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'It's A Different Disease:' Idaho Doctor Describes Younger And Pregnant COVID-19 Patients

Virus Outbreak Hospital
Kyle Green/AP
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FR171837 AP
Ann Enderle, R.N., checks on a COVID-19 patient in the Medical Intensive care unit (MICU) at St. Luke's Boise Medical Center in Boise, Idaho on Tuesday, Aug. 31, 2021. (AP Photo/Kyle Green)

COVID-19 case numbers and deaths continue to climb, putting Idaho among the worst in the nation for the rate of new diagnoses.

The state's vaccination rates remain among the lowest in the nation. To make matters worse—some coronavirus vaccines in the state are set to expire soon because they've sat unused for so long. Only about 51% of eligible residents have been fully vaccinated according to numbers from the Idaho Department of Health and Welfare.

Idaho Matters is joined by Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force, and Dr. Rob Cavagnol, St. Luke's Clinic President.

"We're seeing people in their twenties and thirties end up in the ICU on a ventilator. And unfortunately, we're seeing pregnancy is turning out to be a significant risk factor for a bad outcome with COVID. [W]e've got pregnant patients intubated in the ICU and it's just heartbreaking."
Dr. Rob Cavagnol, St. Luke's Clinic President

Read full transcript below:

Gemma Gaudette: You're listening to Idaho Matters, I'm Gemma Gaudette. State public health leaders painted a grim picture again on Tuesday as they held a weekly briefing on the pandemic. Some of Idaho's coronavirus vaccines will actually expire soon because they have just sat unused for way too long, and COVID case numbers and deaths continue to climb, putting the state among the worst in the nation for the rate of new COVID-19 diagnoses. All this as our state's vaccination rates remain among the lowest in the nation, with about 51% of eligible residents fully vaccinated against the coronavirus. This is according to numbers from the Idaho Department of Health and Welfare. So joining us today to talk more about where we are, our Dr. David Pate, former CEO of St. Luke's Health System, as well as a current member of the Idaho Coronavirus Task Force, and Dr. Rob Cavagnol, St. Luke's Clinic President. Thanks both of you for joining us today.

Dr. Rob Cavagnol: Thanks, Gemma.

Gemma Gaudette: And remember, if you have any questions for our doctors, you can email us idahomatters@boisestate.edu. Dr.Cavagnol, I'd like to start with you and just to ask you how things are at St. Luke's right now.

Dr. Rob Cavagnol: First, thanks for having me Gemma. I'd say that everyone is doing the very best they can. It's a really difficult and challenging situation. We've got nurses and physicians, APP'S, EVS workers just working overtime, doing everything they can to care for the community. It's tough. We're in the thick of it and it's been really challenging.

Gemma Gaudette: And then Dr. Pate--the news...when we hear from Idaho Health and Welfare, they did their weekly briefing yesterday...it just seems the news is going from bad to worse here in our state.

Dr. David Pate: Well, it is. And you know, as I mentioned before, even if we could get everybody to do exactly what Dr. Cavagnol and I would recommend, we'd still have a rough two or three weeks ahead of us because there are some people being infected today that we can't stop. However, if we fail to take the actions that Dr. Cavagnol and I are talking about, then it's going to last much longer and it will get much worse.

Gemma Gaudette: I want to also talk about something that happened up at the St. Luke's up in McCall, and I'd like both of you to comment on this. This was a tagging graffiti that happened on one of the main signs outside of the St. Luke's McCall. And this was a swastika that was tagged on one of the signs. Dr. Cavagnol, here you are on the front lines seeing things that...the average person can't even wrap their minds around, you were trying to save lives every single day and then something like this happens. What was it like for you when you found out about this?

Dr. Rob Cavagnol: Well, it was so disappointing Gemma. And I know, you know, I believe that it's a really small group of individuals who perpetrated this and so certainly wouldn't want to paint that community with a brush. But it's really disheartening to see that. You know, last year, around this time, health care workers were hailed as heroes and, you know, doing all in our power to to save lives, as you said, and to see that kind of graffiti take place was really disappointing. That said, you know, that's not going to deter our team. We have a really resilient team and we're going to keep coming back every single day and doing everything we can to take care of patients. But yeah, it was extremely disappointing.

Gemma Gaudette: And Dr. Pate, your thoughts on that?

