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COVID-19 could be here to stay: local doctors discuss long-term impacts of low vaccination rate

Virus Outbreak
Wilfredo Lee/AP
/
AP
FILE - Starting Thursday, Oct. 14, 2021, the Food and Drug Administration convenes its independent advisers for the first stage in the process of deciding whether extra shots of Moderna or Johnson & Johnson vaccines should be dispensed and, if so, who should get them and when. (AP Photo/Wilfredo Lee, File)

As of Tuesday, 53.3% of Idaho’s eligible population is vaccinated against COVID-19. That’s lower than the nationwide average of 66%.

And in a news briefing yesterday, Dr. Steven Nemerson, Chief Clinical Officer at Saint Alphonsus Health System said, "today I’m here to tell you that we’ve lost the war."

He went on to say that COVID-19 is here to stay because not enough of the public will get vaccinated in order to eradicate the disease, so this will be a disease to be managed for the long-term future.

Joining Idaho Matters today to unpack this—and other COVID-19 questions and issues—are Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force, and Dr. Joshua Kern, Chief Medical Officer for St. Luke's Magic Valley, Jerome and Wood River.

"Typically when you're losing a war, you have to change your battle strategy. And I think it's really up to the American public, whether we are going to change that strategy or whether we're going to continue to be plagued by this virus."
Dr. David Pate former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force

Read full transcript here:

Gemma Gaudette: You're listening to Idaho Matters, I'm Gemma Gaudette. Dr. Steven Nemerson, chief clinical officer at St. Alphonsus Health System, told us yesterday that we are losing the war...

Dr. Steven Nemerson: "And sadly today I'm here to tell you that we've lost the war."

Gemma Gaudette: He said that during the weekly health and welfare briefing. Dr. Nemerson went on to say COVID--it is here to stay.

Dr. Steven Nemerson: "And the reason it is here to stay is because we cannot vaccinate enough of the public to fully eradicate the disease. And absent being able to do that and accomplish herd immunity, we now need to move into the phase of recognizing that COVID is going to be a disease to be managed for the long term future."

Gemma Gaudette: As of Tuesday, 53.3 % of Idaho's eligible population is vaccinated against COVID 19. However, that is lower than the nationwide average of 66%. So joining us today to talk more about this and other COVID related issues are Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force. And Dr. Joshua Kern, Chief Medical Officer of St. Luke's Magic Valley, Jerome and Wood River. I want to thank both of you for joining us today.

Dr. David Pate: Hi, Gemma.

Dr. Joshua Kern: Thanks, Gemma.

Gemma Gaudette: And remember, if you have a question for our medical experts email us at idahomatters@boisestate.edu. I want to start the conversation with both of you about the comment that we just heard Dr Nemerson make yesterday during this briefing that the Health and Welfare Department has been holding every week. So Dr. Pate, I want to start with you...to hear him say we have lost the war...it's disheartening.

Dr. David Pate: Well, it is, and I think he's correct. It doesn't mean that we're helpless for the future and that we can't correct it, but he's quite right that currently we are losing the war. There have been several points along the path of this pandemic where we could have made interventions that would have saved many, many lives and dramatically reduced the disease transmission and probably avoided at least some of these variants. And we've repeatedly failed. So, you know, that doesn't mean we throw our hands up in the air and and surrender, but we're losing. And typically when you're losing a war, you have to change your battle strategy. And I think it's really up to the American public, whether we are going to change that strategy or whether we're going to continue to be plagued by this virus.

Gemma Gaudette: And Dr. Kern, your thoughts on hearing Dr Nemerson say that yesterday?

Dr. Joshua Kern: Yeah, I mean, I think he's capturing the sentiment that many people who take care of COVID patients in the hospital or run hospitals feel, which is the overwhelming number of unnecessary deaths and even disability that's happening because of people who ultimately if they had been been vaccinated likely would not have ended up in the hospital or not died as a result of this pandemic. I will say, and again, not necessarily refuting what he was saying...that I'm not sure that truly sterilizing immunity and elimination of this virus was ever possible. But we are seeing is that people who are vaccinated when they get the virus, get a typical cold. In the long run. I think this coronavirus will be here to stay and hopefully we'll continue to see what we see now, which is if you're vaccinated or you had previous infection, that your risk, even from the Delta variant, remains pretty low for ending up with severe disease in the hospital or death.

