Now that COVID vaccine boosters are here, will life go back to normal? What to expect
Caridad Galastica was terrified of needles.
In late May and early June, the 38-year-old mom of four, with the encouraging support of Coral Gables psychiatrist Dr. Arthur Bregman, conquered her fear and rolled up her sleeve. Twice. She is now considered fully vaccinated against COVID-19.
“I got the Pfizer. I was freaking out. I’m not even going to pretend like I wasn’t,” she said, laughing. “I was glad, overall, that I did it and I feel a lot more confident that even if I were to get sick, I’d feel safe.”
Galastica’s 17-year-old son, Angel, was so overjoyed he told his mom, “I’m just happy that I know I’m not going to lose you to this disease.”
Now, third shots of Pfizer and Moderna are available for immunocompromised people. And a Pfizer booster is available for people 65 and older and other high risk groups — with discussions on a possible booster for the Moderna and Johnson & Johnson vaccines. So Galastica wonders if she’ll eventually need another shot, too.
For Galastica, it’s a daunting thought. But she’s made a decision. If a booster is needed, she’ll face her fears and get another jab to stay safe during the global pandemic. After all, she wants life to go back to normal and for her family to be safe.
Vaccinated people are at less risk of falling seriously ill, being hospitalized or dying from COVID. There are still breakthrough cases — vaccinated people who test positive — but they generally have mild or no symptoms. The majority don’t end up hospitalized or dead, though that can still happen, according to the Centers for Disease Control and Prevention.
Vaccinations and public health measures have helped life get closer to normal, with many returning to in-person work, traveling and having fun at concerts and sports games again.
Yet, in other ways, life has remained the same as over the past 18 months:
▪ While pandemic safety measures have relaxed, CDC guidelines still recommend everyone wear a mask indoors, regardless of their vaccination status, because of concerns over the delta variant.
▪ South Florida hospitals had to restrict visitations again after seeing a surge of COVID patients, this time said to be younger and unvaccinated.
▪ Some COVID safety protocols are still in place across businesses, schools, concert venues, airlines and cruises. And vaccine mandate debates are brewing in the country.
So, what will life be like this fall in Florida during the COVID pandemic?
Here’s what to know:
(If you want to read about a specific topic, click from the options below. If not, just scroll to read the full article)
Boosters and monoclonal antibody treatments
COVID-19 boosters for the Pfizer vaccine are here, but not for everyone.
The U.S. Food & Drug Administration recently authorized the Pfizer booster for people 65 and older and adults 18 and older who have an underlying health condition that makes them high risk for severe COVID. People 18 and older who work or live in a “high-risk setting” are also eligible for the shot. This includes healthcare workers, people who live in homeless shelters and essential workers such as teachers and grocery store workers.
People can get the shot at least six months after being fully vaccinated with Pfizer.
The booster eligibility is a scaled-back version of what the Biden administration wanted. The FDA declined to authorize the booster for all adults, saying that there wasn’t enough data to show it was needed. The agency also noted that current shots remain effective in reducing the risk of severe illness and hospitalization.
Unlike in the early days of the COVID vaccine rollout, when shots were scarce and were only available through hospitals and a few state-run sites, Florida’s booster rollout should be smoother.
Boosters, just like the third shots of Pfizer and Moderna that are available for immunocompromised people, are available through retail pharmacies including Publix, Winn-Dixie, CVS, Walgreens and Walmart. Miami-Dade and Broward-run sites are also offering boosters.
Florida has also begun promoting state-run monoclonal antibody treatment centers for people 12 and older who are sick with COVID-19 and are considered to be high risk for severe disease or death. Also eligible: high-risk people 12 and older who were exposed to COVID and are either not fully vaccinated or have an immunocompromised condition that has lowered their immune response to the vaccine.
The treatment, which is under emergency use authorization and is given through an IV infusion or four injections, is designed to give the immune system an extra boost to help combat the disease, enough to hopefully keep people out of the hospital. It is not an alternative to vaccination.