Dr. David Pate: Well, it's heartbreaking. It's heartbreaking any time symbols of hate are used, particularly some of these that signify really past human atrocities. And it's reprehensible. And I think that what we are seeing too much of today is embracing hate and embracing lies. I think that we've heard far too much from what I am confident is a small percentage of Idahoans. But it is time for all good Idahoans with principles, with love, for their neighbor, with love of our state, with appreciation for our health care professionals, to stand up. If we don't stand up against lies and hate, we allow it to continue to percolate as it has and the cost is people get hurt.

Gemma Gaudette: I want to go back to the news briefing that was held yesterday by health officials in regards to COVID, because Dr. Cavagnol, one of your colleagues, Dr. Jim Souza, outlined some really important differences that you're all you are all seeing in COVID patients now, as opposed to the COVID patients you saw almost a year ago last December 1st. They are much younger. The average age has gone from 72 to 58. There are 36 COVID patients in the ICU, this was as of yesterday, under 55 and 13 under the age of 40. And Dr. Souza says he believes this is due to higher numbers of non-vaccinated patients in the younger population. And then he goes on to say patients are more sick. Most are on ventilators. The length of stay in the ICU--if they survive--is longer. Dr. Cavagnol, this is heartbreaking and it is shocking, but I don't know how we get people to understand the seriousness of this and that there is an easy solution to not being a statistic.

Dr. Rob Cavagnol: Yeah. Gemma, I don't pretend to know the solution, either, I would agree with you, you know, it's a different disease than we were seeing a year ago. And I think that that lulled many people into complacency and thinking that, 'gosh, I'm young and healthy. I don't have co-morbidities. And so even if I get it, it won't be a big deal.' And maybe that was true with the original virus that came around. But with the Delta variant, you're exactly right. I mean, we're seeing people in their twenties and thirties end up in the ICU on a ventilator. And unfortunately, we're seeing pregnancy is turning out to be a significant risk factor for a bad outcome with COVID. And we're seeing, you know, we've got pregnant patients intubated in the ICU and it's just heartbreaking. So those folks who think that they're invincible because 'I'm young and healthy, nothing bad is going to happen.' That's not the case. This is, you know, the Delta variant is a much different disease. The other thing that I just want to point out that Dr. Souza highlighted yesterday as well...you know, people get really fixated on the the fatality rate. Oh, you know, only a small number of people are actually dying from COVID. And that's true. The fatality rate for people who get COVID is around 1% roughly. But the number of folks who have long term debilitating symptoms is upwards of 10%. And these are previously healthy people who are fatigued chronically, who can't go back to work, who can't climb a flight of stairs, who have this brain fog. And so it's not just the mortality rate, but it's also that long term morbidity, that long term disability that we're seeing, that's just crushing.

Gemma Gaudette: So I want to talk about some good news, because there is some out there. Dr. Pate this was on Monday when Pfizer announced that the vaccine is safe and effective for 5 to 11 year olds and that they will be asking for emergency usage soon. What do we know? So when they say soon...I mean, because as a parent --and I've talked about this on the program before-- of a child that is in that age group, I'm like, Can can we have that emergency usage yesterday? Can you talk a little bit about the process, though? I mean, now that Pfizer has said this...are we looking at potentially this time next month, maybe that this age group could start being vaccinated?

Dr. David Pate: Well, I do think it's possible that it could be by the end of next month. I've got fingers crossed. The FDA is not going to shortcut their review--especially because this involves children. So there's quite an extensive review process that goes on. Under general circumstances, that process would last 4-6 weeks. On the other hand, I do know the FDA is acutely aware that we've got a real crisis in this country, and as Dr. Cavagnol said, we are seeing younger and younger people in our hospitals. And one would guess that many of those young people that he talked about that are in our hospitals, in our ICUs and on ventilators are in fact parents who were not vaccinated and got infected by their children. So, you know, key to containing the transmission and spread of this disease is getting children vaccinated, and the FDA knows that quite well. And I know that they won't shortcut the process, but what we are hopeful is that they will kind of devote more resources to allowing a faster review. But even with that, I do think a month from now is the optimistic scenario. It might certainly be end of October, might be beginning of November, but praise God it's coming.

Gemma Gaudette: Well, right, and I mean, Dr. Pate, when that news came out Monday, it literally takes a weight off your shoulder as a parent when you have a child in that age group.

Dr. David Pate: Absolutely. And of course, I've been very anxious for this time to come to be able to get my grandchildren vaccinated.

