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Early last week, Jane Gennarelli put together an article for LNF Weekly that listed several of the fascinating DreamWeek events that were scheduled for neighborhood venues.

Within hours of posting the article, we saw the first cancellation. The new wave of COVID was hitting San Antonio.

The situation changes daily. As the virus mutates and changes, science rushes to catch up and offer the best advice it can for the new situation. It’s hard to keep up.

It’s also hard to be an event host. How do the people organizing events — like those for DreamWeek — make decisions about whether to move forward?

Cherise Rohr-Allegrini

Cherise Rohr-Allegrini is best known in the neighborhood for being president of the Lavaca Neighborhood Association (LNA). Professionally, she is head of the San Antonio AIDS Foundation (SAAF, pronounced ‘safe’).

Those two positions mean she’s in charge of two big events that were planned for this month: The LNA annual meeting and potluck dinner, and a DreamWeek fundraiser for SAAF.

But at the same time, by education, Cherise is an expert in public health and epidemiology. In other words, she understands how this COVID stuff works.

So we talked to her.

We asked Cherise to explain to us what is going on right now with the virus, to tell us how we can all protect ourselves, and to describe for us how she made decisions about whether to move forward with the LNA and SAAF events.

Understanding Vaccinations

A lot of people are confused right now about the efficacy of vaccines. We read about people who get infected with the new variant in spite of being vaccinated. People who even get hospitalized.

It helps to understand how vaccines work, Cherise told us.

Contrary to popular understanding, a vaccine does not give you immunity, she said. It gives you antibodies that fight an infection.

Whether or not you are vaccinated, if you’re exposed to the virus, your body will take some of it in. And as soon as it’s in your body, it will start to reproduce. That will happen either way — whether you’re vaccinated or not.

If you have not been vaccinated, your body will detect the infection and begin working to create antibodies to fight it. This takes a while. Meanwhile, while your body is figuring things out, the original viruses are reproducing. And reproducing.

And reproducing again.

Eventually your body will make sufficient antibodies to mount a defense, but by that time, you’ll have a heavy infection, and you’ll be sick. The potential is there to become very, very sick before your antibodies can be effective.

If you’ve been vaccinated, on the other hand, your body already carries the antibodies and knows how to make more of them. So as soon as the virus gets into your body, it’s going to be attacked. The effectiveness of that attack depends on a lot of things:

  1. How different is this version of the virus from the version your vaccine was designed to fight?

  2. How big a ‘load’ of the virus did your body take in when you were exposed?

  3. Do you have any other health conditions that may affect your body’s ability to fight this battle?

  4. How long ago were you vaccinated or ‘boosted’ (your body’s ability to produce the right antibodies will wane over time — that’s the case with pretty much any vaccine)?

All of these factors are additive. It’s true that the current vaccines are a little less effective against the Omicron variant than against earlier forms of the virus, but, this version is also a bit less deadly than earlier forms. If you’re in good health, vaccinated, and boosted, you may see only minor symptoms.

The important thing to understand is that the vaccine doesn’t deliver ‘immunity’ — it doesn’t prevent infection. Instead, what it does is fight that infection. In the best case, it kills the virus before you get very sick at all. At a minimum, it can keep you out of the hospital and off the ventilator. More than ninety percent of the people ending up on ventilators today have not been vaccinated.

Understanding who gets sick

With that basic understanding about how the vaccine works, let’s talk about who is getting sick.

First of all, most of those getting seriously ill are those who haven’t been vaccinated.

“Almost all of the people on ventilators and dying are unvaccinated,” Cherise says.

However, hospitalization statistics show that vaccinated people are also being hospitalized. Does that mean the vaccine didn’t work?

No, Cherise says. And she’s not just saying that those people are less sick than they would have been without the vaccine.

What the hospitalization numbers don’t show is the difference between being hospitalized due to COVID and being hospitalized with COVID.

The current variation of the virus is so contagious that it’s infecting a greater proportion of the population than any prior variant, even if not everyone shows symptoms. So if a vaccinated person goes into the hospital for something else — maybe a heart attack — routine testing may show that the patient has a COVID infection. From the hospital’s perspective, it doesn’t matter whether or not the patient is symptomatic. The hospital must take precautions and isolate that patient in just the same way as if he had been hospitalized for COVID. It’s good news for the patient that he’s vaccinated and not feeling the effects of COVID, but it makes little difference to the hospital.

And, of course, there are people who have other significant health issues. Even if the vaccine gives them some protection, any level of infection, on top of their existing problems, can be serious.

"People with other issues — auto-immune diseases, heart disease, diabetes, or obesity, 

for example — are more likely to end up in the hospital," Cherise says. “And that's why it's really important that they get vaccinated and get boosted. They're less likely to die or get very, very ill, but they might still end up in hospital.”

Evaluating risk

So here’s what we’re dealing with: a highly contagious new form of the virus; vaccines that work against it (although not quite as well as they work against the original virus); and a population that is only partially vaccinated and that therefore provides fertile ground for spreading the virus.

On a personal level, Cherise says she exercises caution, but she hasn’t isolated herself.

“I've certainly gathered with people indoors and outdoors, but I've been with people I know. I know they're all vaccinated, and I know what level of precautions they’re taking. It’s still not perfect. There’s still a chance of getting it, but it’s a lower risk because I’ve evaluated the circumstances.”

On the other hand, she’s less comfortable in public spaces.

“I’m hesitant to go into a crowded place with a bunch of strangers. I don’t know how many people are being cautious, and it’s harder to stay away from people in a crowded space. The risk is much higher.”

All of this figures into her decisions as an event host.

First of all, Cherise points out how difficult it is for a hosting organization to cancel an event.

“It’s a really big deal,” she says. “We’ve had almost two years now where organizations aren’t having their fundraisers, and fundraisers are how we survive.”

In the case of her two organizations — the Lavaca Neighborhood Association and SAAF — the situation isn’t as dire as it might be for some others. The neighborhood association has a small budget, and SAAF gets a higher proportion of its funding through grants than do many non- profits.

Cherise says she feels a special obligation as a leader of an organization, SAAF, that represents immunocompromised people. She feels that she can’t, in one breath, be telling people to reduce risk, and in the next be encouraging them to attend a public event.

She says that a key question in making the decision is this: Does this event have to be held now. Speaking of SAAF’s DreamWeek event, she says “We were very excited to have it, and I think the conversation we were going to have is extremely important. I also think it was nice to do it as part of DreamWeek, because DreamWeek is such a neat thing. But I’d rather postpone it than have it right now.”

So, looking at the specifics of her two events, Cherise felt the right decision was to postpone.

Jim Feuerstein is co-editor of LNF Weekly; he also designs and manages the website.

The vaccine doesn’t deliver ‘immunity’ — it doesn’t prevent infection. Instead, what it does is fight that infection.

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