COVID-19 vaccines are still the most effective way to reduce the risk of severe illness and death. Think of it this way: Monoclonal antibodies help people ill with COVID-19. Vaccines train the immune system to fight off a future infection.
Florida has opened dozens of state-run monoclonal antibody sites, including in Miami-Dade, Broward and Palm Beach counties. The three South Florida sites offer the treatment for free to people who meet the eligibility criteria.
Travel
Cruising has returned and travelers are bustling through the Miami and Fort Lauderdale airports again. But not everything is how it used to be.
There’s still a federal mandate requiring masks to be worn inside airports and on flights. International travel is also confusing.
Every country has its own COVID rules for entering, including testing and quarantine procedures. Many countries require a negative COVID test to get in, and that’s likely to be the case into next year. Some will accept “vaccine passports” as an alternative to testing or quarantine.
People who plan to take a cruise should also expect to see COVID rules on masking, testing and vaccination. And yes, cruises in Florida can require passengers to show proof of vaccination, at least for now.
The option comes after a federal judge in Miami temporarily blocked a state law banning cruise lines from asking passengers for “vaccine passports.”
Concerts
Both Live Nation and AEG, two of the major concert producing firms in the country, are requiring a negative test result or proof of vaccination for customers hoping to attend shows in Florida. Home testing results will not be accepted.
The policies from the concert promoters don’t conflict with Florida’s vaccine passport ban because they give concertgoers an option to show a negative test instead of proof of vaccination.
On Monday, the Orlando Sentinel reported that Florida’s Department of Health is investigating dozens of businesses for “potential violation of the vaccine passport law.” The list includes Live Nation and some South Florida venues that host concerts, including the Broward Center for the Performing Arts and The Parker in Fort Lauderdale and West Palm Beach’s Kravis Center and iTHINK Financial Amphitheater.
Broward Center President and CEO Kelley Shanley said he believed the venue was in compliance because it gives patrons the option of showing a negative test result or vaccination status.
Christina Pushaw, spokeswoman for Gov. Ron DeSantis, told the Orlando Sentinel, via email, “an investigation is not a finding of a violation.”
What do concert rules mean for you?
It means that if you’re planning to attend a concert, such as the Jonas Brothers, the James Taylor and Jackson Browne co-headlining tour, and Harry Styles, you need to be vaccinated or be ready to show proof of a negative test before the show.
Can a concert deny you entry for failing to produce negative test results?
Pushaw told the Tampa Bay Times the answer is yes.
Theater
Most major theaters are adopting similar policies — masks on for everyone ages 2 and up, and proof of a negative COVID test or proof of full vaccination.
In September, the Broward Center for the Performing Arts in Fort Lauderdale and Tampa’s Straz Center announced new guest policies.
At the Fort Lauderdale venue, which hosts touring Broadway series shows, concerts and other live events, expect mandatory face coverings for performances and required guest documentation showing a recent negative COVID-19 test. These rules will be required to attend ticketed performances at the Broward Center and The Parker, which it manages in Fort Lauderdale, said spokeswoman Savannah Whaley.
As an alternative to a negative test result, theatergoers can also provide documentation that shows they are fully vaccinated. That can be the original vaccine card or a digital copy, such as a photo on your phone or scan in an app.
“Broward Center received legal advice that this policy is acceptable under Florida law and is in line with industry standards,” Whaley said in an email to the Miami Herald.
The new rules will be in place in time for the Broward Center’s first big touring Broadway show of the season, “Come From Away,” which runs Nov. 3-14.
The Aventura Arts & Cultural Center, which is managed by the Broward Center, also adopted the parent organization’s safety protocols. So did the Kravis Center for the Performing Arts in West Palm Beach and the Dr. Phillips Center in Orlando.
But on Monday, the Orlando Sentinel reported that Florida’s Department of Health is investigating dozens of businesses for “potential violation of the vaccine passport law.” The list includes the Broward Center.
