As Idaho Prepares To Ration Care, Health Care Workers Receive First Doses Of Vaccine

Dec 16, 2020

While Idaho health care workers received their first dose of the COVID-19 vaccine this week, hospitals remain strapped with patients forcing a possible move to crisis standards of care. And the health district governing Ada, Elmore, Boise and Valley Counties rejected a mask mandate as politics continues to play a big role in public health decisions.

Joining the Idaho Matters Doctor Roundtable to talk about these topics and answer your questions:

  • Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force
  • Dr. Kenny Bramwell, System Medical Director at St. Luke’s Children’s, specializing in emergency medicine and pediatric emergency medicine
  • Dr. Patrice Burgess, Executive Medical Director for Saint Alphonsus Health System and the Chair of the Governor's Vaccine Advisory Committee

Read the full transcript here:

FRANKIE BARNHILL: You're listening to Idaho Matters, I'm Frankie Barnhill, filling in for Gemma Gaudette. It's been a big week in Idaho. The state received its first shipment of Pfizer's COVID-19 vaccine, and health care workers have begun getting their first dose of it. Of course, protecting our front line nurses, doctors, respiratory therapists and many more people is essential while the coronavirus continues to rage out of control in the state. At the same time, public health officials are continuing to urge mask use and social distancing during the deadliest phase of the pandemic, while politicians resist making new mandates in favor of voluntary action and hospitals are prepared to ration care if needed during this deadly phase. Joining us now to talk about all of this and most importantly, to answer your questions is Dr. David Pate, former CEO of St. Luke's Health System and a current member of Idaho's Coronavirus Task Force, Dr. Kenny Bramwell, system medical director at St. Luke's Children's. And Dr. Patrice Burgess, the executive medical director for St. Alphonsus Health System and the chair of the Governors Vaccine Advisory Committee. We will definitely be talking about the vaccine more. Hello, everyone. How's everyone doing today?

ALL: Hi, Frankie. Thanks for having us.

BARNHILL: Hi, Dr. Pate, and yes, and Dr. Burgess and Bramwell, welcome.

Dr. Pate first, I would love to get your reaction first, I guess, to the Central District Health meeting that did take place yesterday. After trying to meet twice before to vote on a possible mask mandate that would apply to Boise and Elmore counties, adding to the mask mandate that's already in place in Ada and Valley Counties. They were able to meet and they did vote, and the vote was three in favor and three against. The chairwoman declined to weigh in, which meant that the motion failed. So that's a news item. I wonder, Dr. Pate, do you think that was the right decision by the board?

DR. DAVID PATE: Well, I don't and first of all, I thought that Director Russ Duke laid out a very compelling argument for why they should extend the order. And at this time, when you look at the effects of this pandemic in Idaho, why it would make sense for two counties within a health district to be under an order and two not to, you know, defies at least my understanding. I also think that, you know, there's just a lot of bad things that have come out of this. First of all, I think the fact that some people have resorted to intimidation and harassment of these elected officials is just beyond the pale and totally unacceptable. So I think that's one thing. I think the other is I actually was quite surprised. I know I shouldn't be. I keep telling myself, don't get surprised by this stuff. You should get used to it by now. But I was quite surprised that two of the commissioners based their decisions not on the science, not on the public health principles, but by what they suggested was the majority of their e-mails. And certainly if we're just going to leave this up to who writes the most number of emails, we probably ought to be clear about that, because I think there are a lot of people in favor of this that didn't send emails because they thought those commissioners were going to vote in favor of it. So obviously, they just heard from those that were trying to change their minds.

And second, if we're going to resort to just what does the majority of people want, then why do we need to have the expense of these public health boards? Why don't we just have the public health districts put out information and then it's whatever the majority of people want to do. If they want to wear masks, though, wear masks. If they don't, they won't. Why do we need to have these boards and why do we need to have that expense? I think that what we have seen time and time again at the national and state and local levels is lots of people that want to be leaders until they have to make a hard decision. And then we've seen which ones have risen to the occasion and which ones have failed us. And so I think it was very discouraging. But again, I'm trying to work on myself to get to the frame of mind where I don't keep on getting surprised by what people do or don't do.

