacy days in Albany and “everyone we've talked to seemed very supportive; there doesn't seem any appetite of reducing it or taking it out.”

In addition, county health is set to receive $22,000 in performance incentive funds this year, which also can be used for any Article 6-eligible reimbursement, Pettit said.

Pettit touched upon several other aspects of the Genesee and Orleans department, which has been a merged agency for nearly 10 years:

-- Lead poisoning intervention: With the Centers for Disease Controls dropping the permitted levels to 3.5 micrograms of lead per deciliter of blood (and NYS expected to adopt that measure), more people will be eligible for the county's lead program.

Pettit said the department is receiving three grants for its lead program: $1.3 million from the U.S. Department of Housing & Urban Development, $250,000 from the CDC and $100,000 annually for five years from the Healthy Neighborhood program that is targeted for the City of Batavia.

“That’s … where you can go in and work with landlords and homeowners ..., making sure their house is safe – smoke detectors, fire extinguishers and those different things,” he said.

-- Cross Jurisdictional Services: The shared services agreement with Orleans County has worked well, both financially and programmatically, Pettit said.

“I think our response to the pandemic and how we've been able to leverage resources and just share our media and our … information that we share with the public -- our public interface with a website -- those have all allowed us to be more efficient and streamlined with our responses,” he said.

Financially, he said the CJS agreement (shared staffing and programming) has saved $275,000 a year over the 9 ½ years – which equals $2.5 million over that time.

Pettit said he hopes that both counties will receive full accreditation from the Public Health Accreditation Board by early next year.

-- Community health assessment: Every four years, local health departments are required to conduct a full community health assessment. In Genesee’s case, it is being done in conjunction with Orleans and Wyoming counties.

“This is a very collaborative process where we work with all the health systems in the counties, and we bring in our different community partners and other departments … to put together our assessment of basically what's going on in our community, as far as access to health care, other types of services that are available,” Pettit said.

A spinoff of that is the Community Health Improvement Plan that utilizes a survey to obtain the public’s views on health care, transportation and other vital health-related subjects.

-- Septic replacement program: More than $110,000 has been given to Genesee County residents in eligible areas in reimbursement costs for upgrading their septic systems, and that program will continue this year.

“These are along definitely some of our higher tributaries and creeks and streams in the county where, again, we don't want to see incidental discharge occurring,” Pettit said.

-- Adult use of cannabis: The state is ramping up its marijuana legalization guidelines, meaning that the health department will be called upon to provide educational information and, possibly, compliance checks along the lines of tobacco enforcement.

Cases of people who have contracted the omicron variant of the coronavirus are trending in the right direction, giving Genesee-Orleans Public Health Director Paul Pettit cause for optimism that COVID-19 could become an endemic rather than a pandemic in the coming months.

“We’re seeing that decline … which is good,” Pettit said at this afternoon’s Genesee County Legislature Human Services Committee meeting at the Old County Courthouse. “The numbers now are the same that we saw in October and November.”

Pettit said that typically in the spring – when people get back outdoors and “change behaviors” – the numbers will stay low.

“Hopefully, we will see it go down back to a baseline level,” he said.

When asked by legislators if the pandemic could be over, Pettit said that he and his colleagues were talking about the endemic stage last summer, before the new strain came into being.

He said that he thinks that COVID will not go away totally, but eventually would be treated like the flu or other respiratory illnesses.

Pettit said the local health department is focusing on education and the utilization of “tools that we have now that we didn’t have last year,” primarily vaccine boosters, anti-viral medications and natural immunity as well as the continued practice of layered mitigation strategies such as staying home when sick, distancing and masking as indicated based on current public health guidance.  

“We’re providing an ongoing component of education; knowledge and information on how to protect yourself,” he said.

Responding to Legislator Gary Maha’s observation that servers and patrons at many restaurants are no longer wearing face coverings, Pettit said the mask mandate instituted by Gov. Kathy Hochul remains in place – at least for a couple more weeks due to a stay on a decision by a downstate judge who ruled that Hochul did not have such authority.

County Manager Matt Landers said that he is expecting another 2,500 in-home rapid antigen test kits by the end of the week and will be reaching out to towns and villages to see who wants to distribute them to their residents.

According to data on the county health department website, the number of new cases from Jan. 19-25 was 745, down from 1,848 from Jan. 5-11 and 1,104 from Jan. 12-18.

If you have been confused or concerned by the flurry of shifting, revised, questioned and debated pieces of information out there for dealing with COVID-19, one solution is pointing straight at you.