Gemma Gaudette: Yeah. So Adam wrote in, he says,'I'm curious about the views on vaccination and people with natural immunity. Although side effects are rare from vaccination, they are not unheard of. And why would you ask someone with natural immunity to take that risk through a mandate if they didn't reasonably want to?' Ultimately, why isn't COVID infection considered immunity from a vaccine requirement standpoint? Dr Cavagnol, can you talk about this? I mean, we've talked about this on the program before that natural immunity wanes over time.

Dr. Rob Cavagnol: True. And I'd say, you know, the studies show that the best protection that you can get is actually adding a full vaccination on top of prior infection. So even if you've had COVID, there is a benefit to adding vaccination on top of that. Those are the folks who probably have the best immunity now. I would not encourage people to go out and get COVID so that they can then subsequently get vaccinated and and have some strong immunity. But there is definitely a benefit to doing that. And the other thing that we're seeing, Gemma, is that if you had an infection early on in the pandemic back in March, April of 2020--the virus has changed since then. And so there's a real good chance that the antibodies that you have, that you developed during that infection, won't necessarily recognize the new variant of the virus. And so that's where the advantage of the vaccine comes in.

Gemma Gaudette: I want to talk a little bit about Crisis Standards of Care because we have gotten a lot of questions in regards to it. So I want to start with Bruce, and he wrote this, he says, 'regarding Crisis Standards of Care--if I'm in the hospital on a ventilator, but probably I'm going to die and someone comes into the hospital that needs a ventilator that will probably survive...do I get unplugged?' Dr. Pate can you can you start with that question?

Dr. David Pate: Yeah. So not necessarily. I mean, certainly if things get bad enough, it certainly could result in that. But I think the most important thing is for everyone right now--and I want to go back to the comment Dr. Cavagnol made towards the beginning of the show--this variant has changed. If you are in your 20's to 50's, you still are at risk of very serious illness. You need to have a conversation with your families. It's not likely it's going to happen, but Dr. Cavagnol and I have both taken care of people in the hospital that were faced with this situation and they didn't know to plan for it. So have a discussion with your family. Make it clear to your spouse or to your parent, whoever is likely to be making that decision for you...what are your wishes? Because if you do not want to be kept on a ventilator, if you do not want resuscitation if your heart stops, then let's get that out there and let's not waste resources on that. And the best way you can do that is fill out advance directives. So those are on the St. Luke's website. I'm sure they're on the St. Al's website. You can find them on some of the state websites, but fill out an advance directive. Think about this ahead of time. God forbid we get to the point where we have to make these decisions, but certainly that could happen.

Gemma Gaudette: And Dr. Pate, with that said, there's been a little bit of misinformation around DNR's-- these do not resuscitate these advanced directives-- is that if you are sick enough and something like, you know, needing to be put on a ventilator, then even if you have an advanced directive, they're not going to necessarily put you on a ventilator or something like that. That is not the case.

Dr. David Pate: Yeah, the crisis standards allow hospitals to make these kinds of decisions if needed. And I can tell you that St. Luke's, St. Al's, West Valley...all of these hospitals--Kootenai--they're all trying to do everything they can to avoid getting to the point where they would have to do that. And to my knowledge, that hasn't happened at all in Idaho yet.But what the crisis standards do is that it goes ahead and authorizes the hospitals. If you get to that point where you really are so resource constrained that somebody without a good chance of survival is utilizing resources that people need that do have a chance of survival, then you can implement a do not resuscitate order. People may have forgotten that in March of 2020, New York did something of the sort. What New York did when they were having their terrible surge and all their hospitals were overwhelmed is they gave an order to all the EMS that if you respond to a call and that person is in cardiac arrest, do not resuscitate them. And the basis for that is your chances of survival are very low if that happens. And so we're just not going to have ambulances bring those patients to the hospital and tie up hospital resources for someone that we likely can't save. Again, this is a big difference from how it normally is. Under normal circumstances, we do go all out unless somebody has made the decision that they don't want to be resuscitated. We give everybody these efforts. We just can't give everybody these efforts under these circumstances.

Gemma Gaudette: Dr. Cavagnol, Jessica wrote in and she says, 'could you please address if or how implementing the crisis of care protocol affects the care of children? Specifically, would a child ever have to compete with an adult for care in a hospital under crisis standards of care?'