Gemma Gaudette: And Dr. Kern, can you explain for folks who, you know, may not be fully understanding the terms of a pandemic and endemic because I mean, frankly, we can put the flu in that category?

Dr. Joshua Kern: Yeah, absolutely. Influenza is a good example of a virus that we have never successfully created an effective enough vaccine or had an effective enough treatment to completely eliminate it in the way that, you know, we've, for all intents and purposes, eliminated measles in the United States and did eliminate smallpox from the world through a very effective vaccine campaign. But some of that has to do with the details of how those viruses spread. Some viruses spread and work in your body in a way where vaccination creates a sterilizing immunity, and I don't think coronavirus is falls in that category. Likewise, influenza. So they become endemic, which means they're always circulating and there's always some risk of getting infection or some degree of illness. And it's a matter of trying to to control how severe that disease ends up being.

Gemma Gaudette: Yesterday, NPR reported on some new research coming out in regards to breakthrough infections, saying they may not be a big transmission risk. So there is some new evidence suggesting that even though we know that these breakthrough infections may happen, they might not represent the threat to others that scientists originally thought. In fact--I think I'm saying this right--Ross Kedl, he's an immunologist at the University of Colorado School of Medicine, says that the basic immunology immunology suggests the virus of a vaccinated person who gets infected will be different from the virus of an infected unvaccinated person because we've already built up antibodies. So Dr. Pate, I'm not sure if you've read up on this yet, but I'd be curious to know your thoughts on that because I think that this also goes back to some misinformation when it comes to why some people won't get vaccinated. We've heard time and again. Well, you know what, if you get vaccinated, you're still going to get it. You're still going to get a breakthrough case. You can still, you know, give it to other people. But now we've got some potentially new evidence here saying that you may not be as big of a threat even if you get the virus if you've been vaccinated...a threat to other people getting sick.

Dr. David Pate: Yeah. Well,Gemma I think that's right, and that certainly is what we would expect. Dr. Kerns is exactly right--that this vaccine doesn't provide-- and frankly wasn't intended to provide--sterilizing immunity, meaning that a virus couldn't grow at all if you're vaccinated and you got exposed to it...it's a bit complicated, so I'm not going to go into all of that. But nevertheless, even if you don't get sterilizing immunity, what we do know is that those that are vaccinated, if they do get infected, they have dramatically reduced chances of becoming severely ill, ending up in the hospital or dying. And that was our major concern. So we do know that's the case, and we can't assure that if you're not vaccinated and you get COVID. There's certainly a higher chance now because of the high disease transmission that you might get seriously ill. The other thing is, what we do know is that even those who are vaccinated, who do get infected and we can detect virus in their nose, they clear that virus much quicker than somebody who's not vaccinated. So if I had to be around a person who was vaccinated and infected versus a person not vaccinated and infected, I will always choose the vaccinated person. The risks are much less because they clear the virus quicker, so they're certainly going to be not as contagious as long as somebody who's not vaccinated. Then there's the issue that you were just bringing up and that is, even if the virus is there, are those people going to be less efficient at transmitting that virus? We don't have the answer to that, but none of us would be surprised if when we do get the studies, that the answer is yes, you will be less efficient. So certainly we should get vaccinated. Certainly high levels of vaccination will mean that the levels of transmission come way down and when the levels of transmission come way down, we're all less likely to get infected.

Gemma Gaudette: And speaking of levels of transmission going down, once again, that comes back to being vaccinated. With that, said, Dr. Kern, Pfizer is asking the FDA to authorize its COVID-19 vaccine for children five to 11. The FDA has tentative plans to meet on October 26. They have promised that they will move quickly on this request, saying a decision might come shortly after Halloween. Dr. Kern, how critical is this to get these younger kiddos vaccinated once we can?

