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Dr. Rai talks vaccine distribution and antibody treatment success

Published: Dec. 1, 2020 at 7:33 AM CST
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GREEN BAY, Wis. (WBAY) - Hospitals in Green Bay will soon learn about plans to distribute a COVID-19 vaccine. Prevea Health President and CEO Dr. Ashok Rai gave Action 2 News This Morning some insight on the process and what hospitals expect to learn from the federal government.

Dr. Rai joins us Tuesdays and Thursdays. Have a question? Email news@wbay.com

POST-THANKSGIVING ADVICE

“It’s probably too late for them to avoid COVID-19. They would’ve had to stay at home. But if they start showing symptoms, get tested right away. If you find out anybody you were in contact with more than 15 minutes for less than six feet, which is pretty common in a household, that you stay away from everybody else until you know your status. That’s quarantining for 14 days, getting tested about six days after the last time you were exposed to that person. To be honest with you, you should really, because you don’t know what you’re exposed to, if you come back to your home environment, you should be avoiding all contact with people for 14 days. That’s the safest thing you should do. I know people are going to tell me that’s not practical, I’m going to miss work. You probably shouldn’t have done that in the first place. Now what you can do is stay away from everybody for 14 days so we can prevent you from hurting somebody else.

“The impact isn’t always that one person who turns positive. It’s that one person who turns positive that infects five, that infects 25, that infects more. So the people coming back from Thanksgiving that didn’t do the right things, if they’re going to turn positive, likely, probably by this Thursday we’ll start to see some of that, but we don’t know who they’ve infected along the way. So our numbers will continue to go up over this time period. That was the concern. A surge on top of a surge. Because right now, things have not lightened up and you add that onto that. There’s a lot of concern out there that’s what we’re going to see.”

VACCINE PRIORITIES

“I think what we’ve heard that ACIP’s (Advisory Committee on Immunization Practices) going to decide at least the first couple of tiers, or the first couple of rounds of vaccines. Things that we hope to hear from them: who are they feeling is the first round? Is that frontline healthcare workers? Is that frontline healthcare workers and nursing home residents and those who take care of nursing home residents? Because remember, our frontline healthcare worker is not always your doctor, your nurse. It’s the person delivering their food, cleaning their room. We’re looking at tens of millions of people that work in healthcare. Do we have enough vaccine for everybody in round one? It’s important also to remember ACIP’s going to make some recommendations around state distribution, possibly. Say a state got 10 million doses or somebody got 10 million doses. Do they immunize 10 million people? Or do they immunize five million people knowing that in either 21 days or 28 days they’re going to need a second vaccination? Or do we trust the company to be able to produce it and keep us in stock?”

ANTIBODY TREATMENT

“Initially we talked about the [Eli] Lilly monoclonal antibody drug that we’re using here in Green Bay. Regeneron, the second drug, should arrive this week. Hopefully we’ll start using it by the end of the week.

“They’re for people who are at risk. So 55 years or older with a chronic health disease like hypertension; or 65 and older or morbidly obese or a diabetic. Those are the people we want to find. We need to find them early before they’re on oxygen, before they’re in the hospital, and get them the antibody treatment so they don’t get worse. We’ve given it to about 30 people so far. Some are residents in long-term care. Some are at home. So far, everybody’s tolerated it pretty well. Knock on wood, of the people we’ve infused here, our small number of people, nobody’s needed to be admitted yet. So we’re really watching them closely.”

NO HOLIDAY FOR HEALTHCARE

“There’s a variety of concerns with our levels. Our people who had to work Thanksgiving or over the weekend, they’re just asking for a break and they’re not going to get one, in all honesty, with the numbers. They’re getting sick, they’re worried. Every day they’re more and more worried. The ICU numbers--you get a break for a day where you have two open beds and then within 12 hours those beds are full. It’s important to remember we’re not only just taking care of COVID patients. We have our stroke patients, our heart attack patients, traumas, car accidents as the weather gets worse. And it’s being able to fit all of them in, plus COVID, it’s really exhausting the teams right now.”

COVID “LONG HAULERS”

A viewer has spoken to young people who want to get COVID and get over it. What do you say to that?

