Joining Idaho Matters to give us the latest in coronavirus news and research, as well as to answer your coronavirus questions, is Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho coronavirus taskforce.
Have a coronavirus question you want answered? Tweet or email us: idahomatters@boisestate.edu.
Read the full transcript here:
GAUDETTE: You're listening to Idaho Matters, I'm Gemma Gaudette. As Idaho continues to break records with COVID-19 cases, we do want to make sure that we are keeping this pandemic in the conversation, even in the midst of this election process. So joining us for the final 30 minutes of our program today is Dr. David Pate, former CEO of St. Luke's Health System and a current member of Idaho's Coronavirus Task Force. And if you do have questions, please email us now at idahomatters@boisestate.edu. And we will do our best to get them answered. Dr. Pate, I want to talk a little bit before we get into listener questions, because we actually have had people emailing us about this, is this idea of hospitals making profit on COVID-19. There is a narrative being played out that hospitals across the country are inflating numbers so that they can make money on this. I want you to talk about how this is just flat out not true. And I think--.
PATE: Well, that's correct.
GAUDETTE: It is, and it's so critical that we talk about this.
PATE: Yeah, Gemma, thank you so much. You're absolutely right, I think this narrative probably evolved to try to give people the sense that our pandemic is not as poorly controlled as it is. People aren't getting as sick as they are. And unfortunately, in an attempt to propagate that message, the blame has been laid at the feet of the very people who are working day and night, weekends, holidays to care for these people. And I have to say, I take personal offense at it on behalf of all the health care workers. Let's understand: First of all, if a hospital were to do what was being alleged, that is a criminal act. If you misrepresent and inflate codes of diagnoses in order to be paid more from the federal government, there are extremely burdensome fines that can be alleged against you and criminal charges for doing so. This is a very serious allegation to be making. And frankly, if the president or anybody else spouting this truly believes that, then two things should be happening. Number one, his Justice Department should start seeking indictments of these hospitals and doctors that he's referring to. And if it's under investigation and those indictments haven't been sought yet, then he shouldn't be speaking publicly about it. So that's why I don't think any of this is serious. Could there be a hospital or a doctor out there doing something in this regard? Certainly that's possible. I would have no way of knowing. But I can tell you that this would be a this is a huge deal to allege that health care professionals are doing this. It would be a criminal act. It would have tremendous financial penalties. And frankly, it's just a terrible accusation to make without any basis against the very people who are our heroes today.
GAUDETTE: 100% Dr. Pate. I mean, these health care workers have put their lives on the line since this started. Putting themselves in harm's way, putting their families in harm's way, sometimes not even living with their families during this to keep their families safe. Beyond that, I think it's also important to be clear that where many hospitals, including the local hospitals in Idaho, make their money on elective surgeries. They're once again having to pull back from elective surgeries because we have so many people in the hospitals with COVID.
PATE: Well, you're absolutely right, Gemma, if hospitals were approaching this purely from the standpoint of how do we make the most money, it's not by treating COVID patients. It would be, as you say, having their normal activities, the elective surgeries and procedures and so forth. That is not what is happening. In fact, most hospitals across this country have suffered financially because of all of this and in fact, some hospitals have closed due to the financial pressures and Idaho hospitals are not immune from this. So I think it's a very irresponsible, reckless dialog that, you know, if somebody wants to try to make the case that COVID is not a big deal and certainly many have and are, they're certainly free to do that. But let's not drag in hospitals and health care workers who, frankly, are going to extreme odds in lengths to try to help people and be there even under these financial pressures, and to make an allegation that they are taking advantage of a public health crisis, and somehow doing this for financial gain is just very repulsive and is irresponsible. If somebody has evidence of that, they should come forward with their evidence, don't make baseless allegations. None of us want to be accused of wrongdoing without any basis for that is just irresponsible.
GAUDETTE: I want to get to some listener questions now. And Jeff wrote in and has these questions:
LISTENER QUESTION: Many people say the number of cases are up because of the increase in testing. Please explain why this is not the case.