Dr. Joshua Kern: Yeah, I mean, I definitely think particularly in kids that have not had the virus, that getting them protected makes sense as much from a public health standpoint as anything else. I do think that, you know, the risk in children of getting severe disease is much less than in adults. And so, you know, there are many reasons why getting children vaccinated for this virus makes sense. And a big part of it is that we do know they are able to spread it to more high risk individuals. I think it will make it more safe and more reasonable to be thinking about getting back to normal and having, you know, children visit with their grandparents and those kinds of things once they're vaccinated.

Gemma Gaudette: And speaking of children, you know, we've heard many people say and Dr. Kern you just mentioned this, that children do not tend to get the disease as severely as adults. So then there is this idea that kids aren't impacted. I tend to disagree with that in the sense that sometimes getting the disease is not the impact that I think we need to focus on. And in fact, we now know that almost 500 children in Idaho have lost a parent or a primary caregiver to COVID-19. And we also know that when we look at ACES, which are adverse childhood experiences, that COVID--not just COVID, but losing a parent, a primary caregiver--is considered an ace, is consider this adverse childhood experience, which then has lifelong consequences. With that said, Dr. Pate, 497 children in Idaho have lost a parent or a caregiver. 140000 children across the country have. How concerned are you that there is a generation of children who will feel the impacts of this pandemic, frankly, for the remainder of their lives, whether they got COVID or not?

Dr. David Pate: Well, I'm horribly concerned and Gemma, I wish I could have expressed it as well as you just did when I tried to make this point to school boards last year. There was all this talk about the mental health challenges of our children with masks, with isolation and all. All true. I'm not dismissing that. But what I tried to do is get boards to make this a balanced discussion. And yes, no question are children being adversely affected by the circumstances of the pandemic. But there's this whole other point that you're talking about and that children are being impacted by the loss of a parent. And let me tell--if you're focused on concern about the loss of their education, I can't think of too much else that will impact it worse than the loss of the parent or caregiver and understand in many of these cases, that was the financial support for the child. And so the child may now have their own economic circumstances may change. They may have to move out of state to be with another family member or they may be orphaned. There's all kinds of things that happen, and not to mention the challenge of if the child is old enough to understand that they were the one that brought the infection home and infected their parent or grandparent. I mean, this is a huge issue. And so I do think our discussions need to be more balanced. This is a big one. This will impact children for really the rest of their lives. As you mentioned these adverse childhood events, we see the problems down the stream decades later from these things. And so this does need to be taken into consideration. It's terribly sad.

Gemma Gaudette: This listener sent this email earlier today and they say, 'I work at a store in the Idaho Liquor Division. Late last week, my boss tested positive for COVID. Now I find out he's planning to come back to work this Friday, four days after being really sick. I am very concerned about myself and other employees. I am a senior. I'm 70 years old. I'm a kidney cancer survivor. I am fully vaccinated, including my booster shot. What are the proper protocols? What should I do?' Dr. Kern could you take that question?

Dr. Joshua Kern: Well, yeah, I mean, the first thing I would say is that the CDC guidelines continue to say that a person who is tested positive for COVID should be away from other people for 10 days on self-isolation, so it remains unclear why they'd be returning to work what sounds like a shorter period of time than would be recommended. Most employers that I know of are still following most of those guidelines if you test positive for COVID. So that's how I would approach that answer.

Gemma Gaudette: Ok, Lance in Eagle wrote in says 'I'm double vaxxed and boosted, and I just got my old guy high dose flu vaccine. But I'm feeling like I'm all dressed up and I don't know where I can go. What are my options?' So Dr. Pate, I think the question is basically, where can Lance feel safe going right now? I mean...to a restaurant, to the grocery store. I mean, if you're fully vaccinated, what should you still be cautious of? And I'll tell you, I feel like I'm kind of in that boat because I still have a kid that's not vaccinated.

