Dr. Philip Huang, Director and Health Authority for the Dallas County Health and Human Services Department, recently spoke with Texas Health Institute about the continued need for preventive measures against COVID-19, current status of vaccination efforts, and what to expect moving forward in Texas.

Q: Why is it important for people to continue wearing masks in public at this stage of the pandemic, especially as millions of people have been immunized at this point?
A: It’s very encouraging all of the vaccination efforts that we’re having and the improvements in some of the indicators we are seeing, but it’s still too early to relax these measures. In Dallas County, as of March 24th, we’ve vaccinated over 532,000 persons, but that’s still only a fraction of the population. Approximately 26% of eligible persons have received one dose, and 13% have completed the full two doses, but that still leaves about three fourths of the population of adults who have haven’t received the vaccination. So there’s a significant percentage of the population that has not been vaccinated and it’s still very important for people to do the other preventive measures that we know are very effective.

Q: What is the optimal percentage of individuals that we would like to be vaccinated before we reach a place where we could see relaxation of masks and social distancing protocols?
The estimate that’s out there is 75-80% of the population need to be protected. That might include some that have had natural illness and protection, but we do not know how long that protection lasts. So, it’s really difficult to set an exact number on that, but the thought is 75-80% of people being protected. Ideally, [that would mean 75-80% vaccinated]. CDC released additional guidance regarding recommendations for people who are fully vaccinated, which, moving forward, provides some guidance and hope for what people can do safely after being fully vaccinated.

Q: If someone has been immunized, do they need to continue to wear masks and avoid crowded spaces where maintaining social distance isn’t possible?
A: The new CDC guidance has some specific recommendations. When you are visiting with other fully vaccinated persons indoors, these people are within a single household and no one is at high risk for severe illness, then it is safe to not wear masks and not physically distance. However, if it’s with people from more than one household or persons that are at high risk for severe illness, then continue to practice masking and physical distancing. There is specific guidance in the new CDC recommendations. Also, in medium and larger public settings continue to practice masking and physical distancing. You still want to avoid crowds as much as you can.

Q: Now that there are several vaccine types available from different manufacturers, should people be concerned over which vaccine they receive?
A: All three of the vaccines that have been approved are really very effective. They have been almost 100% effective at preventing death and have very high effectiveness at preventing severe illness. There is still limited vaccine availability, so we strongly recommend that you take the first vaccine that becomes available to you. They are all very good vaccines. These [vaccines] are amazing scientific breakthroughs.

Q: What is one best piece of advice you would give to someone who continues to be concerned or confused about what preventative actions they should be taking?
A: I think we all want to get back to normal as soon as possible. We all want everyone to be able to receive the vaccine as quickly as possible, but we’re still not there yet. There’s still limits on the availability of the vaccine. There is still a large percentage of the population that is not vaccinated. Continue to do the preventive measures that we’ve been doing that have been very effective. We have shown that we can slow this down. Continue masking. Continue to avoid crowds. Continue to stay 6 feet physically distant. Continue to wash your hands. If you are fully vaccinated there are some settings where CDC has recognized it is very low risk and you can relax some of the guidance. But, in general it is still good to continue to be vigilant. We really want to slow this down. We are very concerned about these variants that are out there, the UK variant, South Africa, and Brazil, that have been shown to be able to be spread more easily and may have some resistance to the vaccine. Although, still thus far it is showing there is efficacy from the vaccine. But these genetic variances, and other variables out there make it clear we need to continue to be vigilant.

Q: Any closing thoughts or additional comments you would like to add?
A: We are all very excited about the availability of vaccines. We’re doing everything we can to get everyone vaccinated as quickly as possible. We would love for everyone to be priority. Unfortunately, right now there is still limited vaccine availability, but hopefully that will be changing over the short term with more vaccines becoming available. Let’s keep doing the common sense preventive measures and not let up because it would be very easy that we could see some backsliding on this if we let our guard down. 

Philip Huang, MD, MPH 
Dr. Huang has been the Director and Health Authority for the Dallas County Health and Human Services Department since February 2019. Prior to this he had served as Medical Director and Health Authority for the Austin Public Health Department, and as Chief of the Bureau of Chronic Disease & Tobacco Prevention at the Texas Department of State Health Services. He received his undergraduate degree in Civil Engineering from Rice University, his MD from the University of Texas Southwestern Medical School, and his Master’s in Public Health from Harvard with a concentration in Health Policy and Management. While at Harvard, he led the successful movement to divest of their tobacco stocks. Dr. Huang completed his residency training in Family Medicine at Brackenridge Hospital in Austin, and served two years as an Epidemic Intelligence Service (EIS) officer with the Centers for Disease Control and Prevention assigned to the Illinois Department of Public Health where he conducted epidemiologic studies in chronic disease and infectious disease outbreak investigations. He is currently an Assistant Professor with the University of Texas at Austin, Dell Medical School, and an Adjunct Assistant Professor with the University of Texas School of Public Health, Austin Campus. He has served as Principal Investigator for numerous CDC and State-funded public health cooperative agreements.