The Adrienne Arsht Center for the Performing Arts in downtown Miami followed suit on Sept. 20 for performances beginning Oct. 5.
In addition to the negative COVID test for audience members ages 12 and up or proof of vaccination, the Arsht is adding the free Fast Track option through the Bindle app, which is similar to Clear and TSA PreCheck. Users can use the app to create a secure Entry Pass for fast-track admission.
“We believe this extra layer of precaution, which has been adopted by other Florida venues, will keep our community as safe as possible. Not only does this decision help stop the spread of COVID-19, it also reflects the desires expressed by our audiences, protects the jobs of the artists onstage and the crews behind the curtain and complies with requirements established by many touring artists coming to the Arsht Center,” said Johann Zietsman, Arsht Center president and CEO.
Some regional theaters, such as Actors’ Playhouse at the Miracle Theater and GableStage in Coral Gables, have showed solidarity with the larger venues and Broadway theaters by adopting similar safety protocols, including the wearing of masks regardless of vaccination status. The policy at both theaters:
For patrons ages 12 and over, proof of a negative COVID-19 PCR result for a test conducted within 72 hours before the performance or a negative COVID-19 antigen result for a test conducted within 24 hours of the show, or voluntarily providing proof of having been fully vaccinated for COVID-19.
The new policy at Actors’ Playhouse goes into effect Nov. 15 for the opening of “Middletown” and will be enforced for the Nov. 12 production of “The Price” at GableStage.
Hospitals
Though hospitalizations for COVID patients have begun to trend downward after spiking in August, should you go to the emergency room? You can — and should — if you think the reason is serious enough, like possible stroke, heart attack or other serious injury, experts say.
Dr. Hany Atallah, chief medical officer of Jackson Memorial Hospital in Miami, acknowledged that ERs were jammed and carried transmission risks given the number of COVID-positive patients seeking treatment in mid-August. “That being said, especially early in the pandemic, we saw a lot of people with very delayed presentations of very bad, non-COVID-related cases and surgical problems and it made being able to care for them much more difficult as well.”
What about visiting a patient? You’ll be wearing a mask.
In July, Jackson Health suspended most visitations, with exceptions for rehabilitation, pediatrics, the neonatal intensive care unit, maternity ward and non-COVID end-of-life cases.
But as COVID hospitalizations eased in the early fall, Jackson eased up on its restrictions effective Oct. 6.
Currently, visitors must have a scheduled appointment, visitation with a current patient, or emergency requiring medical attention. Visits for other purposes such as going to the hospital’s gift shop or dining facilities are still not allowed. Visitors have to be 18 or older and will be screened and have their temperature taken at the entrance.
The University of Miami Health System also suspended most visitations in July. UHealth includes the UHealth Tower, Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute. But as at Jackson, UHealth similarly amended its visitation policy, effective Oct. 5.
Visitors are once again permitted in a limited capacity for inpatient and emergency department patients at the UHealth Tower and Sylvester Comprehensive Cancer Center to see admitted patients in non-COVID units. But guests are still not permitted for clinical appointments, except for pediatric patients or if it is considered medically necessary for a patient to be accompanied by another adult. Visitor policy can be checked at umiamihealth.org/patients-visitors/we-are-ready-to-care-for-you.
Baptist Health, Mount Sinai, Memorial Health Care and Broward Health allow visitors but with limitations. The rules vary depending on where the patient is placed in the hospital, such as the emergency room or maternity ward. You can find the rules online at each hospital’s website.
Mask and vaccine policies at schools
Educators are focusing on addressing pandemic learning loss and the mental health and social well-being of students, many of whom stepped foot inside a classroom in August for the first time in more than a year.
But the 2021-2022 school year isn’t back to normal. Quarantine and other COVID rules remain, including masks.
And it’s getting complicated.
A legal tussle on whether the state can require school districts to let parents decide if their child wears a mask or not has stalled after the state issued updated rules.