Dr. David Pate: Yeah, yeah, well, certainly understand, and I love how Lance phrased his question. I love his 'old guy vaccine' and his 'all dressed up and no place to go' because he sounds like he'd be a lot of fun to hang out with. Well, I think we start with the fact that Lance, you personally are in really good shape. You're fully vaccinated. You've gotten the booster shot. And generally, we like to see people... You know, the immune response is not static. It's not like you have it one day and you don't the next it evolves. And so and it gets better with time for a while. And and so we do like to see people kind of give their last shot at, you know, a couple of weeks to kind of really prime themselves. But assuming it's been more than a couple of weeks since his booster shot, Lance is in really good shape. So we're not particularly worried about the threat to Lance. The questions I would ask Lance are 'Lance, who do you get around that you need to protect?' So just like what you said, Gemma, you've got a child at home that can't be vaccinated. Lance is probably in a higher age group from the sounds of things, but maybe he's taking care of a grandchild that can't be vaccinated. So if that were the case, I'd tell him to be cautious. If Lance is living with somebody, you know, for example, he has,maybe his wife is undergoing chemo or something that would put her at risk...all of those things would be reasons for us to tell Lance, 'let's take some extra precaution.' But assuming that he doesn't have any of those particular people to worry about-- Lance is good shape. What I would tell Lance is, you know, probably wouldn't go to a packed event where he's going to be very, very close to other people just because, you know, certainly you can get these breakthrough infections we talked about. But most everything he wants to do, he should be able to do it. The question is, if he goes and does it, should he wear a mask? And I would say, you know, just until we get these disease levels down, the transmission levels down, there's just so much virus out there right now that I would tell Lance, 'yeah, go do what you want to do. But if you're going to be with people that you don't know if they're vaccinated, I just wear a mask for now until we get these disease levels down.'

Gemma Gaudette: Dr. Kern, Karen wrote in and she says 'the number of fully vaccinated people in developing countries is still extremely low. What is the risk, or do we know of a risk of a new, possibly more deadly variant coming out of these countries and then coming to the United States?

Dr. Joshua Kern: Yeah. I mean, while we can't know the answer to that for sure, what we can look at is the data with Delta, which does spread easier. It probably results in more hospitalization and more severe disease, although that data is still very preliminary. And yet people who had alpha last year or are vaccinated are again still at pretty low risk from getting severe disease or ending up in the hospital from Delta. So if that holds true, then there is reason to believe that we may maintain some degree of protection from severe disease, even from new variants. But again, we don't know. We haven't seen any variants that really strongly seem to break through immunity, and I'm specifically choosing that word over vaccination. But we're not seeing any variants that break through immunity to a greater degree than Delta at this point.

Gemma Gaudette: Dr. Pate, Coda is asking this question, saying 'I'm encouraged by President Biden's promise to help other countries with COVID vaccines. The J&J vaccine seems like it would be easier to administer from a logistical standpoint rather than Pfizer. Do we know if that's being considered?'

Dr. David Pate: Yes, and so, first of all, I want to say I'm very proud of the United States. We have contributed more vaccine to low income and developing countries than all the other countries of the world combined. So I'm very proud of that. We all need to do more and we need to call on the world to do more. But the J&J vaccine is being used and is being one of the vaccines sent, and it does have the advantage of it doesn't have the extraordinary storage requirements that the MRNA vaccines have. And of course, right now it's a one dose vaccine, which makes it easier. So it is being used. But all the vaccines have to be used because there is no one company... Pfizer, Moderna, Johnson and Johnson...none of them by themselves can make enough vaccine as quickly as we need it for the whole world. So we are using J&J, but we really have to use all of them.

Gemma Gaudette: And Dr. Pate when we talk about, you know, needing the entire world to basically have access to vaccine....how does that then play into... I guess we can't eradicate the disease, but maybe manage it better when we get some type of global immunity and we're definitely not there yet.

