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Dr. Rai talks about who’s next for the COVID vaccine

Published: Dec. 29, 2020 at 7:24 AM CST
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GREEN BAY, Wis. (WBAY) - Health care systems are getting ready to vaccinate a second wave of people against COVID-19. Right now, hospitals are waiting for guidance from the state on who will be in that phase 1B.

“So right now all we know is what the federal government has decided 1B is going to be, and that’s what they’ve referred to as law enforcement, teachers, and those in education, and those that are 75 and older. Now we’re still waiting for the state to come out with their interpretation of that, because that’s the rules we really have to follow, what the state of Wisconsin would say. Hopefully that will be set here in a week or two,” says Dr. Ashok Rai, President and CEO, Prevea Health.

Dr. Rai joined us Tuesday on Action 2 News This Morning to talk about plans to scale up vaccinations and answer viewer questions.

Have a question for Dr. Rai? Email news@wbay.com.

View previous Dr. Rai segments: https://www.wbay.com/health/drrai/

VACCINATION PROGRESS

“It’s going good. You learn something every day. We’re trying to get more and more people through every day, getting more and more people scheduled. We had to do it in waves, making sure we had our own internal priorities to get done. Our hope is to make sure our employees, both at Prevea and HSHS, those that want to be vaccinated have gotten through that process by next week. Because come next Wednesday, we work on shot two for everybody, and then also expanding for shot one for all the other 1A individuals in our area.

“You still have to have a scheduled appointment, you still have to come in, you still have to get that second shot. So shot two a spot where a shot one would have been in. So you need to double your capacity, and that’s what we’re working on right now.”

SCALING UP

“I started doing back of the neck in math over the weekend, looking at how many people we’re getting through in a weekly basis and the operations we have and how much do we have to scale that up. I start looking at what is our typical patients that would identify us as their health care provider across the state. Yeah, we need to scale this up about tenfold to get everybody done by June or July.

“I think probably the biggest adjustment is spacing people. You need find larger space to do this and more people as vaccinators, because our people that are vaccinating right now have other jobs within health care and they’re necessary. So it’s hiring up for this and scaling that infrastructure up, and making sure it’s safe for everybody, that’s the most important thing, is that we have the ability to watch people after their shot, do all of that appropriately.

“We’re looking at all possibilities right now. There’s teams out there looking, as the 1A team is working through their stuff, there’s the 1B team already working on what they’re going to do next and what the future’s going to look like, from facilities, people, everything.”

WHEN DOES 1B START?

“So right now all we know is what the federal government has decided 1B is going to be, and that’s what they’ve referred to as law enforcement, teachers, and those in education, and those that are 75 and older. Now we’re still waiting for the state to come out with their interpretation of that, because that’s the rules we really have to follow, what the state of Wisconsin would say. Hopefully that will be set here in a week or two. It’s important to remember that there’s no hard stop. It’s not like finish all the 1As and then now start on the 1Bs. We’ll get a message from the state. It’s important to understand that health care providers don’t determine what day that’s going to be. The state will say, ‘start immunizing 1B and start asking for your allocation for that.’”

VACCINATING NURSING HOME RESIDENTS AND STAFF

“It’s a huge moment for those of us who work in long-term care or have a loved one in long-term care. As you look at the entire country and how many people we’ve lost that have been in a nursing home type setting, that’s been our most vulnerable. The ones we had to go in lockdown right away. Yesterday was a big day in getting that done. With the help from some national pharmacies and federal contracts with them, it’s a lot easier to get that done. So Walgreens and CVS around the country are acting like hubs and the nursing homes are spokes, and that infrastructure was set very nicely by the federal government to make sure it can happen.”

“You look at nursing home patients, but we’re waiting for it to really get to assisted livings, because that’s when we really start to see curbing the hospitalizations. Then excited about getting started on 1B--those are 75 and older. And then 1C, and as we start phasing through there, the risk of the health system getting overwhelmed becomes less and less and less.”

WISCONSIN TRENDS

“Our percent positivity in Wisconsin has trended nicely, so thank you everybody who’s been listening and doing the right thing over Thanksgiving, and now hopefully did the right thing over Christmas. We need to keep that great enthusiasm of doing the right thing through January and February as we get people immunized.”

IS THERE A VACCINE REGISTRY?

Do Wisconsin residents have to pre-register to get a COVID-19 vaccine?