PATE: Yeah, so that is a good point, because that's another false narrative, is that, of course, we have more cases because we're doing more testing, when actually we can and do measure both the amount of testing we're doing and the amount of cases we're doing. And what we are seeing is far higher percentages of people who are positive for coronavirus. In fact, our state's testing positivity rate right now is 14%. We should be alarmed at anything over 10. And certainly what we want to do is get that number down to about under 5. Probably in the 1-2 range is where we ought to be striving for. So what we know is, yes, we are doing a lot more testing, but that testing is just trying to keep up with all the cases that there are. So we do know that cases legitimately are increasing, more people are getting infected, and we see the end result. More people are in hospitals and more people are dying.
Just one last comment to put this in perspective. I was just looking at the numbers again recently, the numbers that of new cases that we're hitting today, and if we think back to the first peak we had back in March when we were all very alarmed, the numbers are almost six times higher today.
GAUDETTE: Wow, Dr. Pate, this person wants to remain anonymous and here's their question, they say:
LISTENER QUESTION: I have heard that the vaccine itself is only 70% effective on those who take it. In other words, of 10 people who take the vaccine, three of those 10 will be unprotected, as if they never got the vaccine. Is that accurate? We should also clarify, Dr. Pate, that we don't have a vaccine yet.
PATE: Well, that's exactly right, Gemma. So, no, this is not accurate. I can certainly imagine where this came from. And that is in our vaccine trials, which are going on right now, what they set for a threshold of effectiveness was 70% for most of these trials. So that's probably where that number came from. That doesn't mean that when a vaccine is approved or authorized, that is only going to be 70% effective. It just means that our threshold for even having a vaccine to approve or authorize and frankly, that would be quite good. However, we are seeing early indications that suggest that at least one vaccine may be far more effective than 70%. But as you said, Gemma, we don't have any of those yet. Those studies are still underway. We do expect to see some results from one of the first vaccines likely to get approved at the end of the month. And we'll know better.
But let me also say that where this gets misconstrued is that when we talk about this 70 or 80 or 90 percent effectiveness, whatever it turns out to be, that does not mean it is zero for everybody else as this listener is suggesting. In other words, take our influenza vaccines. Our influenza vaccines are never 100 percent effective. Yet even for those people that get the vaccine when we don't have a perfect match, it often confers a great deal of protection. It just means that when if they do get sick, they typically have milder illness. So I would not use the effectiveness to be an argument against getting the vaccine. And actually, I'm quite encouraged that the effectiveness is likely to be even higher. But the big point is we want to get as many people immunized as possible because the more people that are vaccinated, the more immunity we do have in our communities. And that is what will help bring the spread of this virus to a screeching halt or at least to low levels.
GAUDETTE: Right. Dr. Pate, Listener Mike has this question. He says:
LISTENER QUESTION: Back on October 1st, Governor Little held a news conference where he said rapid COVID tests have arrived in Idaho and that schools and teachers were to be the first to get them. I'm a public school teacher. I have not heard anything about these tests from my school, my school district, the governor's office or Central District Health. Do you know where these tests are and why we have not had access to them?
PATE: Yes, so we did receive 35,000 of the rapid tests here. There are some restrictions on how they can be used. For example, one thing that we're trying to work through right now is that the FDA has only authorized their use in symptomatic people and we'd really like to be able to use it in asymptomatic. So we're trying to work through that. But it's going to be different in each public health district. So what has happened is those tests were distributed to the various public health districts and the public health districts had to decide whether in taking those tests, they could also provide the staffing to perform the tests. And I don't know the decision that each public health district, we have seven of them in Idaho, has made. But Central District Health decided that it did not have the manpower to be able to administer these tests. So what is happening right now is that there are discussions about, instead of Central District Health doing the testing, that those tests might go to providers. So I am under the impression that the federally qualified health centers are getting some of these tests. And I am under the impression that Central District Health is in discussions with certain other provider groups as to whether they might be willing to administer those tests for the school district. Ideally, I would love if those tests could be performed at the schools. But another requirement from the FDA is that these tests must be done in a laboratory that has a certain federal designation so schools would not be eligible to do the testing themselves.