Dr. David Pate: Right. And so, you know, one thing that this pandemic should have taught us--of course, previous pandemics have already taught those of us that have studied pandemics, but this should be the sign to everybody that we...it's kind of that weakest link thing. You're at risk for whatever goes on in the world. And that's because we're very interconnected and with the amount of world travel, international travel that occurs, a new pandemic threat occurring anywhere in the world can certainly be a threat. Now there are some countries that are very closed societies. They're not going to pose as greater risk. And certainly, you know, we are more worried about the international travel that occurs the most, which most of it is not going to these poor and developed countries, but they are a big risk. Part of why is they have they typically have the conditions that are ripe for one of these diseases with a new organism to occur because they don't all have clean water, clean all the other public health measures that we've put in place and they may not have good vaccination rates or good access to health care, but they also don't oftentimes have the capabilities of themselves to be able to identify new infectious threats. So that's why we have to have a continuing policy of trying to support all of these countries with vaccines, but also with public health guidance, with the ability to detect new organisms...because even those countries, we are still all connected and they all pose a threat to us.

Gemma Gaudette: Dr. Kern, Jan just sent this in. She says 'I'm 66 years old with significant health issues. I've received both immunizations in the last six months. I did have a breakthrough case several weeks ago, and I'm still having mild symptoms-- congestion, slight cough. When should I get my booster? My husband is also older with significant risk factors and had a breakthrough case and has recovered and he hasn't gotten his booster yet, either.'

Dr. Joshua Kern: Yeah, the general guideline I've seen is "when recovered" and so I think that leaves room for interpretation. Again, in this moment where they've just had COVID but are already vaccinated, their risk of getting the virus again or spreading it remains very low. So I personally would not recommend rushing to get the booster, but waiting until recovered.

Gemma Gaudette: Dr. Pate, we just received this email from a listener, it is long, but I think it's important. The person writes, 'my husband and I are both fully vaccinated parents. We have done our best to keep our family safe, wearing masks, social distancing, et cetera. On top of being a statistically better choice for me and my husband, I felt it my civic duty to get the vaccine and slow the spread. However, I do not feel the same way about getting my three and six year old vaccinated. My job as a parent is to do everything in my power to keep them alive above all else. I cannot shake the hesitation to get my kids vaccinated for COVID. Keeping in mind that they are fully vaccinated with all childhood vaccine. Europe seems to be taking a slower approach to vaccinating kids, and I hope and pray the CDC will do the same. Please tell me something to make me think the risk from COVID and long term COVID is scarier than the long term unknowns of the mRNA vaccine.

Dr. David Pate: Well, you know, it's a very good question. You know--and I think what we have to do is we have to be a little humble right now and that is that, you know, we're still learning about this virus. And I will tell you that with time, what we're learning more about is long term complications from COVID infection. There are some small studies--we need to do many more--that are showing some very concerning long term impacts from having COVID, even if you had a mild case. Now again, I say we don't know, but we have reason to be concerned, and so we have to study that. The problem is is that with these kind of disease levels, you're going to have to make a decision in the not too distant future. Now, when we talk about the Pfizer vaccine being extended down to children next month, that's only going down to five. So your three year old still is not going to be able to be vaccinated, and that may be not until the beginning of next year. We're just not sure. So you've got some time as we learn more about this. Second, don't look to Europe for your example of what to do. Europe has made many missteps, just like the United States has, so I wouldn't read anything into it, whether that's good or bad, that they are slower going to children. The third thing is that, you know, the problem is with with adults, we know how to identify those at the greatest risk. At least we did until Delta and we can identify that. We don't know how to identify the children that are getting really sick or that rarely are dying.