BARNHILL: Well, Dr. Pate, thanks for those comments. And I do want to say that Director Russ Duke did actually say that the majority of the comments they did receive were in support. But it was, as you said, a couple of those county commissioners based it on what they were hearing from folks within their counties, which, yeah, it does create this really interesting tension between, you know, a democratic process or what people are, you know, wanting to weigh in, but then there's these public health decisions, you know, looking to medical experts. And, you know, not everyone in the public has a medical degree or, you know, is a scientist.

PATE: Well, you're absolutely right, Frankie. And of course, we've seen, again, shocking behavior by some of the public health districts. Now, I'm not talking about Central District Health, but by board members that, first of all, don't model the behaviors they say they're giving strong recommendations for themselves. We've seen District Health Board bring in people who are testifying about things that are not accepted science. We have seen board members themselves espouse unscientific and in fact, disproven theories. And so, again, I just think really, you know, the public health system was created back in 1970. I don't think the legislature was considering a pandemic at that time. I think we've seen it doesn't work under a pandemic situation. And I think that, you know, we really have to call into question, should we have people on public health boards entrusted with the protection of those they serve who don't even accept basic public health principles. And, you know, I'm not saying people don't have a right to have their own beliefs and and so forth, but I don't think you should be making public health decisions for thousands or hundreds of thousands of people if you don't even agree with the basic public health principles.

BARNHILL: Yeah, it's a really interesting and worthwhile question to ask. It'll be interesting to see if it does get addressed by the state, you know, someday in the future to remake how it's set up. And those big questions of where does the public weigh in and where do medical and science, you know, take over, really.

Dr. Bramwell, I'd love to have you weigh in on another news item from earlier this week, you're a pediatric doctor. And I know you're closely following the science when it comes to youth sports and what situations are safe for kids to participate in, especially during a time of community spread. You know, for example, yesterday the state recorded almost 1800 new cases, along with 20 new deaths. At the same time, the Boise School District has brought back contact sports, basketball and wrestling specifically. Many parents and students, of course, want to continue playing because, you know, there's obviously positive physical and mental health effects that come along with sports. What do you think about this decision to bring those sports back?

DR. KENNY BRAMWELL: Yeah, thanks, Frankie, that's a great question. We've been following this really closely as I work with Boise school district and I think that they have done a really nice job navigating the pandemic. One of the interesting things that has happened with the Boise school district is it's my understanding that when they modified winter sports, most recently, they were the only school district in the state to restrict sports. And then over time, Central District Health sort of relaxed their stance about the sports recommendations that they had made previously and the Boise school district decided as a board that they were going to return to sports, much like the remainder of the school districts had done throughout the state. It was at that point that the Boise school district leadership spoke with Dr. Nasser and me about the decision that they had made where they basically said, we've decided to open sports back up again. Can you help us come up with plans and processes to make it as safe as possible?

BARNHILL: And your colleague, Dr. Nasser's is someone with St. Alphonsus Hospital is that correct?

BRAMWELL: Yeah, he's with St. Alphonsus. He's a leader, I believe, of their medical group. And he and I have been working together with the Boise School District for a handful of months now, trying to navigate having kids go back to school. So one of the challenges is, you know, I think I think the Boise school district made this decision with an eye to sort of squelch some of the very eager families that needed and wanted sports back, so they made the decision to bring sports back and then Dr. Nasser and I worked with them about making sure that we made things as safe as possible with this return. We weren't really asked, hey, do you think we should go back to sports? Because the answer would have been different from where they landed. But what we were asked is, how can you help us make this as safe as possible since we want to go back to having sports?

So we talked about the importance of masking even during practice. We talked about the importance of distancing. We talked about the need to sort of air out the gymnasium between teams playing. We talked about the importance of cleaning the gym and keeping everybody sick out of practice for quarantining. So we came up with ways to make things as safe as possible, given that they had chosen to reopen the sports. One of the challenges is I think people confused the idea that Dr. Nasser and I supported this plan with Dr. Nasser and I said it was OK and we recommended going back to sports, and that's a rather important distinction. And that was what I was was hoping to draw attention to.