Dr. Rob Cavagnol: Yeah. So I'll speak to what we're doing at St. Luke's. You know, we've got dedicated pediatric units, and so it would have to get to the point where we were overwhelmed with children and having to make those decisions based on who's most likely to survive in the various children. We're not anywhere near that. We've got capacity on the children's side. And so, you know, that decision is way far away.

Gemma Gaudette: And then Dr. Pate Ann wrote in and she says, 'we have heard the description of crisis standards of care and patients being assigned a number for preferential treatment. But what I would like to hear is what happens to those with low numbers, both the one who is currently receiving care, but a person who comes in with a better number and then the person who comes in with an already low number.' And she says, 'I imagine different scenarios from a bed with lots of care, just not event and all the way to sitting them in a waiting room chair or sending them home.' And she says, 'What is the reality?' And Dr. Pate I'd like to point back to the Idaho Department of Health and Welfare director Dave Jeppesen, who basically had to deal with this in his own family when the crisis standards of care were implemented last week. His own mother had a stroke literally hours after the standards of care were implemented and he says she is doing better now, but different protocols had to be put in place. She did not spend the night in the hospital like you normally would do if you came in with a stroke.

Dr. David Pate: Well, that's right. And thank God she's doing OK as far as I hear. But what we have to remember is this crisis standards of care that we're operating under. Just as you pointed out, Gemma with the example of the director's mother, it doesn't just affect those with COVID, it affects all of us. That could be somebody with a stroke, a heart attack, a car accident, appendicitis, all kinds of things that this could impact. And as you rightly pointed out, I mean, typically a woman of her age with a stroke, we're not going to be sending those people home. We'd keep them for observation. We just don't have that luxury today. And so to the listener's question, what we have to keep in mind is this is a dynamic process. In other words, my guess is that Dr. Cavagnol went to bed last night and the hospital capacity constraints were one thing. He woke up this morning...they probably had changed because on one hand, we probably had some new admissions. On the other hand, we probably had some people that got better and could be moved to a lower level of care. And sadly, we probably had some deaths last night, which opened up some beds. And then if--after this radio show--Dr. Cavagnol goes back and checks again, my guess is that situation is going to have changed again.

Dr. David Pate: And so it's a dynamic process. So when we do these scores, we do them to help us decide who does have the best chance at survival so that if we have to make the choice, we have a criteria by which to make that choice. That doesn't happen every minute of every day. We may be better at some points of the day than others, but when we have to, we can use that. And it doesn't mean that if I show up at the hospital and you show up Gemma and we both need an ICU bed and one's not available, it doesn't mean that Dr. Cavagnol is going to kick me out to the curb or send me home because what he's going to do is he's going to say, OK, Gemma, you have the better score, you're getting the ICU bed, but he's going to have me taken care of in the emergency room, in the hallway, whatever. I won't get the attention that you do. I won't get all the resources that you do. But it's not like the hospitals are just going to turn us away or kick us out to the street. We just won't get all the care.

Gemma Gaudette: Yeah. So we've got some questions in regards to booster shots. So one listener says 'I'm anxious for my 88 year old relative with diabetes to get a booster when my Idaho providers have that available.' And then Russ says, 'what is the latest status on the booster shot? I'm 85. I have underlying health conditions, so this is important to me.' Dr. Pate can we start with you on that?

Dr. David Pate: Sure. So the first step in determining what we're going to do with boosters occurred last week. I think it was on Friday--I've lost track of time--but that was when the Vaccines and Biologic Related Products Committee of the FDA met and they made their recommendation. But that recommendation is not final. That goes to the FDA as a whole. The FDA is meeting this week to decide that. And then if the FDA does decide to make an emergency use authorization for the booster, it will go to the CDC Advisory Committee on Immunization Practices, and they will spell it out for us. And my guess is that all of that will take place this week. So I would say stay tuned towards the end of the week for news, maybe at the latest the beginning of next week, but I think it likely is to be before the week is over. And then I think it's quite possible that both of those situations that those people may be eligible for boosters as soon as next week--that's assuming that they had Pfizer because that's the only vaccine that's being considered--and it assumes that it has been at least six months since they last received their second shot. I don't think we're going to see any recommendation come out for a period of time less than that. But again, stay tuned towards the end of this week, beginning of next week at the latest for the actual guidance.

Gemma Gaudette: Dr. Cavagnol, Jane wrote in and she said 'I was told that the influenza virus is active in Boise. One of the high schools had several students testing positive. So how will this impact the pandemic?'