Do your research, talk to your own healthcare provider and self-report when diagnosed with the virus, says Paul Pettit, director of Genesee and Orleans County Health Departments. 

“Any time you have conflicting messages out there it does create confusion … who should they be listening to and why. We want people to be informed. It’s ok for people to question things, we want them to get the most factual information and make a decision based on that. Ultimately, everybody’s individual health care should be discussed with their doctor,” Pettit said during a livestream interview Monday with The Batavian.

Pettit suggests that people check out the Centers for Disease Control (CDC) and their own state and county health departments to make informed decisions. He’s not forcing any one answer on people, but asking that they acquire factual knowledge before making decisions about how to deal with COVID-19. 

Omicron, the latest — and apparently greatest variant in terms of infectious ability — may account for 85 to 90 percent of all positive cases in rural areas, Pettit said. There have been some 500 cases diagnosed locally just this past weekend alone, he said. Due to the quickly climbing numbers, the health department is changing the way it has handled contact tracing; it will be more of an individual responsibility for those 19 to 64 years of age, he said.

“It has to do with the extreme spread across the state. We just cannot keep up with the isolation and quarantine,” he said. “We’re trying to triage a response. We can’t get to all these contacts, we’re trying to use our resources the best we can.”

As of Monday, the system will depend on people who have tested positive for COVID-19 or have had close contact with someone who already tested positive, to self-report online. Go to www.GOHealthNY.org and choose the red COVID-19 Isolation & Quarantine Information button to be directed to the isolation and quarantine documents. For those who have tested positive for COVID-19, you will be contacted by NYS via email or text. Once you are notified of your positive results by the lab or NYS, immediately self-isolate and notify your close contacts of their potential exposure. For those that test positive in the 19-64 age group, follow the general directions that NYS provides for isolation and quarantine and contact your healthcare provider for medical advice.

For those in schools or congregate settings who are under the age of 18 and over the age of 64, contact tracing will continue as capacity allows, he said. 

Although the omicron variant is highly infectious and has caused breakthrough cases for a lot of vaccinated people, there is an upside, Pettit said. 
“The good news is that it’s not as severe,” he said. 

More cases and less severe does not mean ignoring a diagnosis. People should still heed the five-day isolation rule when their lab result is positive, he said. He has heard from many people that they have symptoms resembling a cold or mild flu, and are also known to the omicron variant: coughing, fatigue, a scratchy throat. He tells them all the same thing.

“The only way to verify (that it’s COVID-19) is to have a test,” he said. “Don’t go to work that day, don’t send your kids to school.”

Genesee County is just under 60 percent for those fully vaccinated, which is “pretty close to our counterparts in the rural region,” he said. The health department is fully stocked with vaccines and booster shots, and people just have to call and make the appointment. A much lower rate of Genesee County residents — 28 percent — have gotten their boosters, which have been shown to be “very effective” at preventing illness and slowing down the potential severity of the virus, he said. 

Interviewer Howard Owens, publisher of The Batavian, shared his own experience after receiving the single-dose Johnson and Johnson vaccine and, a six months afterward, the booster. He had direct exposure to someone who later that day was symptomatic and then diagnosed with COVID-19. Owens quarantined for five days and tested negative with no symptoms. He believes that’s a testament to the protection of the vaccines, he said. 

It’s that kind of personal responsibility that the health department is urging.

“We’re going with more of an honor system. We want people to be responsible, make those decisions and do their part to eliminate Covid within their communities,” Pettit said. “Our data is clearly showing that it prevents severity. With spread so high, we can all do our part. If out in public, put the mask on … more of the well-fitting masks. We’re encouraging people to go out and get their booster shots. Stay home, especially if you’re symptomatic. Hopefully, we’re going to start to see those numbers come down.”

To reiterate Pettit's press release issued last week, if you test positive for COVID-19:

• Isolate for 5 days, where day 0 is the day of symptom onset or (if asymptomatic) the day of collection of the first positive specimen.
• If asymptomatic at the end of 5 days or if symptoms are resolving, isolation ends and the individual should wear a well-fitting mask while around others for an additional 5 days.
• Individuals who are moderately-severely immunocompromised should continue to follow standard (i.e., not shortened) Isolation Guidance.
• Individuals who are unable to wear a well-fitting mask for 5 days after a 5-day isolation should also follow standard isolation guidance (i.e., 10 days, not shortened)
• Quarantine (for those who have had close contact with a person who tested positive for COVID-19)
• Quarantine as follows, where day 0 is the last date of exposure:
• If not fully vaccinated or fully vaccinated and eligible for a booster but not yet boosted, quarantine for 5 days and wear a well-fitting mask while around others for an additional 5 days.
• If fully vaccinated and boosted (with the booster at least 2 weeks before the first date of exposure) or not yet eligible for a booster, no quarantine is required but these individuals should wear a well-fitting mask while around others for 10 days after the last date of exposure.
• If possible, test at day 5 with either a nucleic acid amplification test (NAAT, e.g., PCR) or antigen test.
• If symptoms appear, quarantine and seek testing. In this situation, quarantine would end when the test is negative. If testing is not done, isolate according to the guidance above.
• Quarantine orders and releases are also included on the GOHealthNY.org website for you to complete and provide to your employer/school.

