In mid-April, Erie County Executive Mark Poloncarz announced that all fans attending football games at the county-owned Highmark Stadium would need to be vaccinated. That was reassuring to Dr. Daniel Zorich, who bought Buffalo Bills season tickets “assuming that we were going to be safe,” he said.
Then the rules changed.
In mid-June, when New York hit its target of 70% of adults having at least one vaccine dose, Gov. Andrew Cuomo lifted the majority of Covid-19 restrictions statewide. Days later, in a tweet lauding Erie County’s low positive test and hospitalization numbers and “good vaccination rates,” Poloncarz announced, “We are rescinding the vaccination requirement to attend Bills games and stadium events. We will revisit in future if circumstances warrant.”
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Surrounding vaccinated people with other vaccinated people is the scientifically surest way to keep a big crowd safe and minimize the possibility of spread at a big event. But that is not what’s happening – not here, and not in most places around the country. Which begs the question: Are we ready to go back to mega-size events? We explore that topic in this week’s “Pandemic Lessons.”
We hit the targets required to reopen big events. Isn’t that a good thing?
Of course. But even when people agree on the science, the slightest nuances in their perspective make a difference in their feelings.
For this story, we separately interviewed multiple infectious-disease experts who largely agreed that if you are fully vaccinated and possess a healthy immune system, you’re OK to attend big events. Here’s a sampling of their reasoning:
• Vaccination cuts the risk of contracting Covid-19 and “dramatically reduces the likelihood of really significant Covid and all but eliminates death from Covid,” said Dr. Brahm Segal, an infectious diseases specialist at Roswell Park Comprehensive Cancer Center. For people with full vaccination and healthy immune systems, he said, it is “no problem at all to attend events with large numbers of people.” However, Segal cautions that blood cancer and organ transplant patients, among others whose treatment may compromise their immune systems, to avoid large groups – even if vaccinated.
• The outdoor air cuts into virus spread. “Everything in life is relative risk,” said Dr. Thomas Russo, chief of infectious disease at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences. “The combination of being fully vaccinated and having an outdoor venue significantly decreases relative risk.”
• Western New York’s vaccination rate is heading, albeit slowly, in a positive direction. At the end of June, approximately 59% of Erie County residents had at least one vaccine dose, while Niagara County had 54%. That trails the statewide figure (60%), but the trajectory heading toward fall is helpful.
“Our immunization rate locally is pretty good,” said Dr. John Sellick, an epidemiologist with Kaleida Health, Veterans Affairs and the University at Buffalo. “I think for most people it’s probably going to be OK" to attend games.
Why, then, would a fully vaccinated individual be hesitant?
Because there's still risk – and responsibility. We all weigh the implications of that risk in our own context.
Zorich, a primary care physician in Lewiston and Niagara Falls with Trinity Medical WNY, agrees with the science and understands the excitement over reopening.
“The chances of ending up with coronavirus after being vaccinated is a very, very small percentage,” said Zorich, who is fully vaccinated. So is his wife and the people closest to them. “But,” he added, “it’s not zero.”
The three vaccines available in the United States are all considered highly effective. The Pfizer and Moderna versions have demonstrated up to 95% success against the older strains of the virus. That efficacy begins to drop against newer strains – particularly the delta variant that was first identified in India, and is now circulating through the United States. But still, the vaccines are considered reliable at keeping people out of the hospital and alive.
If you’re young and healthy, fully vaccinated and living with an equally healthy partner, and your work doesn’t put you face to face with numerous people daily, you may not worry about catching Covid-19 at a Bills game.
But imagine you’re a doctor like Zorich, who may see dozens of people daily. Or a grocery worker with a diverse group of colleagues – some vaccinated, some not – and hundreds of customers. Or a fifth-grade teacher whose students are too young to be vaccinated, but old enough to readily contract the virus and pass to a grandparent who has multiple myeloma, a blood cancer that can cripple your immune system.
Your responsibility to that risk extends beyond yourself, and even your immediate circle. This is where those small slivers of ominous daylight in vaccine effectiveness creep into Zorich’s mind. Another way of contextualizing 95% efficacy is to acknowledge that the Moderna and Pfizer vaccines are about 5% ineffective. One or two of every 20 people, or perhaps more if a variant comes into play, may contract a so-called “breakthrough infection.” It may be completely asymptomatic; they may never know it. The vaccine may even make them less likely to pass it to others. But it’s still an infection, and the possibility of that happening at a Bills game, however small it may be, would be even smaller if only vaccinated fans were in the stadium.
Zorich acknowledged that New York's 70% partial vaccination rate is something to celebrate.
“That’s wonderful," he said. "But people are traveling in and out. People come from outside the area all the time to see the Bills, so you don’t know what kind of mix of fans you’re going to have.”
Proximity and duration add to Zorich’s concern. At a football game, you’re tightly packed into seats for three-and-a-half hours. If the person next to you is infected and cheering loudly, it makes you more susceptible – even outdoors.
Put another way: The more the Bills make you want to shout, the more vulnerable you would be.
Aren’t unvaccinated people supposed to be wearing masks?
Yes, and if they do, the opportunity for spread becomes markedly lower. This reflects guidance from both the state and the Centers for Disease Control and Prevention, and the Buffalo Bills’ statement released when the team learned it could host full-capacity games of nearly 72,000 fans. It read, in part: “Both vaccinated and unvaccinated fans are welcome to attend home games. Masks are still required for unvaccinated individuals in accordance with CDC guidelines. Additional information in regard to other protocols will be released at a later date.”
Zorich is hoping those protocols will include some sort of screening: showing vaccination cards in order to unmask, or Covid-19 testing for unvaccinated individuals. When we contacted Bills officials to ask about their plans, they declined to comment and referred us back to their statement. But given the gargantuan complexity of effectively screening 70,000-plus people, it seems unlikely to happen, unless it's commanded by government officials.
The Toronto Blue Jays, which currently play at Buffalo’s Sahlen Field, are a relevant example: With Cuomo’s mid-June announcement, the Jays were able to lift capacity restrictions and relax the screening requirements for masking, social distancing and proof of vaccination. Formerly, fans sitting in vaccinated-only sections had to show proof of immunization. Now, all sections are open and masking is the responsibility of individuals.
Sellick, who attended a packed Jays-New York Yankees game with his daughter a few days before the protocols were lifted, noted that although they had to show proof of vaccination to sit in their seats, crowds of people were packed into concession lines in the less-airy corridors of the stadium.
“Fortunately, I have a lot of confidence in the vaccine,” Sellick said. “The reality is, we're never going to be at zero risk. This is going to be with us, essentially, forever. Figuring out how to deal with it, and making sure people are immunized, is the name of the game.”