The new rules, signed by Florida’s new surgeon general, state that the decision on whether a child should wear a mask in school or not is up to the “sole discretion” of the parents.
The rules also give parents the power to decide if their child should quarantine or go to school after COVID exposure, as long as the student remains asymptomatic. People who are asymptomatic can still test positive and spread the disease, causing concern among some that the change could help fuel the disease’s spread in a setting where younger children can’t get vaccinated yet.
So far, the public school districts in Palm Beach and Monroe counties have changed their quarantines protocols to comply with the new rule. Both Broward Schools and Miami-Dade Schools’ quarantine protocols are stricter than what the state is ordering.
COVID-19 vaccines are not yet available in the U.S. for kids younger than 12, though one might be by the end of the year.
Pfizer says its COVID-19 vaccine was found to be effective in children ages 5 to 11 and the company is seeking U.S. emergency use authorization for this age group. The Pfizer vaccine is currently for people 12 and older and has full FDA approval for people 16 and older. Moderna and J&J are also working on a vaccine for kids.
A COVID vaccine for kids younger than 12 could reduce the number of students that would have to quarantine due to COVID exposure. Based on CDC guidelines and the policies of the Miami-Dade and Broward public school districts, fully vaccinated people don’t have to quarantine if they are asymptomatic.
However, don’t expect to see Florida schools make COVID-19 vaccines mandatory like other shots, such as the vaccines to protect children against polio and measles. Florida’s ban on vaccine passports prevents schools from requiring proof of COVID vaccination from students. Of course, this could change, either with a new law or through the courts.
COVID vaccine mandates in the workplace
Businesses cannot ask customers, government entities cannot ask members of the public, and schools cannot ask students to show proof of vaccination to get service. Those that do risk being fined $5,000 for each violation under Florida’s vaccine passport ban.
Private employers can still mandate COVID-19 vaccines for workers, subject to bargaining for unionized employees. And some companies already are, including Disney, Google and Facebook. Some South Florida restaurants are, too.
More businesses might follow now that the Biden administration has announced plans to require employers with more than 100 workers to mandate vaccinations or weekly testing. Federal workers and contractors will also be required to be vaccinated.
But it will get complicated. Lawsuits against the Biden administration over the plan, some that are GOP-backed, are brewing. Florida has also threatened to fine local governments $5,000 for each employee who is required to be vaccinated.
Employers mandating vaccines must still make accommodations for people who cannot get the vaccine because of a disability or a religious belief, practice or observance. Bosses who want to encourage vaccinations but don’t want to mandate the shots can offer incentives instead, including cash bonuses and extra time off.
Employers can also issue a “soft mandate,” which gives workers two options: Get vaccinated or have additional restrictions, such as weekly testing. That’s what Miami-Dade County’s government is doing.
The future of COVID: What’s next?
With all that has changed this year — vaccines and reopenings — some things are staying the same: restrictions, conflict, uncertainty, fear.
For Dr. William Moss of Johns Hopkins Bloomberg School of Public Health in Baltimore, the future is clear: Life will slowly get back to normal — but COVID is here to stay.
Moss, the executive director of the university’s International Vaccines Access Center, thinks the U.S. will control, not eradicate, the virus. But he recognizes there are a lot of unknowns, including questions on waning immunity and the risk of new variants emerging.
Moss said getting vaccinated is still the best way to help control the virus and slow the U.S. mounting death toll, which has surpassed 700,000.
Controlling COVID-19 means the disease will be manageable enough that there will be only occasional cases instead of outbreaks. At this stage, society will have entered what Moss describes as a “status quo,” where hospitals are not overrun with sick people and public health measures like mask mandates are not needed.
A certain number of cases and deaths would be normal, similar to how we see the flu.
“But the question is, at what cost?” Moss asked. “How many people need to die before we get there?”
This story was originally published October 4, 2021 at 6:00 AM.
