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Masking, breakthrough infections and telehealth: Keck Medicine of USC experts on life after June 15

June 15 is a banner day in California. Most COVID-19 statewide restrictions will be eliminated, including physical distancing and, in many situations, mask mandates. How will life change and how will it stay the same? Keck Medicine of USC experts weigh in on what to expect next in the Golden State.

Don’t ditch your mask at the doctor’s office

“On June 15, people who are fully vaccinated will no longer be required to wear masks, with a few exceptions, however. One of those is in health care settings. According to guidelines from the state and the Centers for Disease Control, everyone, regardless of their vaccination status, must continue to wear a mask in a doctor’s office, clinic or hospital.

“At all Keck Medicine hospitals and outpatient offices, we are still requiring individuals to wear masks at all times and maintain six feet of physical distance from others. We will continue to screen for COVID-19 symptoms for all our patients and visitors upon entry. Patients in our hospitals will now be allowed two visitors at a time if both visitors are vaccinated or one visitor if that visitor is not vaccinated. Overnight visitors, however, must be vaccinated.

“While such measures may seem restrictive in the new relaxed environment, we, as health care providers, owe it to our patients, visitors and staff, some who are among the most vulnerable and prone to catching the coronavirus, to continue to take all precautions to protect them from COVID-19. We and other health care providers will continue to evaluate best safety policies throughout the summer as we receive further guidance from state and national public health officials.”

-- Stephanie Hall, MD, chief medical officer of Keck Hospital of USC and USC Norris Cancer Hospital

The possibility of breakthrough infections is low, even with the rise of the Delta variant

“Vaccines, while not foolproof, are highly effective in preventing COVID-19, hospitalization and death. We are seeing a few cases of people who are fully vaccinated testing positive for COVID-19, which is also called a breakthrough infection. However, the chances of that happening are extremely low, way below one percent. Breakthrough cases also tend to be moderate.

“The rare breakthrough infection can happen in two instances. It most commonly occurs when someone is exposed to a variant of the coronavirus, such as the Delta variant prevalent in India, and the vaccine fails to protect against the new strain of the virus. Additionally, a small segment of the population, which includes the elderly or immunosuppressed, is unable to mount a strong enough immune response to the virus, leaving them vulnerable to future infections.

“We are currently seeing a rise in the Delta and other variants in the United States, but data is showing that the vaccine, whether it’s the Pfizer, Moderna or Johnson & Johnson vaccine, protects against variants. We expect breakthrough infections to remain isolated cases even as the state opens up. For the vast majority of those vaccinated, they can rest assured that the vaccine will protect them.”

-- Edward Jones-Lopez, MD, MS, infectious disease expert with Keck Medicine of USC

Expect to keep visiting your doctor virtually

“The pandemic has seen a phenomenal rise in telehealth – patients accessing their doctors online. Keck Medicine telemedicine visits have increased roughly from 10 per day pre-COVID-19 to approximately 800 a day. To date, we have seen more than 75,000 unique patients, resulting in more than 223,000 telehealth visits. In addition, we have increased accessibility to services as a result of telehealth, including psychiatry, neurology, primary care and several medical specialties. 

“Telemedicine, however, has a much longer shelf life than the pandemic. According to one internal survey, patient satisfaction with the quality of service ranked in the 99th percentile. Telehealth offers patients flexibility and convenience in how and where they receive their health care, and could have a long-term impact on increasing access to care. This is a positive change for the industry for both patients and providers. While the number of telehealth appointments may decline as people return to in-person visits, remote access to physicians is here to stay. “

-- Smitha Ravipudi, MPH, CEO of USC Care and Ambulatory Care Services with Keck Medicine of USC