Dr. Rob Cavagnol: Yeah, it's a scary thought. Luckily, we're not seeing a lot of flu yet. Flu season typically is a little bit later in the year, and so the best recommendation that I make to people is make sure to get your flu shot and get it early as you possibly can. Flu on top of the current spike that we're seeing in COVID cases--this current wave--would would literally just completely overwhelm us. And so just grateful that we're not seeing a whole lot of flu right now. I suspect it's coming. You know, it's really interesting that this time last year, with everyone masking and social distancing and washing their hands, we saw almost no flu cases and very little RSV. And so we know that the measures that we're putting in place for COVID are also effective against other respiratory viruses. So I'm just so hopeful that people continue to mask and wash hands and social distance throughout the winter because it's going to help us in all those areas.

Gemma Gaudette: Yeah. Dr. Pate, Susan wrote in, she says, 'when can I donate blood and be sure that my phlebotomist is vaccinated? The Red Cross won't reveal their staff's vaccine status, so I'm not comfortable doing my usual donation there.' Dr. Pate, I would assume that that she probably won't ever get that information from certain organizations.

Dr. David Pate: Yeah. You know, this is one reason for some health care providers who have decided to make vaccines a requirement because there's a very legitimate concern on the part of many of us that we don't want unvaccinated people participating in our health care. Now I am a regular donor at the Red Cross, and I think it's important that we donate. And I do know that since I've been vaccinated and have been going there and everyone is masked that I have felt comfortable going. I don't know if this listener will. My assumption is that most of the phlebotomists are vaccinated, but I hope that the Red Cross might actually come out with an announcement soon and tell us if they are making such a requirement and when that will be in place. Because I have no doubt that it's turning away some donors, and right now we need many, many donors.

Gemma Gaudette: Dr. Cavagnol, this is an interesting question. Lucey says 'could there be a phone number that one could call to find out how to care for oneself at home in order not to go to the hospital?' Maybe not a phone number, Dr. Cavanaugh, but what are maybe some things that people could think about, you know, at home? Because I mean, there are certain things like if you have a heart attack, if you have a stroke, a car crash, you want to go to the emergency room. But other things could potentially be cared for at home...I would think.

Dr. Rob Cavagnol: Yeah, the most important thing I want to emphasize here is if people are experiencing medical emergency, they need to come to our emergency department so that they can be taken care of. You know, we do see some people who because of the concern around the pandemic, they're staying home, even though they're having crushing chest pain or symptoms of a stroke and that. So I want to emphasize that if you're having a medical emergency, please come to the hospital. We will take care of you. We'll figure it out. As far as caring for yourself at home, it really depends on if we're talking about COVID or other diseases. You know, COVID, the treatment for people with mild symptoms is symptomatic treatment, right? So Tylenol for headache, other over-the-counter medications for cough and the other symptoms. There's nothing miraculous that people can do at home, but if they start to deteriorate and feeling worse, feeling short of breath, high fever and other things that they're worried about, they really need to seek medical care. As far as contacting someone and getting medical advice, contacting your primary care physician is always a good idea to ask questions. You can you can talk to the nurse at the office, and they'll can convey that information to the physician and getting medical advice on what the recommendations would be regarding your symptoms and what to do next.

Gemma Gaudette: Gemma, Dr. Pate, Erik wrote in. He says 'with the Delta variant, is herd immunity achievable? How does the pandemic end? Now that we are at this point?'

Dr. David Pate: Well, that's the million dollar question. Very good question. One that we think a lot about, but no one really has the answer. I would tell you that certainly we have not seen any evidence of herd immunity in any other country or any state of the United States. So if it is possible, we haven't seen it. The second point is, you know, he mentioned herd immunity to Delta and certainly, you know, it's an interesting way to phrase it, because that is the concern is that we, of course, to have herd immunity it depends on having individual immunity. And of course, with so many people that are unvaccinated, it seems unlikely. But also, we have to worry about these new variants, and so far we have not encountered a variant that our vaccines couldn't handle. But the fear is one day if we allow all this transmission, even among people that aren't getting ill and coming to the hospital, if we just have a lot of transmission among our kids in, our country, across the globe that, you know, we're just playing the statistics of when is a new variant going to emerge that, in fact, could get around our immunity and if it does...then of course you can't have herd immunity-- at least based on where we are at that time. So I think most of us are pretty skeptical that we're ever going to get to herd immunity. What we can hope is that more and more people will get vaccinated and get immunity that way. And of course, we are hopeful that those people that did have a natural infection, as Dr. Cavagnol mentioned earlier, we're we're hopeful, we don't know, but we're hopeful that they may have enough immunity that together it would get to a point where at least we're not having these big surges...that were just continuing to have a low level of infection. But frankly, I certainly am not expecting there to be significant improvement for a year or two. We'll have to just watch and see, but I think it's going to be a while.

