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Dr. Rai on declining COVID numbers and the need to stay vigilant

Published: Feb. 16, 2021 at 7:34 AM CST
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GREEN BAY, Wis. (WBAY) - Key COVID-19 numbers have been on the decline in the United States, but we’re still not under the peaks of previous surges.

Prevea President and CEO Dr. Ashok Rai says we need to keep our masking and distancing.

“But it’s a really good sign, a really trajectory. And it’s because people are doing the right things,” says Dr. Rai.

Dr. Rai joins us Tuesdays and Thursdays on Action 2 News This Morning. Have a question? Email news@wbay.com

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

DECLINING NUMBERS

“So if you look at the nationwide total cases they’re definitely going down, and that’s a good thing crossing that 100,000 barrier. It’s important to know, and I actually saw this graph online, that as we’re going down we’re still not below the peaks of previous surges, Wisconsin and the United States, actually, as you look at the country. And the concerning part about that is we’re not at that summer lull where we were at and it quickly could change directions. But it’s a really good sign, a really trajectory. And it’s because people are doing the right things. You’re seeing a lot more of states agreeing to masking. That’s helped a lot. The physical distancing, just the education has helped. A lot of people have been infected, unfortunately, but as every single peak in surges has shown when that happens, people start to somewhat wake up around them, start doing the right things. We just can’t take the foot off the gas right now. We need to continue that downward trajectory because it’s still not low enough.

“This would be pretty early to say that this is vaccine related. Obviously, you know, a lot of the 1A, the health care workers that were vaccinated, they’re now through their two weeks after their second dose, so you’re starting to see some of the effect with them not becoming infected and adding to the numbers. But we’re not that big of a work force to make that big of a dent. We’ll start to see that vaccine effect in the coming months, but we need to give that time. That’s why the masking and the distancing and everything we’ve said for this amount of time still needs to be there.”

VACCINE SUPPLY

“So the state’s been really good at working with us. I want to give them credit. Now we’re not getting one-week supply chain updates, we’re getting it in two-week increments. So we’ll be able to start opening up schedules into March--probably next week is when I think we’ll start to look at that. I’d say it’s gotten a little bit better--not to the degree we need it to be. Our last request-and we’re a large site requesting, if you look at the UWGB site, we obviously have more sites than that--you’re getting about 37-38 percent of our capacity is what we’re getting allocated, so there’s a lot more capacity that we could do. But we’re being patient. We understand that some is better than none. To be able to give 1,000 shots-a-week is better than giving zero. Now to be able to give 2,000 shots-a-week is better. We hope that that just keeps going up. If you look at the timeline from the manufacturers, I’m just trying to figure out where that gap is, because they’re supposed to have a lot more to us. Where is that going?”

A BIG DAY FOR SHOTS

“Thursday will be even bigger. We’ll go over 1,600 vaccinations today at UWGB alone. And that’s because now we’re giving second shots plus the first shots. But it’s still nowhere near our capacity. But it will be a busy day there. We’ll continue to improve every single day. We learn every day. The weather hasn’t been fun in this process.”

FEDERAL SITES PROS AND CONS

“I think the ultimate pro that everybody needs to understand is a shot in an arm is a good thing. Everybody vaccinated is a good thing. The concerns I have around it is that going to take away vaccine supply from infrastructures that are already set up that have communities that are ready to vaccinate, such as Brown County, such as Sheboygan, such as Marinette that will be set up. So I’m concerned around that. We’ve always talked about you need to do it at scale but you need to do it right. Fifteen years ago, the federal government told us physicians you need to have an electronic medical record and over the next 10 years we’re going to penalize you if you don’t use it correctly--it’s called meaningful use, it was a law that was passed. Yet they’re going to out and do this without communicating into our electronic medical record when our patients are vaccinated. That’s a concern to me. If you’re going to do it big, that’s great. But do it right. Observe the patients in an area where it’s safe to observe them. Have the right medical equipment to take care of something that happens wrong. Register them in a HIPPA-compliant manner. And make sure that information--because that’s a medication, a really important medication that we’re giving--gets into a medical record. I don’t think the federal government has done all those steps that we do in health care and they haven’t really coordinating with us either.”