BARNHILL: I see, OK. And so now those sports are back and those teams have been given guidance about how to do this as safely as possible. But again, points to this conundrum of, OK, you're going to do it no matter what, so what is the safest way to do that? But, of course, there's always inherent risk to bring something like this back, contact sports and those particular sports and in fact, you know, have a lot of contact and contact is where the coronavirus lives. Right.

BRAMWELL: Yeah, I agree, these are these are strange times where where people have an almost irrational need to have sports and I get it. Sports are important. I just think that it's part of the sacrifice that we're all making right now. I would love to have normal sports and normal gatherings and normal family time at the holidays. It's just a bad time for all those things.

BARNHILL: Hmm. Dr. Burgess, I'd love to bring you into the conversation and talk a little bit about the vaccine, will have more time to talk about this throughout the program and then in the days and months to come. But as I said in the intro, you chair the governor's vaccine advisory committee. I would just love to get your personal reaction first. What has this week meant to you? You know, seeing the vaccine actually arrive in Idaho and begin to be given to health care workers? What's that been like?

DR. PATRICE BURGESS: You know, it's been very exciting. It's something that we've been waiting for for a long time, preparing for. And sometime it felt like it was just over the horizon and we were never going to see it happen. And so this week was just very gratifying to see the actual vaccine arrive and start to be administered. The data looks really good from the studies. These vaccine trials were very large trials, larger than normal, actually, as far as the number of participants with just very good safety profile as well as effectiveness. So we're thrilled to finally see it arriving in our state and starting to get distributed.

BARNHILL: Have you yourself received it yet?

BURGESS: I have as a frontline worker, not as my position in any other capacity, I actually do shifts at the what we call the FURI sites, which are the fever upper respiratory infection sites where we do COVID testing. I've helped the hospitalist with some shifts and I do see patients in clinic. So I counted as one of the frontline workers. So I received my vaccine on Monday.

BARNHILL: Ok, and it requires two doses spaced out over several weeks, is that correct? So when will for you it be to the point where you can feel confident that the vaccine is in your system and is working?

BURGESS: Well, a couple of things that I really want to highlight from that question. One is, even after the vaccine, we are recommending everyone continue to use the same precautions that we always use in health care and in the community. So masking, social distancing, all of those types of precautions aren't going to change until we have a decrease in community spread and enough people with immunity. So it won't change my day to day life. We do know there's a little bit of immunity after the first dose, but the most robust response is two weeks after the second dose. And the Pfizer vaccine is the one that arrived first. And so it's three weeks from the first dose to the second dose. The Moderna vaccine is the one we're hoping, anticipating will get approved and sent out. And I think it's twenty-six days between doses for that particular one.

BARNHILL: Dr. Burgess, I wanted to just continue our conversation a little bit about the vaccine, as you are the chair of the governor's vaccine advisory committee. And I believe that the advisory committee is meeting again this week to talk more about the vaccine rollout. I wonder in this first phase. So there's the front line health care workers like yourself. And then, of course, there's also the long term care facility residents who are going to receive the vaccine in this first group. And then if I'm getting this correct, it will go to the next category, which includes essential workers like teachers, grocery store clerks, first responders. When do you expect that next phase to occur?

BURGESS: Well, we're still learning as everything anybody that's been working with covid knows things change rapidly as far as we originally thought, we were going to get as many as 40,000 doses of the Pfizer vaccine in the first week. And we got 13,000. So every plan is subject to change. And so we don't know exactly the volume of doses that we're going to receive. But I would anticipate we'll get through that first group in the first few weeks. And so hopefully by late January, February, we'll be moving on to the essential workers and then in the spring onto the next group after that. So again, it's all dependent on the supplies that we get and then we adjust our plans according to that. Our job is really to get those priority groups lined up so that we know exactly where we're going once we get the supply.

BARNHILL: Sure, so for folks who are listening right now going, gosh, what am I going to get the vaccine, it's kind of stay tuned and we will continue to learn more depending on the rollout as it goes on. Is that correct?

BURGESS: Yeah, that's correct. And, you know, the Idaho coronavirus dot gov website has a vaccine tab, and we put all of our information there and obviously will be communicating to each group as we get to that group. But we are very excited to get health care workers, long term care facility residents and long term care facility staff vaccinated. That long term care group is the highest death rate group in that age group and those risk factors. So that can really help protect them and also decrease the burden on the hospitals to open up those beds. So that's a very exciting development.