Dr. David Pate: You know, why did that child die or why did that child get very sick? Or why did some children get that multi inflammatory system disease? So there's a lot we don't know, but I will also tell you there's some really exciting research going on, and we're learning a lot about why that might be. I think with time, we'll learn a whole lot more. But I think that you're right, as a parent, your responsibility is keep those kids safe. The chance that your kid was going to get mumps or rubella was pretty low, but you made the wise decision to get vaccinated for that. And your decision, along with everybody else's decision to do that is why the risks of getting mumps or rubella right now is pretty low. Same thing for COVID. If we do not get children vaccinated, then we are going to have high levels of transmission of COVID. If we have high levels of transmission of COVID, we know what happens. These the virus will continue to have mutations or worse. It may have a combination with another virus and we could be dealing with something that, while so far COVID hasn't been an extraordinary issue for children--it could become more so. So I can tell you that when my grandchildren the day that the vaccine is approved for their age. I've already talked to their parents about getting them in that day for the vaccine. And I hope you'll make the same decision and I think we'll only learn more with time that will make you glad that you made that decision

Gemma Gaudette: Dr. Kern...

Dr. Joshua Kern: The other thing to be aware of is that Pfizer had already requested EUA for the vaccine for kids, and the FDA said, we actually need to look at more data before we can improve it. So I do feel that once we get to the point where the FDA approves the vaccine for children, that the data will really support that the vaccine is better and safer than getting the infection. I don't think that they're rushing this vaccine. And so I think they're taking a fairly methodical look at the data, and I would feel fairly confident if it does get FDA approval that it will be safe.

Gemma Gaudette: And I will say this just from a mom to another mom having one child who is now fully vaccinated. The worry and the stress that I have about this particular child not just getting COVID, but being exposed to it, potentially giving it to someone else that has gone down exponentially. But beyond that, you know, my child has in some regards--because we still have a child that's not vaccinated--has been able to go back to a semblance of normalcy that he didn't have before he was vaccinated. So when my nine year old can get vaccinated, I do feel like the burden that my children--that I think all children-- have had to bear during this pandemic will lessen. So, no, that's not a medical reason to get them vaccinated, but I look at the normalcy that I want my children to have. I recently read something that they said, when was the last time a child had a "normal school year"? So if I look at my eighth grader, the last time he had a normal school year without COVID was fifth grade. My fourth grader...it was first grade. I want them to be able to have that normalcy. So as I said, not a medical reason, but I hope that parents take a look at that when you're looking at the decision to vaccinate or not.

Gemma Gaudette: Dr. Kern, Ed wrote in today, saying 'I am 75 with multiple comorbidities. I took part in the AstraZeneca study and I received the two shot regimen in December and January of 2020/2021. Astrazeneca is not authorized in the United States, so my question is should I get the Pfizer booster?'

Dr. Joshua Kern: Oh man, I actually don't know the answer to that. I think it gets a little tricky in that people who have had other vaccines that are approved--Johnson & Johnson and Moderna--should not get the Pfizer booster, in part because those vaccines seem to, at least right now, provide ongoing protection, maybe slightly better than the Pfizer vaccine. For the AstraZeneca, that was not approved. It's because it wasn't very effective, and I don't know what the answer to that is. And I would myself probably be tempted to go get a full series of another vaccine that's more effective.

Gemma Gaudette: So that could potentially be an option then? Just get the the full series?

Dr. Joshua Kern: Yeah. Well, and again, I don't know all of the details in his situation, whether he found out if he got the placebo or the actual vaccine because there's a chance in a trial that he got actually just placebo in that original trial. So there's a lot to be worked through. I would probably direct him to his physician to have a conversation around his specific detail.

Gemma Gaudette: Yeah, and we should note that is always the best thing to do. We are definitely here to give some guidance, but when you do have questions like that, it is always best to go talk with your actual physician. Dr. Pate, Kate wrote in and she says, 'I continue to be cautious and to protect my grandsons. I've received my booster and my flu shot, but I'm getting criticized by my friends who think I'm being too overly cautious. It's hard and it's hurtful, but I will do what is best for my family and my community. So do you have any advice Dr. Pate for what I can tell my friends?'