TIME BETWEEN DOSES

A viewer is receiving her second Pfizer dose after 19 days instead of the recommended 21 days. Is that safe?

“It’s safe and the vaccine will work for you. The ideal time period, and most providers, vaccinators should commit to this, to doing 21 days for Pfizer, 28 days for Moderna. There are occasional situations that happen. A winter storm, or something that would happen around supply that that date might change. The CDC does give you a four-day window on either side to do that. But the research really was based on 21 and 28 days, but the CDC says a four-day window on either side is acceptable under very certain circumstances. If that appointment needs to be moved, once again we have a weather situation or it’s a supply situation, that would be allowable.”

FERTILITY ISSUES?

A viewer heard the vaccine may be linked to long-term fertility issues for younger people? Is that true?

“This is one of those wonderful social media rumors out there. The Facebook medical school created it. It’s unfortunate. The spike protein that this vaccine is created to aim for on COVID-19, some say it’s similar to that of a placental protein. Yes, there are some similarities, but not similar enough for the vaccine to affect the placenta in any way. It’s actually interesting that people have brought this up because people in trials that got the vaccine got pregnant. That was noted as well. Really, the OB-GYN societies have come out and said those two proteins aren’t similar enough to create that effect. It’s more of, once again, an unfortunate story that’s been put out there. Not true. It’s not going to affect female fertility.”

VACCINE EFFICACY AND WEIGHT

Does a person’s weight impact the efficacy of the vaccine?

“There are definitely some drugs and some medications that are weight-based. This is not one because of how it works. That platform, that messenger RNA platform. It only takes a little bit, no matter if you’re a 350-pound person or an 80- pound person, it only takes a little bit to create just a few of those spike proteins for your immune system to respond to. It’s not a dose-dependent medication. It’s not a size-dependent medication. So you shouldn’t be worried that it’s the same dose as somebody larger. The mechanism of action is the same. It’s actually a very small amount of medication being given to you, no matter what your size is.”

WHEN WILL WE BE SAFE?

A viewer wants to know what percentage of vaccinations we need to reach to feel safe again.

“It’s more of an educated guess-type of question than it is one I can give you an exact number. The reason for that is it’s not only looking at the number of people that have been vaccinated, the number of people that have had COVID-19 on top of that that may carry some immunity--and that number is a little harder to peg because not everybody got tested like they should and we had asymptomatic infections out there--so there are definite computer models working on it. Some are really well published models by very intelligent people that have been trying to peg that number. So people would say, anywhere from 60 and 80 percent, which is really broad range, should get vaccinated for us to move forward and feel safe enough that the level of serious infections would be down in our community, that the burden of disease would be down in our community. When will that happen? Some computer models project end of July. But a lot of it has to do with the volume of vaccine we can get into people’s arms. Which really is a supply issue, not a vaccinator issue right now.”

VACCINE DOCUMENTATION

Do people get vaccine cards after the second dose?

“Well guess what, you get a little card that shows it. You’ll get a white card from the CDC. Do not throw that away. The good part is, like if you get vaccinated through your health care provider, that’s also put into your medical record. But in certain circumstances if you go to a pharmacy or say a state site or a federal site, that may not go into your medical records, so you want to make sure you get that card to your physician so it can be documented as well. It’s a white card, has a couple of lines on it. One is it tells you the date you got vaccinated on. The other is it actually has a label or somebody has handwritten the lot number and the vial of that vaccine just in case there was ever a recall they would be able to do that. On the backside it’s your appointment for your second shot. It’s a little white card that has the CDC logo on it and you can have that. More importantly, it’s really important if you did not get your vaccine through your health care provider that you get that card at your next appointment to your doctor so they can put it in your medical record. It’s important to know who’s been vaccinated and who’s not. The only real way to find that is through your medical record.”

BOOSTER VACCINES

As time goes on, will people need to get booster vaccines?

“I think only time will tell. We don’t even know the length of protection of this vaccine. Most hope it’s over a year. It may only be a year. Will it be a booster-type situation? Will it be redoing the sequence? Remember, we have not only two vaccines that are going to be there within the year, we are going to probably have five or more different vaccines for COVID-19. So it may be a different set of rules for each one. So we’ll see is probably the best answer I can give you.”

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