For COVID-19 data please visit the NYS site: https://coronavirus.health.ny.gov/covid-19-data-new-york.





 

With the percentage of Genesee and Orleans county residents who have received at least one dose of the COVID-19 vaccine significantly less than the New York State number, local healthcare and government officials are stepping up their efforts to reach those who, for one reason or another, are among the “vaccine hesitant.”

Speaking during a media briefing via Zoom this morning, Genesee/Orleans Public Health Director Paul Pettit reiterated what he has been saying for the past year: “That vaccines are the best protection against the coronavirus … and against severe illness and death.”

Statistics provided by Pettit reveal that 61.8 percent of Genesee County residents and 59.3 percent of Orleans County residents, when looking at the total population, have received at least one dose of the Moderna, Pfizer or Johnson & Johnson vaccines. (The first two are administered in two shots; J&J is one shot).

That pales in comparison to the state as a whole, with the percentage of the total population that has received at least one shot at 79.4 and the percentage of those 18 and older at 91.8.

When looking at the completed series, Genesee County’s number falls to 55.9 percent and Orleans is at 52 percent. In the age 5-11 category, Genesee is at 10.6 percent and Orleans at 9.5 percent.

For the eight-county Finger Lakes Region, the one-dose percentage is at 70.7 percent and the completed series percentage is at 63.1 percent, Pettit reported.

“That’s why we again are trying to get our vaccination rates up as high as we can,” he said. “COVID vaccines significantly reduce the likelihood of hospitalization and death.”

Pettit placed special emphasis on the vaccine booster shots that recently became available.

“We just need to go and get that booster shot now and make sure we're protecting ourselves as best as we can,” he said, adding that both Genesee and Orleans health departments continue to offer weekly COVID-19 vaccination clinics (Wednesdays in Genesee County and Thursdays in Orleans County).

Joining Pettit on the call were Dan Ireland, president of United Memorial Medical Center; Matt Landers, Genesee County manager; Marianne Clattenburg, Genesee County legislator, and Lynne Johnson, Orleans County Legislature chair.

Acknowledging the need to improve Genesee County’s vaccination numbers, Landers – as initially reported on The Batavian – mentioned the Finger Lakes Region’s push for a “targeted rural campaign” focused on hard to reach populations such as Native American, Amish and Mennonite, hard to reach zip codes and under vaccinated zip codes.

“We’re trying to find more creative ways to attack and go after targeted media advertising towards them,” he said, adding the plan is to use direct advertising, postcards and other mailings. “Their targets are not necessarily trying to change minds of people that are absolutely set, but it's really to educate, to go after vaccine hesitancy and to go after some of the harder to reach populations potentially …”

On the hospital side, Ireland said UMMC and Rochester Regional Health’s “number one priority” is to maintain full access to healthcare in the community, noting that UMMC is open for all types of elective surgeries at this time.

He also pointed out the importance of getting vaccinated, wearing masks where appropriate and getting tested, especially prior to social or family gatherings.

He said that his family did just that before Thanksgiving and, fortunately, no one tested positive.

“So, really it’s a small step, but it makes a big difference,” he said. “And it will help us on the hospital side. Because certainly as we continue to have a fair number of unvaccinated in the community. It makes a difference when they become positive as we're seeing a higher percentage of unvaccinated patients in our hospital versus the vaccinated COVID patients.”

Statistically, Ireland said that there are more than 200 patients who have tested positive for COVID in RRH hospitals, with 11 percent of those at UMMC. Sixty-two percent in the Intensive Care Unit are COVID positive, with 80 percent of those people unvaccinated.

“Put in non-statistical terms, the unvaccinated truly are showing signs of higher acuity in the hospital,” he said, noting that 100 percent of patients on ventilators are unvaccinated.

Ireland said UMMC continues to partner across the RRH system and with other hospitals in the region to “work on any load balancing options that we can provide; in order to make sure that all patients in our region get care, regardless of where you seek that care.”