“It really depends on where you plan on getting your vaccine. The most important thing you can do is always have a primary care physician. A lot of primary care offices or health system offices will be facilitating you getting the vaccine. What you can do now, if you don’t have one, is make sure you establish with a physician so they know your risk factors. Also, when it comes to pre-registering, register with that physician’s internet portal. Most, if not all, health systems have some kind of online portal. That is going to be a key way for people to register for the vaccine with their doctor, to schedule it. Ours is myprevea.com, but every health system has one. The more you can get familiar with that now, the easier it will come with it comes time to get your vaccine.

“The internet is not going to be the only way you get vaccinated. Make sure you have that conversation with your health care provider.”

SAFETY AND PHARMACIES

Pharmacies will be administering some COVID-19 vaccines. Is it as safe as getting it in a health care setting?

“Pharmacists, especially in the state of Wisconsin, are all trained and licensed to give a vaccine, and they’re a great source of vaccinations. Pharmacies play a key role in vaccinating the community. We want to make sure that people understand that. They still have to follow the same rules as any of us in health care would, by watching a patient for 15 minutes and up to 30 minutes, depending on their health history. They take the same health history we do. They’re a key component of this battle of getting everybody vaccinated.”

ANTIBODY TREATMENT

After an antibody treatment, do you still have to isolate?

“You definitely do. That monoclonal antibody is great. What the point of it is to do is to try to slow down the growth of the virus, if not stop the growth of the virus in you. But you still are infected. So you still do need to follow all the isolation guidelines. Isolate from 10 days from the onset of symptoms. And make sure in that last 24 hours that your symptoms are resolved. And then you’re done with isolation. Everybody exposed to you during that time period still needs to quarantine. So that’s why you still need to isolate. But the monoclonal antibody drug has been great in trying to prevent people from getting sicker, especially those who are at risk, from going into the hospital.”

BETWEEN SHOT INFECTIONS

What happens if you get COVID-19 between vaccine doses?

“It’s important to understand that the first vaccination provides you some immunity, but you’re not immune. If you looked at the studies, it wasn’t enough. That’s why you need the second shot. And yes, you can still get COVID between shot one and shot two. If you do, and what you really need to make sure is that you’ve fully recovered from COVID, which means that 10 days, before you get the second shot. If that takes you past that 21st day, that’s OK. On that 11th day, your provider should give you the shot. If you get COVID between the two, contacting your doctor right away so they can measure those days and get you rescheduled for that second shot is really important. Because you still need that second shot, even if you get COVID in-between.”

VACCINE, IMMUNITY AND TRAVEL

An 80-year-old viewer wants to know if she gets the first COVID shot and travels to Florida for a month as planned, what’s the impact on immunity if she waits three-to-four weeks before getting the second shot?

“It’s way outside the window. Remember, it’s 21 days. There’s a little bit of a gap there, but not weeks by any means. So it’s important that everybody get that second shot, and not schedule your first shot unless you know you’re going to be in the same place for that second shot. Remember, the federal government, how this vaccine is being distributed is pretty complicated. Logistics are not easy. We actually went through this yesterday with the state. Your second shot will arrive where your first shot was given, as far as the distribution goes. You have to make sure that you’re there. So some people may need to readjust their travel plans according to that, or wait to get the vaccine, which I would not recommend if you’re at risk.”

VACCINE FOR DENTAL PROFESSIONALS

When will dental workers get the vaccine?

“Dental professionals rank in the phase 1A, first-line contact medical professionals, so those will be coming in the coming week or two. The first priority for most health systems was, let’s get our people immunized so we can keep taking care of everybody else, which also means we can keep immunizing everybody else. Most health systems in the state received their first round two weeks ago. Next week will be kind of where they’re starting to wrap up and working on their second shot and working in other 1As while they get their second shots done. So now we’re going to have to literally double our capacity in a week to get everybody their second shot and a whole new group of people doing their first shot, and then keep expanding from there.”

WEEKEND AND HOLIDAY VACCINATION SCHEDULES

Why are health care professionals not vaccinating people on weekends on holidays?

“We want to get the vaccine in as many arms as we can. Right now, the rate-limiting step is getting the vaccine. We have enough to do health care. We do not have enough to do the community. As we do, we will change our hours. Even for health care right now, for our own people, we’re doing them on Saturdays. We started evening hours this week trying to get as many people done by early next week. We have a goal to be done by early next week so we can keep moving this forward to the other phases and move as quickly as we can. But really, the rate-limiting step is getting the vaccine.”

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