Dr. Michael Fine – No, we’re not back to normal. Vaccines, boosters, masking, distancing, holidays, events…

Few Rhode Islanders understand that while the vaccines do a great job preventing hospitalization and death in people under 80, they do not prevent infection and are not very effective at preventing hospitalization and death in people over 80, and those with chronic disease.  

We think boosters help, but we’re not yet sure just how effective boosters are in helping prevent hospitalization and death in people over 80 and those with chronic disease, or for how long protection works in that group.

That means vaccinated and boosted people over 80, and those with chronic disease should act now to protect themselves from getting infected, by getting vaccinated and boosted – AND – staying home when they can – AND – masking and social distancing whenever someone from outside the household is inside the house, and whenever they go out, if they must leave the house.

Few Rhode Islanders are aware of the current CDC recommendations on masking and attending large events. CDC defines high viral transmission as new cases greater than 100 new cases/100,000 people/week.  Rhode Island is experiencing close to 600 new cases/100,000/week as of December 10, 2021.

CDC recommends everyone — people vaccinated, people boosted, and people not vaccinated yet — mask indoors in public during periods of high transmission. 

CDC also recommends that organizers of large events assess whether to cancel or or postpone those events when high transmission is present, and to implement universal masking and social distancing (separating people by 6 feet) and carefully sizing the event so that the number of people does not exceed the socially distanced capacity of the venue.  

CDC does not define large events. I believe any event over fifty people in Rhode Island should be considered a large event because it is very likely that any event over that size will include one person who is Covid positive, because about 2 people in 100 Rhode Islanders are positive for Covid19 today. 

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Michael Fine, MD, is a writer, community organizer, and family physician. He is the chief health strategist for the City of Central Falls, RI, and a former Director of the Rhode Island Department of Health, 2011–2015. He is currently the Board Vice Chair and Co-Founder of the Scituate Health Alliance. He is the recipient of the Barbara Starfield Award, the John Cunningham Award, and the Austin T. Levy Award.

He has served as Health Policy Advisor to Mayor James Diossa of Central Falls, Rhode Island and Senior Population Health and Clinical Services Officer at Blackstone Valley Health Care, Inc. He facilitated a partnership between the City and Blackstone to create the Central Falls Neighborhood Health Station, the US first attempt to build a population based primary care and public health collaboration that serves the entire population of a place.

He was named Health Liaison to the City of Pawtucket. Dr. Fine served in the Cabinet of Governor Lincoln Chafee as Director of the Rhode Island Department of Health from February of 2011 until March of 2015, overseeing a broad range of public health programs and services, overseeing 450 public health professionals and managing a budget of $110 million a year.

Dr. Fine’s career as both a family physician and manager in the field of healthcare has been devoted to healthcare reform and the care of under-served populations. Before his confirmation as Director of Health, Dr. Fine was the Medical Program Director at the Rhode Island Department of Corrections, overseeing a healthcare unit servicing nearly 20,000 people a year, with a staff of over 85 physicians, psychiatrists, mental health workers, nurses, and other health professionals.

He was a founder and Managing Director of HealthAccessRI, the nation’s first statewide organization making prepaid, reduced fee-for-service primary care available to people without employer-provided health insurance. Dr. Fine practiced for 16 years in urban Pawtucket, Rhode Island and rural Scituate, Rhode Island. He is the former Physician Operating Officer of Hillside Avenue Family and Community Medicine, the largest family practice in Rhode Island, and the former Physician-in-Chief of the Rhode Island and Miriam Hospitals’ Departments of Family and Community Medicine. He was co-chair of the Allied Advocacy Group for Integrated Primary Care.

He convened and facilitated the Primary Care Leadership Council, a statewide organization that represented 75 percent of Rhode Island’s primary care physicians and practices. He currently serves on the Boards of Crossroads Rhode Island, the state’s largest service organization for the homeless, the Lown Institute, the George Wiley Center, and RICARES. Dr. Fine founded the Scituate Health Alliance, a community-based, population-focused non-profit organization, which made Scituate the first community in the United States to provide primary medical and dental care to all town residents.

Dr. Fine is a past President of the Rhode Island Academy of Family Physicians and was an Open Society Institute/George Soros Fellow in Medicine as a Profession from 2000 to2002. He has served on a number of legislative committees for the Rhode Island General Assembly, has chaired the Primary Care Advisory Committee for the Rhode Island Department of Health, and sat on both the Urban Family Medicine Task Force of the American Academy of Family Physicians and the National Advisory Council to the National Health Services Corps.