Doctor hopes his scary COVID story convinces people to get vaccinated

Health

WPLG Local 10 21 July, 2021 - 03:49pm 10 views

Dr. Daniel Chan, the Chief of Orthopedic Surgery & Sports Medicine for Memorial Healthcare in Broward County, says his entire family caught COVID in mid-December.

He tested positive right when vaccines were just being rolled out to healthcare workers.

“My vaccine appointment was the very day I tested positive and had to remove myself from work and start quarantining,” Chan recalled. “Our 2-year-old daughter had contracted it through her daycare and the daycare was shut down. We didn’t think much of it. At this point, we were very deep into the pandemic. I was going to work every day and wearing PPE and so far had been fine, so we thought this would be nothing.

“Ended up that we, the entire family — my wife, my three children, our nanny — we all ended up testing positive. I had to leave work, the adults started getting progressively sick. It got to the point we had difficulty breathing.”

[ALSO SEE: How many COVID-19 patients in South Florida were vaccinated?]

His wife Eun Chan spent five days in the intensive care unit.

On Christmas Day, as Daniel Chan was on his way to Joe DiMaggio Children’s hospital to get his three kids (ages 8, 5 and 2) tested, he nearly collapsed in the emergency room and had to be whisked across the street into an ICU.

He was in ICU for 12 days, and with both parents hospitalized, a family friend cared for the kids.

“When we should have been opening presents,” said Chan, who had no preexisting medical conditions.

“Even after that my wife and I had a pretty prolonged course of physical recovery,” he added. “It was definitely an eye-opening experience for the entire family.”

Chan tells his story as a way to convince others to get vaccinated if they haven’t already.

“I think the vaccine has a good track record,” he said. “With the current trends we are seeing across the state with the Delta variant and the fact the vast majority who are getting sick now are unvaccinated, I think that is very compelling evidence. I was healthy and still was able to contract and getting very sick from COVID. Hopefully, that helps sway some minds out there who are on the fence or maybe skeptics about the vaccine.

“In light of current events with COVID making a resurgence, and its skewing toward younger patients like myself. I was working out at Orangetheory three times a week at 5 a.m., so I was probably one of the least likely people that people would have assumed would have gotten COVID badly. So if we can convince people that vaccination is a good idea, that COVID is probably here to stay for a while ... we really want to avoid the hospitals get overrun again and everything shutting down again.”

[ALSO SEE: Experts say vaccine hesitancy to blame as COVID numbers rise again in Miami-Dade, Broward]

Memorial Regional’s Chief Nursing Officer Leslie Pollart points out a 125% increase in COVID-19 cases at their facilities since July 1 “and what is really concerning is that 98% of those are in the unvaccinated community.”

“The surge was starting to decline, the numbers were starting to go down and this is at a time when all the staff is tired from working so hard and they were all looking forward to family vacations, time-off, a bit of a reprieve,” Pollart said. “And now it is surging again.

“Please get vaccinated. I know there is a lot of disinformation, please talk to our doctor. While there is information that getting vaccinated may not completely prevent you from getting COVID, we do know it will keep you from getting severely sick.”

Pollart added that at this stage, the COVID patients are younger, with about 60% of them under age 60.

“It is a younger patient population and when they are unvaccinated they have a higher severity of illness,” she said. “Help our community stay safe. Let’s get this surge to decline so that we all can go back to somewhat of a normal life.”

The hospital workers say that it has been such a long fight on the front lines that there’s a certain anguish to witnessing so many sick people at a time of ample vaccine supply.

“It can be frustrating,” Pollart said. “Seeing people so sick and having a younger demographic and knowing a simple vaccine could potentially get all these folks from being in the hospital.”

Chan said that “adds insult to injury at this point,” especially for someone like him, who at one point worried his kids might have to grow up without him.

And the rise of COVID cases can also have an effect on patients with other ailments.