He added that 95 percent of RRH outpatient clinics are open, although he did say that wait times may be longer than normal.

Looking at specific areas of concern:

COMMUNITY SPREAD

Pettit said the number of positive cases have remained steady recently but are still too high, with 250 active cases in Genesee County and 334 active cases in Orleans County. Forty-eight of those are in the hospital (35 in Genesee and 13 in Orleans).

Over the past seven days, the positivity rate in Genesee and Orleans is at 12.5 percent and 12.2 percent, respectively.

As far as breakthrough cases are concerned (positive tests of those who are fully vaccinated), Pettit said the percentages are 30 percent in Genesee and 29 percent in Orleans – with these types of cases increasing over the past two months.

He urged those who have been vaccinated with Moderna or Pfizer at least six months ago and those who had the J&J vaccine at least two months ago to get a booster shot.

Pettit pointed out that most of the spread is from social gatherings "where there's prolonged contact indoors" and from those who think they just have a cold (due to it being cold and flu season).

"So, again, one of our messages we've said from day one is if you're symptomatic, stay home, don't go to work, don't go to school, stay home while you have the symptoms, get that test and verify," he said. "Regardless of COVID, we don't want to be spreading germs around."

COVID-19 TESTING

Pettit said that limited testing is being offered at both health departments by appointment, and that local pharmacies and urgent care centers also are providing testing.

He advised that home testing kits will become more prevalent as time goes on, and that GO Health is getting closer to accepting results of home testing.

“Ultimately, they are very accurate, if done properly. And a positive is a positive on those test kits. So, again, we'd encourage you to get those and use them if available,” he said.

Homebound individuals are asked to call their health departments (Genesee: 585-344-2550, ext. 5555; Orleans, 585-589-3278) to get on a list for a home visit.

OMICRON VARIANT

Pettit said the Omicron variant has not bee identified in Genesee or Orleans, but “that does not mean that it is not here, it just means that it has not been detected (yet).”

He said the new variant likely spreads more easily than the original COVID virus, very similar to how Delta (variant) spread a lot easier.

“The early indication is that the severity does not seem to be too bad again, but it is early and they're continuing to track that,” he offered.

CONTACT TRACING

For those in isolation or quarantine, responding to health department or New York State contract tracers is essential, Pettit said.

“I can't reiterate this enough,” he said. “We need folks to answer the phone; we need folks to engage with us during the process. Because if we don't, if we're not able to do the investigation, and we're not able to talk to you, to release you, we can't send the (release) letter.”

GUIDANCE IN SCHOOLS

Pettit said the collective goal is to keep students in school, and “this year, I think we've done a fairly good job of that.”

Per state mandate, masking continues to be required indoors at schools.

He said his department is talking with superintendents about new strategies, specifically Test to Stay and Test Out of Quarantine.

“There is a checklist and the schools have those and we are discussing how we can implement but ultimately they have to have a written plan around how they would implement these different approaches within their school system,” he said. “And one of the biggest barriers is that it has to be done equitable. We can't have this just for some kids and not for others …”

Eighteen months and still no signs of slowing down.

Public Health Director Paul Pettit and his staff at the Genesee & Orleans Health Departments have worked tirelessly since February of 2020 to educate, test and vaccinate residents dealing with a COVID-19 pandemic that seemingly just won’t go away.

The Batavian spent about 15 minutes on the phone with Pettit this afternoon, picking his brain about the increase in cases, the Delta variant, community spread categories, face coverings, booster shots and natural immunity.

Q. With the number of cases increasing, do you plan to release information on a daily basis as was the case last year?

A. We’re discussing that; it is readily available as anybody can go to our website (www.gohealthny.org) and/or the dashboards to get all of the current data. We probably will be moving back to reporting at least once a week on the numbers.

We’re in the process of discussing that component of it. We have seen our numbers definitely pick up over the last eight to 10 days compared to where we were in July.

Q. When you talk about numbers, is it the same virus or is it the Delta variant? It seems like there is confusion over what people are coming down with now.

A. The reality is that every time you have a COVID test, there’s not a serotype done to see what strain of the virus it is. So, a lot of times we don’t have that level of detail. The state’s Wadsworth Lab in Albany does do that level of detail – they’ve been doing surveillance sampling of random samples from around the state and they’re also in the process of opening additional labs that will be able to do that. I believe the University of Rochester and one of the labs in Erie County are going to be able to do that.