Gemma Gaudette: Yeah. Dr. Cavagnol, Joe and Sarah sent in this question. They say 'we're a family of five. Four of us are vaccinated except our 10 year old. We live in the Eagle-Star Area. He attends a West Ada school. He's playing soccer right now. We're trying to give him some normalcy. But do you think having him play soccer outside, given the current surge is a good idea?' They say 'we just got him back into sports after an 18 month hiatus. If he were your child, what would you do?' And we must say that we don't give out medical advice on this program. Talk to your normal doctor about that. But I mean, Dr. Cavagnol, we went through the same thing in our in our house, where our nine year old is playing, you know, Friday Night Football, it's outside. But we're not having our oldest play basketball, even though he's vaccinated because it's inside, unmasked, probably playing with a lot of kids that aren't vaccinated.

Dr. Rob Cavagnol: Yeah, such a tough thing to wrestle with, right? And I can certainly empathize with parents who feel bad for their kids and really want them to try to get back to some level of socialization and some level of normalcy. I have 14 and 15 year old boys myself, and I can certainly relate. So I couldn't tell these parents what to do. I think you have to make the best decision that you can. You know, as Dr. Pate already shared, that hopefully the vaccine will become available for kids in that age group, and so that might improve their comfort level. Being outside is probably safer than being indoors, although you can imagine the group of kids getting together for a huddle and talking about things, and someone can be coughing and things like that. So, you know, there's no such thing as no risk. You have to sort of assess the risk. And so playing outdoor sports is probably lower risk than indoor sports, but there's always going to be some element of risk. And it's just how much risk are you willing to assume...tough, tough one to wrestle with, and I completely empathize.

Gemma Gaudette: Dr. Pate, I am trying to find the question, there's so many of them that I want to ask. Let me find it here very quickly...so many...holy cow...we've got a lot in. Ok, here it is, one listener wrote in. She says, 'I have a couple of family members who have many reasons for not taking the vaccine. They have a lot of technical questions regarding what's in it, how it works, the new technology used, etc.. Do you have a good, reliable source for specific information that I can give them?'

Dr. David Pate: Well, it depends. You said they have a lot of technical questions--to me that would imply it's not the level of questions that the general public has, they're more detailed questions. If it's that detailed, then you know, of course, where I go to get a lot of the information on the vaccines that are technical in nature is I look at the emergency use authorization document and the FDA briefing documents on the vaccines. I mean, if technical information is what they want. If what the listener really means is they just want to have a lot of information general, there's easier sources to understand if you don't have a medical or scientific background There's a lot of information on the CDC website that probably would be the easiest to understand. I think that the big thing is you just want to make sure that you're going to reputable sources. Certainly, you know, I'm on Twitter if people have a specific technical question that they want to get answered. We want people to get vaccinated. So if you're still holding out because you have a question for the love of God, ask one of us. Ask myself, Dr. Cavagnol is on Twitter as well. Somebody that's reputable. Get your questions answered and let's get you vaccinated as quickly as possible.

Gemma Gaudette: And then Dr. Cavagnol, Melissa wrote in saying, 'what are the rates of transmission in schools when kids are fully masked?' I mean, we may not have exact numbers, but I mean, Dr. Cavagnol, when we look at schools from last year where they had mask mandates, they had incredibly low numbers of COVID-19 even being transmitted in the schools.

Dr. Rob Cavagnol: Totally agree. I don't think I have a specific number I can quote--and I defer to Dr. Pate if he knows more than on this topic--but I would say you're exactly right. Last year, when mask mandates were strictly enforced, we saw very low transmission rates in the school, and the opposite is true. Every day in the news, there are stories of schools being shut down in Idaho and across the country because of massive outbreaks. And then you hear these stories about schools in California, like in San Francisco and Los Angeles, where they've had zero outbreaks because of the really high vaccination rates and masking. So the evidence couldn't be more clear that vaccination and masking works and the rates of transmission in areas where there's really good compliance is exceedingly low.