“If the trends continue and we are forced to shut down elective procedures or elective surgeries in the next several weeks, that is going to mean cancer patients who won’t be able to have cancer treatments, it is going to me who are debilated with hip and knee arthritis can’t get their hip or knee replacement done,” Chan said. “As hospitals continue to get full there may be some people who are wary of going to the hospital at all and people dying at home with heart attacks because they don’t want to hospital, so there are downstream effects to COVID continuing to linger in our community.”

Copyright 2021 by WPLG Local10.com - All rights reserved.

Christina returned to Local 10 in 2019 as a reporter after covering Hurricane Dorian for the station. She is an Edward R. Murrow Award-winning journalist and previously earned an Emmy Award while at WPLG for her investigative consumer protection segment "Call Christina."

Copyright © 2021 Local10.com is published by WPLG INC., a Berkshire Hathaway company.

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COVID-19's spread among unvaccinated still main concern

NJ Spotlight News 22 July, 2021 - 03:01am

What Is A Breakthrough COVID Case, And How Big Is The Risk? : Shots - Health News

NPR 22 July, 2021 - 03:01am

There have been a number of recent reports of fully vaccinated people testing positive for the coronavirus — at the White House, Congress, the Olympics and Major League Baseball. And with the fast-spreading delta variant driving up infections, hospitalizations and deaths, a lot of people are wondering whether the vaccines are as protective as we thought.

But the current crop of vaccine breakthrough cases doesn't surprise or alarm public health experts. "I haven't seen any signals in the U.S. indicating that they are occurring at the levels that would give us concern that the [vaccine] effectiveness is going down," said Saad Omer, director of the Yale Institute for Global Health.

Still, people who've been vaccinated may rightly be asking: Are breakthrough cases becoming more common because of the delta variant? Could I get sick or get a family member sick?

Here's what to know about breakthrough cases in the context of delta, and what scientists are doing to track the vaccines' efficacy:

Bottom line: Don't panic. So far, research shows the current vaccines are holding up well against the delta variant. For instance, a June study from the U.K. found that the Pfizer vaccine is 96% effective against hospitalization from the delta variant after two doses.

If you do get infected (which is not likely but possible), the vaccine should help you keep from getting seriously sick. "Breakthrough infections, they tend to be mild — they tend to be more like a cold," said Dr. Carlos del Rio, professor of medicine and infectious disease epidemiology at Emory University.

"Those mild breakthroughs, according to a New England Journal study three weeks ago, are accompanied by lower viral loads and less — much less — symptoms," added Dr. Monica Gandhi, infectious disease physician at the University of California, San Francisco. In particular, the study "showed that if you get a mild breakthrough with any variant, you have a 40% lower viral load in your nose after vaccination than you do if you had a natural infection," she said.

Severe cases among vaccinated people are possible, but extremely rare — the vaccines dramatically reduce the risk of serious illness that leads to hospitalization or death. And 97% of those currently hospitalized with COVID-19 are unvaccinated, according to Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention.

The chances of getting seriously ill after being vaccinated are higher for those with certain health conditions that affect the immune system. Dr. Marc Boom, president and CEO of Houston Methodist, said that at his hospital, 90% of the patients with COVID-19 are unvaccinated. The small percentage of vaccinated patients who do end up hospitalized, he said, "have underlying significant health risks — like cancer, like [organ] transplants — that probably prevented them from mounting a full immune response to the vaccine."

"I think we are misusing the term breakthrough," said Dr. Paul Offit, director of the Vaccine Education Center at Children's Hospital of Philadelphia. "If someone who is fully vaccinated is subsequently hospitalized or killed by the virus, that's a breakthrough case." He said he wouldn't call an "asymptomatic or relatively mild case" a "breakthrough case."

What matters, he said, is "the vaccine is still doing what it is designed to do — keep people out of the hospital and out of the morgue."

