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Who’s next up for the COVID vaccine? Dr. Rai talks local rollout

Published: Jan. 5, 2021 at 7:32 AM CST
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GREEN BAY, Wis. (WBAY) - Health care systems are preparing to expand COVID-19 vaccination efforts.

“We’re starting to expand who we’re going to vaccinate on that 1A category, even within this week,” says Prevea Health President and CEO Dr. Ashok Rai.

Dr. Rai joined us Tuesday on Action 2 News This Morning to discuss the progress, what could’ve been done better and answer viewer questions.

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

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

LOCAL VACCINE ROLLOUT

“I’d say we feel pretty good about where we’re at. You’ve got to understand, today would be the 21st or 22nd day since the doses arrived in the state and into our freezers. We started giving it 21 days tomorrow, because I’ll get my second shot. During that time period, I think we’re up to about 5,000 people vaccinated between Prevea and HSHS employees and those who work around us. Is that 100 percent of everybody? No. But it’s farther than I thought we would be three weeks ago when we only started with 20 people on a Wednesday. With two holidays worked in, we’re doing really well. And we’re starting to expand who we’re going to vaccinate on that 1A category, even within this week.”

WHO IS NEXT FOR VACCINE?

“I think, if you look at the 1A list, who was next on there was EMS, so we invited them to start coming through last week. Now, it’s hard to figure out who’s next on that 1A list, so it’s pretty much just open the doors. If you’re on the 1A list and you can show that to us, then we’ll start to work with public health and start to open those doors to, say, those who work in a dentist office that are exposed to patients every day. Those are people on the 1A list that need to go forward. Remember, the faster we can move through that, the faster we can get on to 1B, and that list has yet to be determined.”

CLICK HERE to view the CDC’s recommended vaccine phases.

“We looked at everybody that, for example, that’s a Prevea patient. Somebody who’s seen us in the last year. Over the age of 16. And we took that number and we said, alright, if we want to immunize 60-to-70 percent of them by this summer, mid-summer--and that’s a lofty goal if you think about it, remember we have to give two shots, and that’s kind of our bare minimum expectations, we obviously want to do more than that--that’s 10,000 people we need to immunize every week, running six-days-a-week, eight-hours-a-day, between now and say, mid-or-end-of July. So that’s what we’re ramping up to do for our next scale up. And then we have to scale up from that. So I think we’re two weeks away, or three weeks away, from hitting that scale. But I have some concerns. To me, it’s, you know, you’ve got a restaurant, you’ve got reservations, everybody’s sitting there, and there’s no food to be served. So we can scale up our operations, we can hire nursing, we can rent larger space, all of which we’ve done in the last 48 hours and worked on, but if there’s not vaccine there to give, that will be very frustrating to the public and very frustrating to us. So we have to make sure that as we scale up our operations, we educate those who determine where the vaccine goes that we’re ready. And that’s kind of the political step that we’ve got to work through, because that’s tough.”

WHAT COULD’VE BEEN DONE BETTER?

“Hindsight’s always 20/20, and I always say that to the group, that we have to look for it. And the government and the people involved in there, these aren’t politicians that are involved in there. These are hard working people that are trying their best. I think what was lacking, and what we should have done better as health care, is advocate, saying ‘put us at the table.’ You have to understand how to operationalize this. Those that are delivering the vaccines have never actually had to put shots in arms, never had to hire up staff, understand what it takes to register a patient in the IT systems, to do consent forms that have never been done before. There’s a lot of work, even before a patient’s vaccinated, that they don’t understand how much labor’s involved in that. So I think in hindsight we would have liked to have been at the table, now we have to advocate for, ‘we’ve got the system set up, get us the vaccine.’”

ANOTHER SURGE?

“It’s hard to predict, because once again, you know, our testing numbers get skewed every time there’s a holiday, and the delays. We are starting to see a slight increase. It’s not that we didn’t do the right thing. I think a lot of people did the right thing, not everybody did. But it’s also what’s going on around the country and when’s it going to get to Wisconsin. We’re seeing what’s going on in other parts of the country, and usually we lag, and sometimes we lead. It’s going to be two-to-three weeks that we have some concern about what the next few weeks hold for us.”

TESTING NUMBERS DOWN

What’s causing the drop off in testing numbers in Wisconsin?

“I think some of it is true, people aren’t coming in like they should be with symptoms. It’s important to understand, in Brown County especially, we test people without symptoms. So people should be getting tested no matter what. Some of it is the reporting delays. I think people need to understand-- and we’ve said this pretty much after every holiday, Memorial Day we saw a little bit, July 4th because we were testing more we saw a lot, Labor Day, Thanksgiving, now Christmas and New Year’s combined--that there’s a lot of noise in the numbers. Let’s give this a few days to actually figure out what’s truly going on. But what we can see in our lines, is that volumes are down, and that’s concerning. People aren’t treating even the mildest of symptoms like they should and get tested. And we’re not doing enough surveillance testing to see if we have control of this virus, which, you know, given our hospital numbers are starting to creep up a lot, we don’t have control yet.