BARNHILL: And we did just get this question from Karen speaking to what I just mentioned. She says,

LISTENER QUESTION: I'm a healthy 70-year-old woman living in Boise. This is the part that I think is interesting. Will someone notify me of where and how I get the vaccine when it gets to that group?

BURGESS: You know, we're still working through that. Whether, you know, hopefully folks have a primary care doctor, whether we will have the doctors themselves offices reach out, or whether we'll just do a media outreach and say, look, if you're in this category, you are now eligible. Those details are still being worked out.

BARNHILL: OK. And one more question from this one from Barbara, who wonders about data management when it comes to the vaccine as far as, you know, who gets inoculated and who is eligible. Is the state going to keep track of that? Who has received the vaccine? And, of course, with the two doses to make sure that the follow up dose actually occurs.

BURGESS: Yes, so we actually have a great registry, which we've had all along, it's called Iris, Immunization Registry. Now, I don't remember what the I and the S stand for, maybe Kenny or Dr. Pate might remember. But anyway, it's Idaho's registration for immunizations and it's really been more robust for children, but it's capable of tracking adults as well. So we are going to, we are already using that to enter in the first dose and then it will be where we enter in the second dose as well. And that'll keep a very accurate record of who's received the dose. It's very important if your first dose is Pfizer, that your booster dose is Pfizer, you can't mix a match between the different brands. So that's another reason for keeping that tracked carefully. Kenny just sent me a lifeline: Idaho Registry Immunization System. That's what IRIS stands for.

BARNHILL: Oh, perfect. Thanks for helping each other out. And Dr. Pate, I wonder if you could weigh in on this and any other doctor that might have an additional point. Ellen is asking about,

LISTENER QUESTION: What kind of, you know, over-the-counter medicine people should have stocked in their cabinets. Obviously, with so much community spread going on, more and more people are getting COVID and hopefully, you know, getting mild cases of it where they can take care of themselves from home. What should they have? Ibuprofen? Bring down fevers? What should people be eating? Popsicles, keeping them hydrated? What are some thoughts there? Dr. Pate.

PATE: Yeah. So, you know, first of all, people that get COVID can have very different symptoms. So certainly having some symptom relief medications on hand is not a bad idea. You know, one of the most common symptoms is or signs is fever. So having some Tylenol on hand to reduce the fever may be helpful. Other people will have problems with sore throat or cough. And so some of the over-the-counter cough suppressants, you know, probably one of the best ones that is available without a prescription are the ones that have D.M. in the name of them. And because that's dextromethorphan and that's helpful. So is certainly having some of those things on hand is not a bad idea. And of course, if you have special medical problems, you do need to check with your doctor. Sometimes, depending on your age, you shouldn't take certain medications. And sometimes based on underlying problems, like if you have kidney disease, you may not want to be taking a nonsteroidal like Advil or those kind of things.

BARNHILL: Sure, any other doctors have any other suggestions?

BURGESS: No, as always, Dr. Pate's correct, I think the important thing is to not stay home if you're getting short of breath to really seek attention. But a lot of the other minor symptoms can just be dealt with at home, perhaps communicating with your regular doctor, making sure you don't stay home if you're getting more and more short of breath, that's when you really need to seek treatment.

BARNHILL: And this question from Stacey,

LISTENER QUESTION: If someone has already been infected and fully recovered from COVID, can they be carriers and transmit to others? Dr. Bramwell, if you could take that one.

BRAMWELL: Sure. So the question is about if someone has had COVID and recovered, can they be carriers? You know, we think that the times that people are most infectious is two days before they develop symptoms or significant symptoms and then for about seven days, 10 days afterward. So it's really those 10 to 12 days where symptoms are at their peak, where we think that people are most infectious. Once somebody has recovered, let's say they did everything right. They quarantined for 14 days, they recovered and they're fine. We think that the likelihood that they are still infectious is exceptionally low. Unfortunately, some of the tests like the nasal swab tests that we're relying on quite a bit, some people remain positive for some time. And that's where some of the newer saliva tests or antigen tests are much better in the sense that you become negative sooner and you don't stay positive, for some people as long as two months after they have recovered. So the short answer to that I would give you is when someone has done things correctly and quarantined and their symptoms have been entirely resolved for 10 days, we don't think that they are particularly infectious anymore.