GAUDETTE: Speaking of our health districts, Dr. Pate, another listener who wants to remain anonymous, asks:
LISTENER QUESTION: If you could give your thoughts on Ada County Commissioner Diana Lachiando being defeated last night. She is on the Central District Health and she has been a proponent for mask mandates, for other issues surrounding COVID. Your thoughts?
PATE: Well, I'm a bit heartbroken. I have really appreciated Diana's leadership. I know she was very concerned about doing the right thing because it might not be politically well-received. And, of course, it appears it was not. You know, I applaud her because I think that these days we need leaders of either party to do the right thing to help protect people and help benefit people without regard to simply what's going to get you reelected. Unfortunately, when someone like Diana does not get reelected, this just reinforces to leaders that it's not about doing the right thing. It's about doing whatever the most vocal or the largest contingent is going to turn out to vote against you is willing to do. So, I personally, it's a terrible loss. And second, I think it's a terrible sign for where politics is going. Not to say that we haven't dealt with these kinds of issues in the past, but right now it would sure be nice to reward legislators for doing the right thing. And unfortunately, that didn't happen in this case.
GAUDETTE: As she said, we do hard things and we do them for the right reasons. And, yes, we would hope that our elected officials would do that. Another question from a listener, and I think this is really interesting, Dr. Pate she says:
LISTENER QUESTION: In talking about getting the flu vaccine with our 12-year-old, he said kids at his school were saying the flu vaccine just infects you with the virus. So do you have advice on explaining to this age group? I'm assuming she's meaning middle school kids how the flu vaccine works and why it's important.
PATE: Yeah, so this has been long-standing. Just as we have dealt with many myths about coronavirus. I mean, all through my practice, I dealt with these myths around influenza that if you get the flu shot, you can get influenza from it, or I got the flu shot and I'd never gotten flu before, but then I got the flu or any number of things.
But the flu shot is killed virus. In other words, you cannot be infected from the flu shot. Now, there is one other preparation of the flu vaccine that does actually have some what we call attenuated virus, where it certainly is possible that you could get a very mild case. But the flu shot that we all talk about, that you cannot catch the flu from that, that you cannot get sick from that, from the flu, you can have side effects. And commonly people get sore arms and those kinds of things. But you don't get the flu from it. And what I would say is to kids in that age, it's really important to get the flu shot. And the reason is, whereas in coronavirus, it doesn't appear yet that students are a major mode of transmission of COVID in schools, probably because of the precautions schools are taking. But that is not the case for influenza. In influenza, school children are every year a major source of spread of influenza. And so, again, while children tend to do in most years very well with influenza also, although they do typically do worse with influenza than coronavirus, the big risk is again that those children are going to take influenza to their homes and infect people who will have severe outcomes from influenza. So we encourage everybody to get flu shots. Plus, it's just an added importance this year because as you and I have talked about on many occasions, Gemma, our hospitals are very busy right now taking care of COVID, some hospitals in Idaho are struggling. And anything that we can do to reduce the burden that they're going to have to deal with with influenza and other infections is only going to help.
GAUDETTE: Right, and you can still get your flu shot now, even though we're early November.
PATE: Yeah, yes, yes, we're already seeing cases. So please go get your flu shot now if you haven't already. It takes about two weeks to mount your full immune response. So you need to be careful. But if you get the shot, it will help prevent you from getting the flu. Or if you do get the flu, you'll have a much milder case.
GAUDETTE: And speaking of that, we have some breaking news. The Idaho Department of Health and Welfare just reported that Blaine in Twin Falls counties have had their first two flu-related deaths this season. They both had COVID-19, a Blaine County man over the age of 60, a woman over 80 from Twin Falls County. Those two first flu-related deaths of the 2020-2021 season. So one more reason to get that flu shot. Dr. Pate, thank you so much for your time today. Really appreciate you.
PATE: Thank you, Gemma.
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