There's no exact number of breakthrough cases, for several reasons. First of all, there would be no way to count the asymptomatic breakthrough cases, because the U.S. isn't testing nearly enough to catch them all. And in fact, the CDC stopped keeping a running tally of mild breakthrough cases in May.

But that's not necessarily a problem, said Emily Martin, epidemiology professor at the University of Michigan. "You don't want to test everybody — you don't need every positive to be identified," she said. "You just need to understand how the positives that you're finding represent the whole pie that you're not seeing."

The CDC runs carefully designed surveillance systems (which try to find pie slices that are representative) and does burden estimation (calculations you use to fill in the rest of the pie). It's a process that's already done every year with the flu, Martin said, to assess how well the flu shot is working when the vast majority of people who get the flu are never tested.

Now, the CDC is doing the same thing to monitor COVID-19. Hospitals and health departments are sending the CDC detailed information about certain cases of vaccinated patients who are hospitalized with COVID-19.

"We'd like to have a sample of the virus so that we can understand the viral load, so that we can sequence it, we can understand their symptoms and their risks that potentially put them in that situation," the CDC's Walensky told a Senate panel on Tuesday.

At the same time, the agency is doing ongoing vaccine effectiveness studies at long-term care facilities, academic medical centers, hospitals, and among health care and essential workers. "We're doing many of those studies across the nation," Walensky said, explaining that these allow the CDC to get an accurate picture of the real rate of breakthroughs among vaccinated people and whether that's changing over time.

"That is a more systematic way of measuring breakthrough cases," Martin said. Realistically, health officials can't count every case, so this careful, long-term surveillance, along with calculations to extrapolate those findings, gives a fuller picture of how much virus is really out in the community.

There's basic arithmetic at play: As more people get vaccinated, even if breakthroughs are rare, a rising number of cases will be among the vaccinated.

"Even with a 95% efficacious vaccine, you will have one in 20 vaccinees who are exposed get the disease," said Dr. Kathleen Neuzil, director of the Center for Vaccine Development and Global Health at the University of Maryland. The important thing to note is that "the overwhelming number [of cases] are among the unvaccinated," she said.

Certainly, with the delta variant taking over — which spreads about two to three times faster than the original strain — there will be more cases among everyone, vaccinated and unvaccinated, said John Moore, professor of microbiology and immunology at Weill Cornell Medicine.

"But its ability to infect fully vaccinated people is much less than those who are not vaccinated," he said. "In other words, the vaccines still work, just a bit less well."

Epidemiologist Martin added that there's no clear data yet to show that delta is to blame for a big rise in breakthrough cases in the United States. "We are still watching carefully though," she added.

In general, people who are vaccinated and get infected have less virus. "That lower viral load makes it less likely for you to transmit — not impossible by any means but less likely," Gandhi said.

Dr. Anthony Fauci, chief medical adviser on COVID-19 for President Biden and the nation's top infectious disease expert, told reporters Friday that research on "whether or not the transmission occurs is a large study that's ongoing right now," referring to Prevent COVID U, a study of transmission among about 12,000 college students vaccinated with the Moderna vaccine.

While there aren't yet results from that study, Fauci added, the lower viral load in breakthrough cases suggests "it would be less likely that that vaccinated breakthrough person would transmit, compared to an unvaccinated person."

"We have not seen reports yet of breakthrough cases causing long COVID, thank goodness," said Gandhi of UC San Francisco. One reason for that could be that long COVID involves "a very dysregulated inflammatory response that you get with natural infection," she said. "What you get with an infection after you've been vaccinated, it's what we call a more regulated response or adaptive immunity."

However, virus expert Angela Rasmussen of the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada noted the data on this is limited so we can't completely rule it out.

"The safest thing to do is to avoid being infected altogether, and that's why I think it is appropriate for people to employ additional mitigation measures," she said.

That might mean — in addition to vaccination — breaking out masks again, re-upping good hand hygiene and getting more air circulating when gathering indoors. "The mitigation measures that we have put in place previously will still work against the delta variant — it's not being transmitted by some other route," she added.