BARNHILL: And another question for you, Dr. Bromwell, about children perhaps being asymptomatic. This is from Katie. She asked,

LISTENER QUESTION: My son and his wife have recovered from mild cases. There are two young children, never got sick. Do we assume they were asymptomatic cases? Also, was it safe to be around them after they quarantined for two weeks?

BARNHILL: So I'm guessing that the children were never tested. So we're not sure if they actually had it or were asymptomatic.

BRAMWELL: So my answer to that complex series of things is a reserved yes, I think it's safe with enough time between when symptoms start. So let's say, for example, that her daughter was the first person to get sick. And if you go 14 days out from when that started, then it's OK to be around the daughter again, as long as you're doing the other things that we've talked about with masking and distancing. The challenge is, when can you then be around the grandchildren who may or may not have had symptoms? So I think one safe way to think about it is if her daughter had it and two weeks passed, you would assume that somewhere in there the kids were exposed and they got it. But the kids did not get it at the same time as the mom did. So you have to allow for a couple of quarantine cycles. So like first, let's say her daughter gets it and then 10 days later, her daughter's husband or her son in law gets it. And then 10 days or 14 days after that, the grandkids get it so it can add up enough strings of days, I think you ultimately get to a point where you're about six weeks out and you can I wouldn't go into the house with impunity saying there's no way anyone here can get me sick as much as I think it's very unlikely that they would contract it at that point, assuming that they're doing the things that we've talked about. So you have to add a couple of two week blocks in a row, assuming that not everybody got the disease at the same time, but they got it from each other in a staggered way.

BARNHILL: Right. And Dr. Pate, of course, we're getting a lot of these questions about when can I see someone? Because it's the holidays and people want to be able to visit their families. And we know that that comes with inherent risk. This question is from Marilee and other people have asked something similar:

LISTENER QUESTION: Family, friends, everyone in that family home have all recently gotten over COVID. Can we visit them in their home with the comfort of knowing we won't get COVID from them and we cannot give it to them because they might be immune for a period of time?

PATE: So my answer is going to be similar to Dr. Bramwell that he just gave and the answer is yes, this is probably going to be safe. But if by the phrasing of a question, can we take comfort, if that means can we be assured, then the answer is no. So there's just a lot of complicated factors here. So the first thing is that Merilee says it was recent. Well, I don't know what recent means to Marilee. What does that mean, a few days, or does it mean a few months? If it's a few days, that may be too soon. As Dr. Bramwell was telling us, you know, most people do become no longer infectious after about 10 days. It can take some people longer. And generally we assess that by making sure that they are in isolation for at least 10 days and that they don't get around other people until their symptoms are significantly improved. They don't have to be resolved, but they need to be significantly improved and they should not have had fever for at least 24 hours.

And back to the question you asked me before about home remedies. When we say at least without fever for 24 hours, we mean also that you're not taking any of those medications that we just talked about that might be suppressing the fever. But clearly, there are some people that take longer and there are some people that continue to shed the virus. And we just don't have great studies about just how long they could be infectious, particularly if you're going to be in an intimate setting like in their home. The other thing is, on the flip side, the question about, you know, assuming they're immune, it's a pretty good assumption. But we do know from studies that it's not 100 percent and it does seem to be variable among people. Some people do seem to mount a very robust response. However, other people tend to mount a pretty weak response. And so we have seen people reinfected in as soon as 45 days. So if she meant by recent several months, I could not assure those people that they couldn't be reinfected. And so a complicated answer. But let me just say that to make things simple and I know this is not what anybody wants to hear, but the best rule of thumb, until we can get this disease activity down and get our hospitals de-stressed is really you shouldn't be getting together in anybody's home with people you don't live with. If you do, you're taking risk. This is probably on the lower side of risk, but it's really hard to tell. And without a complicated evaluation of that situation, I just don't know that they can be completely assured.

BARNHILL: Right. Well, thank you so much for taking those complicated questions. Of course, more people will likely be writing into us around the holidays on these topics. And it's just a tough time. And these sacrifices are really, really challenging for folks. So thanks for giving your medical advice on that.

