ast: COVID-19 modeling shows 100,000 people in the U.S. could die over the next 3 months

coming up on mayo clinic q a we have over a hundred and one thousand americans in the hospital with covet many of them fighting for their lives in icus and on ventilators the vast majority of those are occurring in people who are unvaccinated so this is an argument a continuing argument for the immense importance of getting fully vaccinated to prevent this carnage while the vaccines for covet 19 have been proven safe and effective there are still those who are unsure misinformed or just don't believe in them what could this hesitancy mean for our future protection against covid and its variants what i think is going to happen is that we're going to be plagued with this it's impossible to speculate how many more variants might arise and kind of torture us like this for the next year or two or longer until we think settles down into a more seasonal type of infection so our failure to contain this means that we're going to be immunizing against it through the rest of our lives and our children's lives and the generation after that welcome everyone to mayo clinic q a i'm dr helena gazelka we're recording this podcast on monday august the 30th 2021 the fight against the delta variant continues as hospital systems in many parts of the country are strained with caring for patients with covet 19. it still holds true that nearly all of the people who are being hospitalized however have not been vaccinated well here with us to discuss the latest is dr greg poland our weekly a visitor and expert uh on all things virology vaccine and infectious disease welcome back gray thank you elena you know after more than a year of this we're not visitors we're family that's right that's right and greg i see that you are back in your natural habitat today yes that gives me a little bit of comfort got a little bit of moving around hard to believe we are touching right on september already isn't that something here in here in rochester you know greg a lot of the kids are going back to school today i think they've staggered it some for different ages but it's just there was a crisp chill in the air this morning and i thought it really is fall yeah it's fall pretty amazing well tell us what is happening in the world of coven 19 greg well you know again as we as we have predicted uh is is exactly happening we have over and one thousand americans in the hospital with covid many of them fighting for their lives in icus and on ventilators we're having over a hundred and sixty thousand new cases a day and just below a thousand deaths per day and as you mentioned uh the vast majority of those are occurring and people were unvaccinated and occasionally in people who were vaccinated but who either genetically or because of other medical issues they have didn't respond well to the vaccine so this is an argument a continuing argument for the immense importance of getting fully vaccinated to prevent this carnage greg how are the numbers for vaccination in the united states and what about numbers of individuals who are eligible to have a third dose at this point yeah we don't know uh how many have taken advantage of getting a third dose at this point it's just for immunocompromised individuals that's a group that generally has been very highly motivated for obvious reasons and i and i think we'll have very high rates of compliance there we have about 50 percent of 12 to 17 year olds that have gotten vaccinated we're about 53 percent of the entire u.s population so that's everybody and obviously people below the age of 12 can't get vaccinated and if you look at adults who have gotten at least one dose we're at about 71.72 percent

so those are numbers that are nowhere near hurt immunity so for the people that have gotten vaccinated good on them they have substantially protected themselves including against the delta variant for those that are unvaccinated there is grave concern in fact if you look at the latest model in the next three months the model suggests that another 100 000 americans are likely to die of covid greg i've been a little dismayed by the lower numbers of vaccination in uh teenagers who are eligible to be vaccinated and i admit that i am not familiar with uh the social media pressures or or what might go into pressures on teenagers as they're making that decision i know that you and i have been contacted by a number of parents and grandparents saying i don't want you know i'm letting my child make this decision um and uh what do you think of um where we are with uh vaccinations and teenagers compared with uh older adults yeah yeah it's a it's a very mixed bag as as you're suggesting part of it is the limited number of vaccine choices so that that i hope will uh improve shortly but you know like any important life decision uh you would hope that parents are influencing their children and giving them proper information the dilemma occurs for a child or a younger person like that who may well know something about the data and is inclined to get a vaccine and yet may have a parent or parents voicing anti-vaccine sentiment or vaccine hesitancy that puts a child in in a big dilemma and yet we have seen a sharp sharp increase in the number of cases among uh kids the number of hospitalizations in people 18 to 30 years old so this is serious business this isn't oh i wonder if i should get a vaccine or not this is your health your well-being and so i so i hope that younger teenagers will take advantage of of getting a vaccine greg i have often wondered whether there's a lack of understanding at times of what it looks like to be a patient hospitalized with covid19 and what that actually that process is like and how ill these patients sometimes are in uh that people are refusing vaccines who could end up in that situation themselves reminds me a little bit of i think it was the 1980s when they had these anti-smoking campaigns where they would show terrible pictures of people who were deformed after having surgeries laryngectomies etc