COVID-19 Vaccines PSA: Side Effects – Marquis 40 seconds

Centers for Disease Control and Prevention (CDC) 22 July, 2021 - 03:01am

Rare 'breakthrough' COVID cases are causing alarm, confusion

Yahoo News 21 July, 2021 - 03:06pm

The best indicator: U.S. hospitalizations and deaths are nearly all among the unvaccinated, and real-world data from Britain and Israel support that protection against the worst cases remains strong. What scientists call “breakthrough” infections in people who are fully vaccinated make up a small fraction of cases.

“When you hear about a breakthrough infection, that doesn’t necessarily mean the vaccine is failing,” Dr. Anthony Fauci, the U.S. government’s top infectious disease specialist, told a worried Senate panel this week. The shots are holding up, he said, even in the face of the highly contagious delta variant that is burning through unvaccinated communities

Health authorities have warned that even though the COVID-19 vaccines are incredibly effective -- the Pfizer and Moderna ones about 95% against symptomatic infection in studies -- they’re not perfect. No vaccine is.

But it wasn’t until delta variant began spreading that the risk of breakthroughs started getting much public attention. The barrage of headlines is disconcerting for vaccinated people wondering how to balance getting back to normal with more exposure to unvaccinated strangers — especially if they have vulnerable family members, such as children too young to qualify for the shots.

Sports fans are seeing daily reports about infected athletes, from the New York Yankees to the Summer Olympics. With the Games soon to start, Kara Eaker, a member of the U.S. women’s gymnastic team who said she was vaccinated, tested positive in a training camp just outside Tokyo. WNBA player Katie Lou Samuelson pulled out of the Olympics and the 3-on-3 basketball competition after testing positive despite being vaccinated.

And politicians in the nation’s capital are being rattled by reports of breakthrough cases, including from a congressman, Florida Republican Vern Buchanan; some Texas Democratic lawmakers visiting Washington as a political protest; at least two people in the White House and several congressional staff members.

White House press secretary Jen Psaki said Wednesday that with 2,000 people on the White House campus each day some breakthrough cases are inevitable, but that the administration will release information if doctors determine any staffer had close contact with the president, vice president or their spouses.

One critical question about breakthrough cases is whether the person actually had symptoms, Dr. Francis Collins, director of the National Institutes of Health, told The Associated Press. "Or is this somebody just being sampled out of an abundance of caution because they had to go into some place like the Congress?” he added.

Indeed, the U.S. Centers for Disease Control and Prevention has said for months that vaccinated people don’t even need to get tested after a virus exposure unless they develop symptoms. The agency cites limited evidence that they’re less likely to infect others than unvaccinated people who get an asymptomatic infection.

But different places have different rules. In Britain, Prime Minister Boris Johnson -- who survived COVID-19 early in the pandemic and now is fully vaccinated -- began quarantining over the weekend after contact with someone experiencing mild symptoms from a breakthrough infection.

And rigorous testing is required as thousands of athletes, coaches, officials and media -- not all of whom are vaccinated -- descend on Tokyo for the pandemic-delayed Olympics.

While there's not a specific count, it's clear breakthrough infections are rare. As of July 12, the CDC had tallied 5,492 vaccinated people who were hospitalized or died and also tested positive for coronavirus — out of more than 159 million fully vaccinated Americans. CDC Director Dr. Rochelle Walensky has said 99.5% of all deaths from COVID-19 are in the unvaccinated.

There isn't a separate count of mild or asymptomatic breakthroughs, although CDC is tracking those through studies such as one that gives weekly virus tests to more than 5,000 essential workers, she told senators.

Breakthroughs tend to be mild because a vaccinated person's immune system doesn't have to start from scratch to fight the coronavirus. Even if the virus sneaks past vaccine-spurred antibodies and starts replicating in your nose or throat, secondary defenses jump into action and usually, “the virus is stopped in its tracks within a few days,” said University of Pennsylvania immunologist Scott Hensley.