It’s pretty much understood to be the Delta variant the way the cases are picking up. Samples that have been identified in the region are primarily Delta. It is presumed that it is the Delta strain by the way the numbers are picking up so quickly, but we don’t have the ability locally to analyze every sample.

Q. Do you think there will be some guidance out of Albany – either from the new governor coming in (Kathy Hochul) or from the New York State Department of Health?

A. We haven’t heard any updates on that beyond what the lieutenant governor commented on yesterday that she plans to meet with all of the cabinet members … ultimately it will be her decision on what direction they want to go with that.

(Since this interview, Hochul has announced that she wants students and staff to wear masks when school opens up next month. “My view is that people — children and everyone in the school environment — will be wearing masks,” Hochul said).

We’re going to continue locally to deal with cases through isolations and quarantines, and working in the community to keep the numbers down as best as we can.

Q. It seems like the categories that indicate the level of cases have changed. What are the actual categories now and how are they defined?

A. There’s low, moderate, substantial and high; four buckets basically that the CDC is using to essentially categorize community transmission of COVID. So, moderate is greater than 10 cases per 100,000 per week; substantial is greater or equal to 50 cases per 100,000 per week, and then high is greater than or equal to 100 cases per 100,000 per week.

From 10 to 50 is a pretty big jump, right, but then when you get to substantial, you have to double your weekly count of cases to get to high.

Q. Is it true that Genesee County currently is in the moderate range?

A. We have been in the moderate category but the numbers that we have seen over the past four to five days, averaging from seven to 10 cases per day, if those numbers continue over the seven-day period – which the CDC uses as their window – we’re definitely on the edge of potentially going to substantial.

Per the CDC guidelines, once an area is designated or classified by their chart as substantial spread, that’s when they would start to recommend that people consider masking indoors – vaccinated or unvaccinated – especially if you have certain underlying health conditions or are at high risk, so to speak.

It’s not a mandate – there are no local mandates – and, obviously, the state has not put out any mandates because the executive order/state of emergency has lapsed, but it is recommended due to the amount of spread that is occurring.

Q. How effective do you feel are the masks that people are wearing, especially considering the different types of materials the masks are made of?

A. We’ve talked about the mask question all along, from day one … we’ve heard that you should mask and that you shouldn’t mask from the federal side.

What we do know is that masks are effective in certain settings in reducing risk. People are not wearing, in most cases, N-95 – those are the gold standard masks in stopping viruses and bacteria, etc. But when it comes to what people are wearing in the community, you see many different types of masks.

Your medical surgical masks are probably the most effective outside of the N-95 because they are used in clinical, healthcare settings, and then you have cloth and buffs and all different kinds of barriers that people have created to try to meet the face covering requirements.

It’s a spectrum of how much protection they will provide depending upon the type of material of the masks. I will say that any type of barrier is going to provide some type of protection; depending on which one, more or less, and depending upon how it is worn. There are a lot of variables.

Is it foolproof, that if you wear a mask, you’re not going to get COVID? No. In the general setting, masks are a tool to try to reduce risk of getting the disease. The recommendation is that if you put it on, you’re protecting yourself and potentially others if you have COVID, and providing a layer of risk protection.

Q. Do you agree with Dr. Fauci that everyone will need a booster shot down the road?

A. The boosters are being studied on the federal level by the FDA (Food & Drug Administration), looking at the effectiveness of the current vaccines that we have out there. What we do know is that the vaccines are safe and effective; they’ve done a very good job of preventing illness and preventing disease in those who are fully vaccinated.

We have seen that there are some breakthrough cases occurring and the efficacy of all three vaccines is a little bit lower with the Delta variant than what it was with the original variant of COVID that we were dealing with since the beginning of the pandemic.

With that being said, they’re still very effective. Even with any of the breakthrough cases we are seeing, these folks have had very mild symptoms or asymptomatic, and none of them have gone to the hospital and none of them, obviously, have passed. We know the vaccines are working; they’re keeping people from getting sick. They may get COVID but they’re not getting sick.

As new variants come along, we need to give folks or encourage them to get a booster shot to match up better with the new strain and boost the antibodies and protection they may have. I think there will be a need for a booster shot at some point.

Q. What about people who have had COVID? Don’t they already have natural immunity, and do they need to be vaccinated?

A. Obviously, when you have a disease you develop natural antibodies, so there is some level of protection. But, again, what the data is showing is that those who have had COVID, their antibodies are not as high as they are when you get the vaccine. The recommendation still is that you get vaccinated even if you have had COVID.

The vaccine efficacy gives you better protection from re-infection than just having natural antibodies.