“It’s pretty irresponsible behavior for two reasons. Number one, think about everybody else around you. So if you get it, and you’re younger, and you think you’re going to do fine, remember, you’re going to spread it. This disease does not live unless it’s spread person to person. It doesn’t kill the next person unless somebody spread it to them. So it’s an irresponsible thing to say, ‘I just want to get it and get it over with.’ Because if you get it, you’re going to spread it.

“Secondly, yeah, there are younger people--many younger people--ages, even teenagers and on forward that have long-term effects. We’re still learning about that. Remember, we’re only nine months into this. As people learn about the long-term effects, it’s so bad right now in this community where we actually have a clinic set up to see people that are two weeks, six weeks, 10 weeks, 12 weeks out from COVID and are still having issues with their memory, their mental status, their breathing, their kidneys. There are a lot of things that are affected, and we’re learning more and more everyday. Like an athlete with heart issues, which we’ve seen in the press a few times. There’s no reason--absolutely no reason--to go out there and say, ‘I just want to get this and get it over with.’”

SNOWBIRD TRAVEL

Snowbirds are planning winter in Florida. Should they stay home in Wisconsin? Will they have the same access to the vaccine in Florida?

“A lot of people are going to snowbird now, including my own parents, so it’s an important question. We don’t know about the vaccine distribution for the multiple phases that are going to come. Actually, we’ll learn a little more later today on which category you’ll be in, when we learn from the phases from the federal government today. It’s important to know that the vaccine, so far, is going to be distributed by state, and each state will then distribute it to people according to those phases. It’s hard to predict. It’s hard for me to tell you that you’ll have better access in Florida versus Wisconsin, or vice versa. But if you’re an at-risk population, you’re over the age of 65, you are an at-risk population and you will be in one of the higher tiers, no matter where you’re staying or living, you should have access to it.

“It’s important to travel safely. Make sure that you’re staying physically distanced and masking, even when you are in Florida.”

PERCENTAGE OF ASYMPTOMATIC CASES

Do we know the percentage of asymptomatic cases?

“Unfortunately we really don’t have that stat as much because not everybody tells us what their symptoms are when they get tested. We do know that it’s a growing percentage. Unfortunately, we’re just not testing enough people to have a really reliable number on that. It’s a small number when you look at people that are coming in for pre-procedural testing. That’s still less than one-to-two percent. But overall population, it’s hard to tell unless we can get more and more people to come in for testing. We’ve been encouraging it now for almost three-to-four weeks in Brown County where you can get tested if you have absolutely no symptoms. And then we can start to measure that. We know it’s a higher number. We just don’t know what the number is now.”

CONTAGION

How soon after a COVID infection are you no longer contagious?

“We have approximate numbers on that. Nothing that’s truly where we can tell you you’re contagious today and you’re not contagious tomorrow. That would take us to actually culture the virus from your nose and being able to understand that culture. Can’t do that in a rapid time period. What the CDC says is that after 10 days, most people don’t have a virus that’s replicating anymore that they’re actually spreading. So 10 days is the number from onset of symptoms for most people. For those who are immune compromised, you’re in the hospital, that number stretches to 20 days. But 10 days is the number. After that, you shouldn’t be contagious. But that’s for a 90-day time period and then that clock restarts where the CDC says you can be re-infected after 90 days.

SYMPTOMS

Are wheezing and throat-clearing symptoms of COVID-19?

“Most definitely. We talk about upper respiratory and lower respiratory symptoms. Upper respiratory, clearing your throat. Lower respiratory, being wheezing. Both of which can be seen in COVID and actually aren’t that uncommon when we start to see COVID patients.”

CHRISTMAS CAROLING

Can people go Christmas caroling if they wear masks and distance?

“So, walking outside definitely safer than being inside. So let’s take the caroling outside. So now you’ve increased your safety. You’re wearing masks, you’ve increased everybody else’s safety even more. The distance that you need to be apart from each other actually changes with singing. We’ve talked about this in the past. There’s some good research articles that talk about singing and wearing a mask and where the virus is spreading. It’s six feet maybe front to back you’re protected, but side to side it says you actually need more space if you’re singing and wearing a mask. If you have to go out--and once again we’d really like you to stay inside--but if you truly have to go out, you really need to widen that radius past six feet. Some will say 10-to-20 feet depending on how powerful that singing is and where the wind is and all that. So to be safe, don’t do it. But if you need to go out and do it, stay farther than six feet and wear your mask and make sure you stay outside and never go inside.”

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