“Shared expectations lead to predictability.”
158. The US Supreme Court rules on New York’s religious attendance restriction.
Q. Does the Supreme Court’s decision on COVID-19 religious restrictions affect us?
A. On November 25, the US Supreme Court ruled that New York governor Andrew M. Cuomo’s “strict virus limits – capping attendance at religious services at 10 people in ‘red zones’ where risk was highest, and at 25 in slightly less dangerous ‘orange zones’ – violated the First Amendment’s protection of the free exercise of religion.” The opinion resulted from a 5-4 vote with the deciding vote cast by the newest justice, Amy Coney Barrett. Justice Barrett was apparently the author of the majority opinion, although that opinion was unsigned. It took issue with what it said was Mr. Cuomo’s unduly harsh conditions that were opposed by several church organizations, and that he “singled out a particular religion for blame and retribution for an uptick in a society-wide pandemic.”
The opinion also said less restrictive measures would work. “Among other things, the maximum attendance at a religious service could be tied to the size of the church or synagogue. It is hard to believe that admitting more than 10 people to a 1,000-seat church or 400-seat synagogue would create a more serious health risk than the many other activities that the state allows.”
This column recently discussed the issue of risk assessment.[1] It was proposed that vigilance over specific situations (e.g. ventilation and air exchange, people tightly packed, eating without wearing masks, etc.) would be more effective than assigning attendance restrictions to different locations (e.g. schools, retail stores, religious facilities, etc.). This Supreme Court ruling identifies the weakness of our current system of reducing risk by adding restrictions on different locations where people congregate.
In summary, this ruling specifically applies to the specific restriction New York had made (and later withdrawn) regarding size of attendance at religious events. The guidance offered by the ruling would apply to government agencies to set minimum attendance restrictions evenly when based only on the of locations that events are held.
159. Vaccination updates
Q: What’s the latest in treatment for COVID-19?
A: The popular press has been reporting on the imminent approval and availability of several vaccines. This has led many to speculate that in just a few more weeks, we might be able to return to normal. That will not be the case, however. It will take many months before enough people can be vaccinated. Two vaccines are in the immediate pipeline for Emergency Use Authorization (EUA). Pfizer (in partnership with BioNTech) was the first to apply for approval. Moderna followed on Monday, November 30 with its application.
Both vaccines are made using the genetic code of the coronavirus contained in its messenger RNA (mRNA). Generating this mRNA and including it in the vaccine has never been used before to immunize humans, and many safety concerns had to be addressed. The mRNA in a vaccination causes the human body to generate antibodies to fight the virus as if there was an infection. This, while the mRNA cannot itself cause an infection as it cannot replicate into complete virus cells. The following steps will now be required:
- This past Tuesday, the CDC Advisory Committee on Immunization Practices met to vote on how scarce initial supplies the vaccines will be given out once it is approved. Both applicants require two shots, several weeks apart.
- The CDC Planning Guidance Allocating and Targeting Pandemic Vaccination Guide (2008) will be reviewed, modified and updated as needed for COVID-19.
- Five tiers are proposed. (note that while children and pregnant women are listed, they weren’t included in either of the Phase 3 COVID clinical trials.)
- Tier 1: 26 million people – health care workers, first responders, public health and pharmacy workers, pregnant women and toddlers.
- Tier 2 – 16 million people – military support personnel, mortuary services, community IT and utility services, and high-risk children.
- Tier 3 – 68 million people – other health care, military, infrastructure and government services personnel, and healthy children.
- Tier 4 – 79 million people – adults at high risk and over age 65
- Tier 5 – 132 million people – healthy adults 19-64 years of age,
- An independent review panel will meet on December 20 to review the data and clinical trial findings of at least Pfizer’s application and recommend to the FDA its recommendation for EUA approval.
- The FDA will act on this recommendation in the following few days. Approval will activate the initial distribution of the already manufactured doses of the vaccine to the states. Note: this will probably take place in the midst of the holiday season.
- Five tiers are proposed. (note that while children and pregnant women are listed, they weren’t included in either of the Phase 3 COVID clinical trials.)
- Length of quarantines
Q: News reports say the CDC is planning to reduce the period of quarantines. Has this happened yet?
A: Not yet. On November 24, many major news outlets reported that the CDC was considering this action, but it has not yet happened. As Reuters reported, “a top official” at the CDC said the agency “may soon shorten the length of the recommended self-quarantine period after potential exposure to the coronavirus.” Health authorities currently recommend a 14-day quarantine, but there is some evidence that the period could be shortened if testing is done during the quarantine. “Let me confirm that we are constantly reviewing the evidence and we are starting to have evidence that a shorter quarantine complemented by testing might be able to shorten that quarantine period from 14 days to a shorter (number of) days,” a top U.S. health official said.
No change in the 14-day recommendation has yet been made.
[1] FAQ #152
