How New Orleans health leaders are reacting to city's lifted vaccine mandate
Three weeks after Mardi Gras, Dr. Jennifer Avegno looked at the COVID-19 data for New Orleans and made a call: it was time to drop the city’s vaccine mandate for businesses.
Hospitalizations, cases and deaths from COVID-19 have all plummeted in the last two months.
“All of our numbers are quite low, and have been three weeks after, you know, some of the most risky events that we could have had,” Avegno said.
She added that the vaccine mandate was critical during earlier surges, but the data changed, and so should restrictions.
Of course, with the caveat: COVID restrictions could return, if the virus surges.
After a dramatic surge in cases caused by the omicron variant, COVID-19 transmission is down. Cases have dropped precipitously from their peak in early January. The city reported less than 30 cases a day over the course of last week — a rate similar to the low transmission in October of last year.
Hospitalizations in the city and across the state have likewise fallen. Only 129 people are hospitalized with COVID-19 across Louisiana, down from the most recent peak of 2,367 in mid-January.
As COVID waned, the city had been getting pushback from some business owners who felt the mandate hurt them and had an economic cost, Avegno said.
Public health measures are “always a trade-off,” Avegno said. And this time, the potential hit to the economy outweighed the potential benefit to public health.
Dr. Jeff Elder, the medical director of emergency management at LCMC, agreed the time is right.
“I think it’s a reasonable thing to do,” he said. “We’re in a good place.”
Elder cited new guidance from the Centers for Disease Control and Prevention that layers COVID-19 case counts with hospitalization data to determine the community risk now. New Orleans’ risk — along with every parish in Louisiana — is currently low.
But Dr. Mark Kline, the physician-in-chief for New Orleans Children’s Hospital, called it a risky approach.
“I understand why it's being dropped. I think that everybody wants to put this behind us, hopes that it's behind us,” Kline said. “I'm concerned that it's not. And I'm certainly concerned that we're going to be back in the same boat again before long.”
Kline worried that dropping public health measures will only make the city more vulnerable to the next possible wave, one that could be fueled by variants in other countries, such as the new BA.2 omicron subvariant causing cases to rise in the U.K.
New Orleans and Louisiana remain vulnerable to another surge for one key reason: “We don't have a sufficient number of people with immunity,” Kline said.
New Orleans has higher vaccination rates than most in Louisiana. Roughly 77% of adults are fully vaccinated in the city. But that number drops to just 49% for children aged 5 to 17. Across Louisiana, only 38% of kids ages 12-17 in Louisiana are fully vaccinated — putting it among the bottom-10 states in the nation.
And new vaccinations are happening “at a snail’s pace,” Kline added.
Then there are the groups that remain vulnerable: children under the age of 5, who aren’t yet eligible for a vaccine, and people with compromised immune systems who face greater risks from COVID-19. Those people need to be “very, very cautious,” he said. Kline advised parents of kids too young to be vaccinated to avoid crowded indoor spaces, especially public spaces where you don’t know the vaccine status of those around you.
Avegno said the city’s wastewater testing for COVID-19 will be key to helping health officials spot a potential next surge in time to bring back public health measures.
“That is the canary in the coal mine. That generally gives us a sense of trends happening, probably at least a week before it starts to show up in the testing data,” she said.
And she said the burden is shifting onto those with less protection: kids under five, and people at higher risk of COVID-19, part of the “unfortunate trade offs” of public health decision making.
“Whether that's fair or not, I don't know,” she said.
Elder said public health officials are going to have to continue to push vaccinations.
“There are reasons why we eradicated measles, there's a reason why we eradicated polio in our communities, and we did that by vaccination,” he said. “And we have to remind people that, you know, we do this yearly with the flu. And we do that to protect the immunocompromised, we do it to not overwhelm the health system. We're going to be doing the same thing for COVID in the near future.”