for lung cancer and i thought you know it's really hard to comprehend i think sometimes when you're young and you feel sort of um very strong and that that things like this could happen to you yeah you're right helena i i i wish in many ways that we could take cameras we can't because of patient privacy but i wish we could take cameras in and allow people to see what happens what it's like to have a plastic tube down your throat and ivs in you with no privacy what it's like to be in the hospital on oxygen and feel miserable you feel like you're going to die we just had in our own family in our extended family a member of our family fully vaccinated who nonetheless did get infected did not have to be hospitalized but you know this person's quarantined for the next 10 days out of any family activities feels miserable and it's it's a real disruption in life and of course that's not accounting for possible long covet symptoms that that would occur so you know somehow we've got to reach people and if that means reaching them emotionally by seeing pictures of reality when somebody's infected i'm for it say greg now that the fda has granted full approval to the pfizer vaccine what future do you see for moderna and johnson and johnson who are under emergency use authorization at this point yeah i think uh the modern data has been submitted to the fda so i believe very shortly in the next weeks we'll see uh that one also be approved johnson and johnson remember got their eu a much later than the other two is submitting their data they'll be delayed past moderna the other thing is that i hope yet in in the next few months we'll have um approval down to age 12 and an eu way down to age six which we we really need i mean it's quite obvious as people have gone back to school particularly where there's not distancing and masking like we didn't already know that was going to happen and profound numbers getting infected getting hospitalized probably some people are aware of a recent news report of an unmasked unvaccinated teacher who spread covet to half her class that's no surprise that is exactly what this virus does speaking of boosters as we have and johnson and johnson when do you think or what is the future of a booster for the johnson and johnson vaccine yeah we we don't know yet they have released some preliminary data showing that after the second dose antibody levels were boosted nine fold which is pretty impressive the the real question surrounding boosters is yes we know that we can raise antibody levels what is not as clear is does that lead to increased protection which really is winding back to the question of are we seeing increased rates of infection because of the amount of time that has lapsed since the second dose of vaccine or because of a much more contagious variant the delta variant or some combination of the two and when we focus on antibody levels we're really ignoring a major and important arm of immunity which is cellular immunity which is a very powerful arm of immunity and i think that's why what we're seeing is exactly what you said helena we're not seeing people who have been fully vaccinated otherwise healthy get severe disease or die that is extremely rare do they get asymptomatic mild and even moderate disease and a small percent be hospitalized yes but we always see breakthrough disease we always see waning antibody levels with every vaccine we have so none of that's a surprise so the the real issue going forward is do we need boosters when do we need them and how do we best administer them all of that discussion is happening now there's a been sort of a pre-planned implementation implementation date of the 20th of september some voices saying that may be moved up some saying it may be maybe moved back i think they're still in discussions over these very controversial areas more to come on that indeed i saw a very disturbing um news article that i wanted to ask you about greg because it uh it was about ivermectin being given to individuals um i i can't remember if it was to treat coveter to prevent covet uh tell us about that yeah people are using it for for both reasons you know this is a remarkable thing if i said to you you know what instead of an fda approved vaccine that's been tested in uh hundreds of thousands of people instead let's take a drug that's used to treat parasites and many people are buying it over the counter in in an animal treatment preparation that hasn't been studied for this which makes people sick can cause hallucin hallucinations coma and if you take it when you're pregnant can cause birth defects and let's use that instead and people are flocking to it it astounds me it is astounding this is not approved not advised by the fda it is not an anti-viral drug it's an anti-parasitic drug that that has its proper uses at proper times there have been some reports of effectiveness these have been very poorly conducted trials the cochrane collaboration which has a very strict set of criteria by which they judge studies have said there's no data here to suggest that this is uh effective in fact what's interesting is that the manufacturer of the drug released a statement saying in fact there is quote no meaningful evidence for prevention or efficacy here and despite that here's a stunning piece of information i came across when you look back a year or two ago so at the proper use of ivermectin there were about 3600 prescriptions written in the u.s per week if you look at the last week of august there were 88 000 prescriptions being written per week so this is this is one of those you you can't even believe that you're seeing in hearing this you can't believe the number of calls to poison control centers as people take this drug unregulated often taking the animal preparation which is not fda regulated has other ingredients in it that human forms of the drug do not have and they're getting sick and no benefit it's hard to explain it boggles the mind it really does greg we receive many many listener questions about the uh safety of the covid vaccines