Gemma Gaudette: Dr. Pate, Deborah wrote in--I think this is an interesting question-- she says,'please explain how being vaccinated helps or protects others. It's clear how being vaccinated helps the individual and can help the medical community, but I don't think it's clear how it benefits the community.'

Dr. David Pate: Well, in the largest sense, the benefit is when we get large numbers of people that are vaccinated, the virus finds it harder to find people to infect. And so our transmission rates go way down and this is the principle upon which herd immunity is based and that is getting enough people vaccinated that the virus cannot efficiently transmit. This is why we tell new moms --because their babies cannot be vaccinated--that the way you protect your child is to make sure everyone who's coming in contact with that child is vaccinated because their chances of being infected are not zero, but they are way reduced. And when we reduce the level of transmission, the chance that anybody is infected goes way down, and that is how it makes safer for everybody, that results in fewer people being infected, it results in fewer people being hospitalized, and it results in protecting our hospitals and our health care professionals, and it ultimately leads to fewer deaths.

Dr. Rob Cavagnol: Gemma if I can tag on...

Gemma Gaudette: Oh yeah, absolutely.

Dr. Rob Cavagnol: I'm sorry to interrupt. You know, if there's someone out there who is young and healthy and doesn't want to get vaccinated for themselves because they're just not worried about what the impact of COVID will be to them, I would I would ask them to reflect on how would you feel if you were asymptomatically infected and passed that on to someone who didn't have a very good outcome, someone who was immunocompromised or someone who was too young to get the vaccine or who was older and got the vaccine and still ended up in the hospital and in the ICU. So Dr. Pate's exactly right...he nailed it. The only other thing I'd add is the ability to transmit it to people who are more vulnerable than you if you're a young, healthy person. And so that's just one more reason to go ahead and get vaccinated.

Gemma Gaudette: Mm-hmm. I have a question for both of you. It seems to me that when we look at the statistics in Idaho in regards to our vaccine rates, right...51% percent of all eligible Idahoans are fully vaccinated. What is it going to take for people to be vaccinated? It feels to me as if every stone has been turned. And frankly, we're hitting our heads against a brick wall. Dr. Pate, I'll start with you. We've got about two minutes. Is there anything else we can do?

Dr. David Pate: Well, yeah, I can answer it in about 10 minutes. [laughter] So the first thing I would say is if we could just shut down the sources of misinformation...these are the people that are getting in the way of getting more people vaccinated. So, you know, I call on our Lieutenant Governor, I call on those legislators who have been promoting false information...I call on everyone who's been promoting false information...please stop. Please. If you can't do anything else, just be silent. But if you would please stand up, admit you were wrong. Encourage people to to get vaccinated. That would be a game changer if we could do that.

Gemma Gaudette: Dr. Cavagnol, your thoughts on that...

Dr. Rob Cavagnol: You know, we've tried the sharing, the data, and the information, and the science, and the coercion, and the preaching...and I think that that has reached the population that it's going to reach. I would love for people to do exactly what Dr. Pate shared earlier, which is if you have questions or concerns, ask. I think there's a portion of the population who is just against vaccination, and maybe they're not going to be convinced no matter what. But I think there's another section of the population that just is unsure. They have questions. They're worried. They're concerned. They've read maybe some stories, especially on social media, that have questionable validity. And so they're just apprehensive. And I don't want to vilify those people. I think they're scared and I think they need more information. And so I'd really encourage those folks--make an appointment with your doctor and share your concerns, talk about your medical issues that you have and talk about the benefits of getting the vaccine. Message Dr. Pate or myself or someone else, and someone who is going to give you evidence based recommendations. And so I think that's what it's going to take is more listening and probably less preaching on our part on the medical community.

Gemma Gaudette: And I will tell you this, my sister had questions I had to reach out to Dr. Pate. She got her first vaccine shot just last week. I want to thank Dr. David Pate, Dr. Rob Cavagnol. We will, of course, have our medical experts back on next week. If you have a question, email us idahomatters@boisestate.edu. I'm Gemma Gaudette. We'll see you back here tomorrow.

Gemma is the host of Idaho Matters, Boise State Public Radio's daily show which broadcasts live Monday-Friday at noon. She is an award-winning journalist and has spent the majority of her broadcasting career in Idaho. Gemma was a television news anchor and reporter in Boise for close to 15 years. She came to Boise in 1999 to start Fox 12.
Samantha Wright is a news reporter and producer for Idaho Matters.