There are caveats. The vaccines don’t work as well in people with severely weak immune systems, such as organ transplant recipients.

And the government is watching closely for signs that breakthrough cases, especially serious ones, are rising, because that might signal the need for booster vaccinations.

But meanwhile White House officials want to “normalize” the concept of breakthrough infections for the public, because they're worried that these rare, inevitable events could play into the misinformation wars that have helped to keep millions from rolling up their sleeves.

“The vaccines were developed to keep us out of those terrible institutions we call hospitals,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “We have to keep coming back to that.”

Associated Press Writers Jonathan Lemire and Zeke Miller contributed to this report.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

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Why 'misinformation' is the wrong label with vaccine hesitancy

The Hill 21 July, 2021 - 06:30am

My first reaction to these statements was: Who decides what constitutes misinformation and what doesn’t? Who is the guardian of scientific truth? The problem with even using the term is that it implies that the person using it knows what is correct and what isn’t. This is particularly difficult with something like a viral pandemic, where the science is evolving, where one set of useful guidelines that initially applies may not apply as well to a new variant, for example, which is more easily transmitted. The science on the effectiveness of masks and the exact usefulness of these incredible COVID-19 vaccines is still evolving.

But it turns out that the word "misinformation" is even more off-putting than I realized. This narrow condescending view doesn’t take into account why people make the decisions they do, especially when it comes to an intervention like vaccines. How does getting vaccinated against a still hypothetical threat fit into their day-to-day lives?

Dr. Heidi Larson, an anthropologist and founder of the Vaccine Confidence Project and author of “Stuck, How Vaccine Rumors Start and Why They Don’t Go Away,” spoke to me this week on SiriusXM about her problem with the term “misinformation,” as well as the ineffectiveness of overly scientific rhetoric applied to what is frequently an emotional decision. “Rather than throw numbers at them, or use our calculations, my view is that you try to listen and hear out and see why they feel that way … I’ve had people say to me it’s one thing to say one in a million but if that one is my daughter or someone in my family, it feels different. But if you let people talk about why they feel the way they are and start to get a conversation around it, it does make the person feel like you are open, that you want to hear about how they feel about it, and it does at least create a possibility.” 

In other words, you need to meet people where they are, rather than where you think they should be. As a doctor, I need to take into account that health care decisions are made based on strong emotions rather than dry facts. This is what I try to do in my own office every day with my patients. Nothing is more off-putting or provocative than telling someone seeking help that their information is wrong.

Larson described her group’s work with the World Economic Forum and their analysis of social media, in which they found that the word “protection” created a much more positive conversation and resonated with people far more than “stop disease or prevent.” Protect was a much more “feel good” term that generated a positive sentiment and was far more likely to lead to discussion and potential compliance. The other end of the spectrum was that if anyone on social media used “moral responsibility” or something similar, it immediately triggered a negative kickback. This is similar to the problem with terms like “stopping disease” or “misinformation,” abstract sterile words that don’t resonate and yet make you feel targeted if you didn’t comply. 

She pointed out that vaccine hesitancy and associated anxiety have a long history, connected to fears of being forced or coerced, that the very first smallpox vaccine prompted the “Anti-compulsory Vaccination League.” And back in the 19th century, many people thought vaccines were against God’s plan. Who were we to be putting something in our systems? Larson wisely cited three main things that have stuck with the public since then: one, freedom, liberty, choice; the second, vaccines are against God’s will and they’re not natural; and the third, questioning the safety of it all.

The solution is to have a conversation, which must begin not with condescension, dry statistics or a desire to correct “misinformation,” but with an understanding of where people are coming from and what their concerns are. My desire as your doctor is to help you protect yourself and your family. The vaccine is a tool to get us there.

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