and i'm wondering if you could give a little update on what we know um now because we've talked before about the data that is being kept regarding reactions adverse events etc to the vaccines what is known now about the covid uh vaccines versus other very familiar vaccines to us you know the um maybe the easiest way that i can can put it is these vaccines are more reactogenic than something people are very familiar with flu vaccines they are about as reactogenic as the shingles vaccine so that would give people kind of a measure who have taken either of those vaccines so very typically we'll see a sore arm low-grade headache low-grade fever muscle aches maybe swelling at the site of immunization those are all transient they resolve on their own i think what people are concerned about are some of the side effects that can occur guillain-barre syndrome which has occurred in association with the johnson and johnson vaccine that's a transient self-limiting ascending paralysis that can occur so you know pretty scary if something like that happens we've seen evidence of inflammation of the heart or of the lining of the heart called myocarditis and pericarditis respectively those occur at very small rates in fact i'll i'll give some numbers in a while because you you have to balance all of this with the risk of covid and we've talked about this before but i want to emphasize it again if you get a vaccine there are certain risks that you take by getting any vaccine the key is do those are those risks outweighed by the considerable benefits of getting the vaccine and the risks of not getting vaccinated and getting the disease so you know we've got some up-to-date numbers that we can look at this comes from a study that was just published in the new england journal it's a very large study where they enrolled almost a million vaccinated and a million unvaccinated okay so these are called real world effectiveness type studies if you look at the risk of myocarditis after getting the vaccine that vaccine risk was about 2.7 let's just call it three per hundred thousand people okay so three per hundred thousand if you get the vaccine well what if you don't get the vaccine and you get infected with covet well that same risk of heart inflammation goes from three per hundred thousand to uh 16 per hundred thousand goodness so which risk do you want in addition if you get infected there are other risks that you don't run if you get vaccinated heart arrhythmia 166 per hundred thousand acute kidney injury 125 per hundred thousand how about a pulmonary embolus 62 per 100 000 bleeding into your brain eight per hundred thousand so there's this long rif list of risks if you get coven and this teeny short list of risks if you get the vaccine to prevent covet and again that's where i think wisdom comes in people are emotionally swayed i think by saying oh there's a risk of heart inflammation if i get the vaccine and they never stop to consider but what's that same risk of heart inflammation if i don't get vaccinated and again this is true with every vaccine there are risks and benefits just as there is for every single activity we undertake as human beings and the balance is what's important and where you hope people make reasoned decisions rather than emotional ones i'm glad that you specifically addressed the myocarditis i actually had a colleague asked me that just late last week regarding her teenage son should he be vaccinated um because of that that risk and i didn't know what the numbers were i knew that what you would say about um getting vaccinated but i wasn't sure what the um numeric yeah their data was they're very small and fortunately they are almost always short-term transient resolve on their own uh what we don't know is could there be in a very teeny fraction of cases any more serious consequence of that so far other than perhaps a transient arrhythmia nothing else but that needs to be watched long term that risk if it's there will logically be far higher in people who get coveted i've also seen in the news and i've had several people send me articles about someone who died in fact there was an obituary that someone sent to my attention saying that the individual had died as a result of receiving the covet vaccine what is your response to that right yeah again you know let's look at the numbers so and this gets to some complicated uh issues that that lay people might not think of so let's just spend a minute on that there have been 363 million doses of covid vaccine given in the u.s there have been reported to theirs 6 968 deaths so a death rate of 0.0019 percent okay you look at those and cdc has you look at those let's just call it an even seven thousand deaths they have not found any causal relationship between getting a vaccine against covet and death except in the small handful of cases of people who got the j and j vaccine developed a significant clot and then bleeding in in the brain so that association which led them to death as a consequence of that side effect but this idea that and you hear it all the time well uh a bunch of people in a nursing home got the vaccine and two people died well the reason for that is if you look on any given day in the u.s

