“One of the biggest myths in medicine is the idea that all we need are more medical breakthroughs and then all our problems will be solved.”

-Dr. Quyen Nguyen, Pioneer in Fluorescence-Guided Surgery

Most recent estimates from Great Britain are that the SARS-CoV2 VOC 202012/1, also known as COVID-19 variant (B.1.1.7) is 50% more infectious than the previously dominant COVID strain. DNA sequencing of samples of SARS-CoV2 has been at very low rates in the United States, so we don’t know how quickly this strain is spreading. On Wednesday, San Diego County announced that they had detected 34 cases in the previous few days.

Fortunately, this strain is no more deadly or likely to cause serious illness than other COVID strains. It appears to be more infectious due to a higher number of particles being shed in the early pre-symptomatic or asymptomatic phase.

Unfortunately, a higher rate of infectiousness means that we will need higher rates of vaccination to achieve herd immunity and stop the spread of COVID. Some estimate that a vaccination rate of 90% will be needed to achieve herd immunity to this new strain, instead of the 70% we were counting on since March 2020. In addition, the current distance and time standards (6 feet and 15 minutes) that define high risk exposures may need to be changed as this more infectious strain spreads.

Even when we get past the current major logistical challenges involved in vaccine prioritization and distribution, given high rates of vaccine hesitancy, we have a major public health challenge ahead, which will require consistent strong communication from you, your clinicians and your staff.

By all accounts, much of 2021 is shaping up to look like 2020, from a COVID perspective.

The January 6 edition of the New England Journal of Medicine included a comprehensive overview of the many strategies that can be used to increase vaccination rates. Here is their list of recommendations for primary care clinicians:

1. Prepare a list of common vaccine questions
2. Investigate specific concerns of your various segments of patients
3. Develop a list of effective responses
4. Practice and train staff for responses
5. Add incentives (free sports exams, prizes).
6. Develop prompts to persuade vaccine-hesitant patients and offer compromises.
7. Make vaccination status observable in your community

In addition, they describe how to vary the message, depending on the level of vaccine hesitancy.