BARNHILL: Dr. Burgess, this vaccine question came in from Theresa. She's wondering with, you know, so many different companies, four companies, five companies, six companies, Of course, there's only one right now that's available in Idaho, the Pfizer vaccine. Is there any reason to believe that these vaccines could interact and create something other than the current coronavirus, she asks?

BURGESS: Well, the vaccines aren't creating disease, I don't know if the question is really about if the coronavirus could mutate, but let me just kind of talk about the vaccines and how they're working. So the front line vaccines, the Pfizer, the Moderna vaccine are what we call MRNA vaccines. And so they're sending a message that instructs our cell to make one of the proteins from the coronavirus just a harmless protein that then our body forms antibodies to and an immune response to, so that when the real coronavirus comes along, we are able to fight it off. So that's how those first two are working.

The subsequent ones, there are several different types that are out there that are not yet up for approval. We think some of them are going to be looked at in January by the FDA and then beyond. Some of those are more traditional, like inactivated virus vaccines that we've used for other diseases. And then some of them package that protein in another virus that's kind of a harmless virus that then transports that to our bodies so that we can then react to the protein. So I didn't really understand about the causing different types of coronavirus, but none of these vaccines have active virus, so they can't cause any coronavirus. They're really designed to prime our immune system to fight off the coronavirus if we're exposed to it.

BARNHILL: And I think you interpreted that correctly as far as just the crux of the question and the fact that, yeah, these vaccines, they don't have the virus present in them. They're acting very differently. This is a new technology, in fact.

BURGESS: And we do have a few live virus vaccines that we've used for other diseases. But there are no, at least not to my knowledge, in the pipeline, live virus, coronavirus vaccines being developed. These are all presenting the protein or there are some down the road that have an inactivated virus for our immune system to respond to.

BARNHILL: Ok, and Dr. Bramwell, Shela asks or says, rather,

LISTENER QUESTION: A letter writer in The Statesman said he was on the fence about mask-wearing because Ada County had a mask order and also had the highest number of cases and deaths. Can you comment on that?

BRAMWELL: Sure. So it sounds like this particular person felt that the high number of cases in Ada County might argue against the need for masks there. But what is probably more important to look at is [misspoke]. So I'm getting my sentences confused here. I'm sorry. The number of cases is always higher in population centers and it's always higher in states that have more people. So one of the dangers is if you look at a city like Los Angeles and you say, oh, my gosh, they have so many more cases than we do, well, it's largely because they have millions and millions of people in 20 square miles and millions of people ten miles beyond that. So I don't think you can make the argument or the leap that the number of cases is an argument against the masks. You would need to look at the rate of illness by population, not just the total number of cases.

BARNHILL: Right. A very important distinction. Those raw numbers versus per capita Dr. Pate, Dave wrote in about this,

LISTENER QUESTION: What happens to vaccine patients where the efficacy isn't there? Or, you know, there is obviously a percentage with the tests of the Pfizer vaccine, the Moderna vaccine, et cetera. What would your comment or your thoughts be about this for the vaccine patients where it hasn't taken or it's not working?

PATE: Yeah, there's a couple of important points here. So these two vaccines the one that's out right now, the Pfizer one and then the one that we expect we might be getting in as soon as a week, the Moderna vaccine, both of those looked to be about 95 percent effective. But let's not be confused here. It doesn't mean that those five percent that got vaccinated didn't get any benefit. It just means they were still susceptible. Both of these trials suggested that even if the vaccine didn't fully prevent you from getting infected, it did seem to in one study it greatly reduced your chance of having severe disease. And in the other study, they didn't have anyone get severe disease who got vaccinated. So I would say that don't get confused when we talk about the efficacy and then assume that when it's 95% efficacy, that that means it's not effective in those remaining five percent. It is still helpful, it's just they are potentially still vulnerable to disease. But the good news is they are going to be much less likely to have severe disease end up in the hospital or even die.

BARNHILL: Hmm. And one final question that we're going to take one more quick break and be back with our final round of listener questions. Dr. Burgess, if you could weigh in on this,

LISTENER QUESTION: How do COVID death rates compare with other causes of death statewide? It seems to me it must be higher and might be a wake up call to people who are doubting the seriousness of this disease. Can you comment on that?