about 8 000 ten thousand people die every day in the us when you are get doing a mass vaccination program and you're giving right now between a half a million to eight hundred 000 doses of vaccine a day in the u.s by chance alone those 10 000 that are going to die today and the 600 800 000 people you're giving the vaccine to by chance alone that's going to happen in the same timing the trick is to look to see is there any common pathophysiology is there any evidence that the vaccine caused the death and we do not have evidence like that so it's just natural overlap yes and and whatever they were going to die of was what they were going to die of and the vaccine didn't have anything to do with that i had a member of our extended family who chose not to become vex not to be vaccinated and developed covet a couple of weeks ago contacted me late last week saying i was getting so much better and now i'm very very sick again i had no idea that this would go on so long yeah and you discussed that concept of you mentioned the concept of long haulers earlier now we are a year out and more from some of the initial infections and know that individuals can have difficulty even at a year absolutely helena and this is something very much undervalued by people they'll say well you know my friend got coveted and they didn't die they didn't get hospitalized we don't know the long-term consequences of that we've got about a year to a year and a half data if you look at a recent report that came out of china one third of those people still have symptoms a year later oh my goodness often fatigue shortness of breath what people have been calling brain fog inability to work at the same levels they were pulmonary scarring cardiac scarring a host of side effects that you know they they never thought of they thought well it's an issue of am i going to die or not but there's far more at stake than that so what do you see in the future greg i've been wanting to ask you this question because a colleague and i were philosophizing in the clinic between patients last week and talking about will we ever be rid of covid19 and when will we move from this being a pandemic to endemic perhaps and is that what will happen you know i think most of us that study this are now of the opinion that um we we gave up the opportunity to eradicate this we could have if we had used appropriate lockdown measures masking and distancing and then the very soon the introduction of vaccines that did not happen instead in the united states one out of every 500 people have now died of covet and as we mentioned the estimate is in the next three months about one out of every 3 300 people are going to die of covid as a result of this unmitigated transmission and this lack of mask wearing which is just inconceivable to me in the face of a respiratory threat like this we've had many mutations arise we've gone from alpha variant to delta we have beta gamma lambda is coming up another mutant called b1621 that doesn't even have a greek letter yet that is very concerning now causing about 10 percent or so of the cases in miami so what i think is going to happen is that we're going to be plagued with this it's impossible to speculate how many more variants might arise and and kind of torture us like this for the next year or two or longer until we think settles down into a more seasonal type of infection let me just make the point because i think it helps people to understand the 1918 influenza pandemic we are still immunizing against aspects of that a hundred years later so our failure to contain this means that we're going to be immunizing against it through the rest of our lives and our children's lives and the generation after that that's the consequence of not controlling a highly transmissible variant like this that is really interesting to me greg because someone had said to me very recently well we just need to do what we did in the spanish flu of 1918 where everybody just kind of gave up and let it burn itself out and um and then we went on with life that's not gonna happen here and clearly has not happened even though the estimate is that over one out of eight americans has probably been been infected look at the number of cases we have and as you develop new variants that escape previous infection-induced immunity you just keep continuing the cycle and it it raises the question and i i i maybe leave this as a question um that that is now being asked at what point given the tremendous uh medical impact the tremendous psychological and economic impact at what point do you say um this is silly and we will use mass and we will vaccinate because to do otherwise and to keep entertaining crazy theories uh that are that are put up as disinformation on social media and which scare people away from doing the right things how long do you tolerate that and at what cost well you're always good for provoking thought for us greg well it's a backwards plea to say please be wise and use mass and be immunized you know nothing has been studied at the level that these vaccines have been studied it's really remarkable if you can't find your way to a vaccine in the midst of this i'm sorry but you're going to have a lot of difficulties with making good medical decisions about a lot of things and instead we see people engaging in what psychologists call magical or fantasy thinking it was hydroxychloroquine it was uh azithromias it was bleach it was uh uv light it was ivermectin and it's just garlic it's vitamin d it's just one thing after another it doesn't work folks quick this doesn't work vaccine works mass work distancing works what are those that saying that used to if it sounds too good to be true it probably is it's too good to be true and that get-rich-quick schemes don't work so probably probably um get rid of virus quick schemes don't work either it doesn't work thanks for being here today greg any last words for our listeners it was my pleasure uh you know we're going as as we have talked about into a very dangerous face for the unvaccinated this will be accelerated unfortunately by school districts that do not mandate masking we have seen ample evidence of that parents please protect your precious children thanks greg for being here today okay my pleasure and thanks to you two for listening in today please mask up and vaccinate i hope that you learned something today i know that i did and we wish each of you a very wonderful day mayo clinic q a is a production of the mayo clinic news network and is available wherever you get and subscribe to your favorite podcasts to see a list of all mayo clinic podcasts visit newsnetwork.mayoclinic.org then click on podcasts thanks for listening and be well we hope you'll offer a review of this in other episodes when the option is available comments and questions can also be sent to mayo clinic news network at mayo.edu you

2021-09-03 02:50

Other news