“I think I was asked back in March, ‘what do we need to win?’ And in April, ‘what do we need to win?’ Obviously, we needed treatments and vaccines and we needed human behavior, but the key thing that we’ve talked about is testing. It’s testing, tracing and isolating. When you know somebody’s positive and you isolate that person away, they stop infecting other people. You don’t know that until you’ve done enough testing. We obviously, in this area, aren’t doing enough testing.”

PRESIDENT’S TREATMENT AND PUBLIC AVAILABILITY

A viewer wants to know if the treatments given to President Donald Trump are readily available for the general public.

“After President Trump got Regeneron, two basically competing drugs came onto the market--Regeneron and the one from Lilly, the company Lilly, came out into the market. They’re monoclonal antibodies. We’ve been giving it now for over a month. We’ve given it to over 200 people in the state of Wisconsin, with pretty good results. It’s important to understand it’s not the average person that qualifies for it. You need to be of a certain age or risk factors. The president was of a certain age, he qualified, so he got it. Then it got through FDA and now more and more people are getting it. Every morning, we’re calling patients who qualify for it and trying to get them in to get it.”

RETIRED HEALTH CARE FOR VACCINE EFFORT

Are retired health care workers needed to help with the COVID-19 vaccination effort? Are the hospitals hiring?

“Great timing, had a meeting on this yesterday, and yes we are. We actually have jobs posted, because we know that now that we’ve gotten three weeks of experience in vaccination, we need more people. We need to scale up. We’ve got jobs posted and we’re reaching out to those who’ve retired to come back and to help us out, and the response has been great. If you’re retired and want to come back into the game, jobs are posted.”

ORGAN TRANSPLANTS AND COVID-19

Are organs from a person who dies with COVID-19 still viable for transplant?

“It’s a great question. It’s somewhat of a complicated question that’s been worked on since March. So the American Society of Transplant Surgery has been looking at this since March. We wanted to make sure, that obviously, there’s a balance. The safety of transplanting an organ that may be carrying a disease to the person on the receiving end that if they don’t get an organ soon, they may pass away, so there’s a balancing act that needs to be looked at. Every case is individual. It’s also important to understand if that person passed away of COVID, was that the cause of death and was there multi-organ damage in the process? So not every organ will be good for transplant. You have to remember that this virus affects more than just the lungs. You see clots in the heart. You see clots in the kidneys, in other extremities. So maybe just eyes and skin can be donated. What they haven’t shown, in a good way, is nobody’s actually gotten COVID from a transplanted organ that they knew where somebody was positive. So there’s no actual proof of that blood transmission. Remember, our total, and the population we’ve done this in, is extremely small. The research isn’t great, so it’s really done on a case-by-case basis, and that’s what the society recommends right now.”

RADIATION TREATMENTS AND VACCINE

Is OK for someone on radiation to get the COVID-19 vaccine?

“It’s important to understand what else you have going on, other than radiation, at that time. Radiation in itself is not a contrary indication to getting the vaccine, but you need to be able to mount an immune response. So if you’re also concurrently getting chemotherapy or coming off or about to start, that’s an important conversation with your oncologist to make sure the timing of it is planned well so you can be vaccinated and be protected. But the majority of people, over 90 percent, should be able to get the vaccine at that time.”

FLU SHOT AND COVID VACCINE

Is a flu shot required before you get the COVID-19 vaccine?

“Not required. Highly recommended that you get both. But it’s important to remember that flu shot and that COVID vaccine need to be separated by 14 days. So you’ve got to plan out your life, because you need a second COVID shot 21 [Pfizer] or 28 [Moderna] days later, depending on which shot you get. So you’ve got to squeeze a flu shot in before or after or in between. It’s highly recommended, since you’re likely not going to get the COVID vaccine in the next couple of weeks because of the rollout, that you get your flu shot now, so you’re ready for that COVID vaccine in two weeks.”

HEALTH CARE WORKERS AND VACCINE

Some health care workers are opting not to get the vaccine. Should patients take precautions when going in for treatment?

“It’s important to understand that most of health care just got offered. So, when you look at only half the people got it so far, or maybe they only had the operations to give it to half their people yet, so the denial rate is, I think being a little exaggerated in the press, and we’re seeing that definitely. But it’s also important to remember that we’re not stopping our protective measures for a very long time. Our full PPE, personal protective equipment, that’s to protect me and to protect you. So we’ll be wearing that for the foreseeable future to protect you. So the health care environment is still one of the safest places you can go to because of the precautions we take.”

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