BURGESS: Yeah, I would again refer folks to the coronavirus Idaho coronavirus gov website that has all those statistics. And we also have some statistics on death from out of the ordinary. So we have obviously our normal death rates that happen from heart disease and everything else, cancer, all the things that we die from. And then there's how much more deaths we're seeing based on the COVID situation. And it is significant. And the death rates both in our state and in our country are much higher during this time frame. And rather than try to rattle off the statistics, I would refer you to those websites. But it is a staggering difference. And again, like you've heard, the other issue is our hospitals being full. We don't see that with the flu, for example, we don't see that in our normal death rates. You know, people come and go from the hospital. We usually have a nice cushion of beds available and we are seeing the beds, especially the ICU is near capacity and we just don't normally see that. So those are the differences, I would say, from this pandemic.

BARNHILL: And we're going to take a quick break and be back with our last round of listener questions. I will point out for folks who want to know more about the statistics that were just talked about, coronavirus.Idaho.gov, it includes now a little area that has the vaccine doses that have been administered, which is a new feature on the website up to date right now. 119 vaccine doses have been administered in Idaho. I'm Frankie Barnhill. You're listening to Idaho Matters.

Dr. Bramwell, if you could take this one, Ron had this question.

LISTENER QUESTION: Are COVID-19 treatments like monoclonal antibodies available to higher risk patients diagnosed with COVID-19 prior to the need for hospitalizations? If so, how would these patients access these treatments?

BRAMWELL: That's a great question, Frankie, and some of these therapies, I'm going to mispronounce it very badly if I try to say we're just calling it Bambam, but I think it's bamlanivimab.

BARNHILL: That's a mouthful!

BRAMWELL: Bambam is a lot easier and it goes back to the Flintstones. So, that particular therapy as an example is available for patients who are at high risk of developing complications and it's only recently become available in the last few weeks here locally. What can be done for these patients is probably the best way is they work with their primary care physician and they get an appointment and they get evaluated and particularly early on in their illness before there's a need for hospitalization or an emergency department visit and their physician can work with them and and get this infused into the patient as an outpatient. And there are a couple of different ways that that can work. But, yes, the answer is this particular therapy is available for patients at high risk of complications.

BARNHILL: And so that person, if that were to be a listener right now or someone that they know, they would be in touch with their medical provider about that, about how to access that potentially.

BRAMWELL: Exactly. And that would be something to try and investigate now before the holidays come and before things shut down a bit as far as some of those access points. But it would be good to get that plan in place for not necessarily setting up the infusion, but just how to get that started and how to get that conversation rolling.

BARNHILL: Absolutely, and Dr. Burgess, another question about the vaccine question about roll out and how exactly is being rolled out as far as why a public system of delivery is not being considered. Judy is a nurse and she asked,

LISTENER QUESTION: I worked for a firm that supplied immunizations in Arizona. We operated out of pharmacies, grocery stores, et cetera. Is that something that the state is considering?

BURGESS: Yes, so the rollout plan will be further rolled out and communicated once we get to that stage. I think the issue right now is we have such a small amount of vaccine that we are really focusing -- and the ultra cold storage is an issue as well -- really focusing on that top priority group. But once we get more vaccine, we don't have the ultra cold storage issue, then we will be discussing how it's going to be rolled out to high risk people, essential workers and eventually the general public. I suspect it will be very much like she's describing once we get to that point. This is different than most of our vaccine rollouts. This, remember, this supply is coming from the federal government to the state, then being distributed by health district, much different than what we typically see. And again, because of the limited supply at first and the complications around storage that make this quite a bit different.

BARNHILL: All right. We've been speaking with Dr. Patrice Burgess, the executive medical director for St. Alphonsus Health System and the chair of the Governors Vaccine Advisory Committee, along with Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force. And Dr. Kenny Bramwell, system medical director of St. Luke's Children's. Thanks to you all so much for spending time with us. I know this is a big time commitment, an hour every Wednesday, but we here at Boise State Public Radio News Idaho Matters really appreciate your time and we know that our listeners do as well. So thank you.

ALL: Thank you, Frankie. Thanks, Frankie. Stay safe.

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