Dr. David Pate: Well, you know, first of all, let me just commend Kate. I do think until we know more that her caution is well advised, and especially since it sounds like she has young grandchildren. And I know as a grandparent the last thing I would want to do is to do something that hurt one of my grandchildren. So the first thing is I think, especially in these days where there's so much division and there's a lot of people with opinions that frankly don't have the information or expertize to be offering those opinions...I think it's first you just have to feel OK with yourself and that, you know, everybody has a different risk tolerance or risk level, and your risk assessment is not unreasonable. In fact, it's pretty similar to mine. And so first, take comfort in that. And then I think that the second thing is for her friends, if they're good friends, they're going to respect her decision and her amount of caution. I have friends, some of my friends have the same beliefs about the practices that we should take. And I have some friends that don't have those same sentiments. And frankly, I don't go around the ones that don't have the same beliefs because I'm not willing to take the chance. So I just commend her. Be OK with knowing that you're doing the right thing for you. And then, you know, just tell friends that 'look just based on what I know and given my concern for my grandkids, this is the decision I've made for now. I may make another decision in a couple of months, but this is my decision for now.'

Gemma Gaudette: Dr. Kern, a listener, just wrote in saying, 'does taking a booster mean that some person in an underdeveloped country has less chance of receiving the vaccine?'

Dr. Joshua Kern: I don't think that's quite how the economics of all this are working out right now, I think again there is enough vaccine available in the United States, that has already been purchased for use within the United States, that taking a booster is probably not taking a vaccine away from somebody else in a developing country.

Gemma Gaudette: Dr. Pate, Courtney wrote in, she says 'as an educator, I'm wondering when the Moderna booster will be available and why is it not yet? I'd rather have Moderna because I've heard that it does better at fending off variants, and I feel like I'm a sitting duck right now.'

Dr. David Pate: Well, the first thing let me reassure you, you're not a sitting duck. If you've gotten both doses of Moderna, such as I have, I don't feel like I'm a sitting duck. I do think that when the data is reviewed and the recommendation is made for a booster, I will promptly get it. But we know that those who are fully vaccinated--regardless of what vaccine you've gotten, whether it's Pfizer or Moderna or J&J--we just are not seeing many people get very sick, even if they get infected. So don't be overly concerned. And then I guess the other part of my answer is I go back to something, Dr. Kerns said and that is the FDA reviews this very carefully, and that should give us all a lot of reassurance. So take Pfizer, for example, that did get the booster approved. Obviously, it's in Pfizer's best interest if a booster is approved or authorized for everyone because they sell more vaccine. But that's not what the FDA did. The FDA looked very carefully at the data, weighed who really is going to get a benefit and then they came out with, yes, we're going to approve it. But for people in these specific higher risk groups. I think that is exactly what we're going to see for Moderna. Moderna has submitted that data. I've taken a look at that data, and my guess is that they're going to come up with a decision that is probably almost identical, if not identical, to what they decided for Pfizer. But no need to worry. Just stay tuned. I think a decision could be made this month, but certainly in the next month or so, I think a decision will be made and then you'll be fine to go get your booster then.

Gemma Gaudette: Dr. Kern, before we wrap things up today, I'm curious to know just how things are down in the Magic Valley, Jerome, Wood River as we are still dealing with crisis standards of care. Have you seen improvement? Where would you say your hospital system is?

Dr. Joshua Kern: Yeah, we have seen a trend towards improvement. We've seen a somewhat reduction in our numbers, although keeping it in perspective that that's a reduction down to where we were at the peak of our surge last fall. So we still have a very high number of COVID patients in the hospital, a high number of ICU patients and again...adding a little color to what Dr. Pate was saying around not being a sitting duck if you're vaccinated is that people who end up in our ICU or die in our hospital are almost exclusively unvaccinated people. And while some people who are vaccinated are ending up in the hospital, they just don't get the degree of illness to end up in ICU or have death from the virus as the unvaccinated or not immune do. So again, we've seen a trend towards improvement. I can't say that we know if that is going to hold or continue to go down. We have seen a resurgence of cases up in northern Idaho. Kootenai's numbers improved and then got much worse within two weeks of improving. So we're kind of holding our breath to see what's going to happen.

Gemma Gaudette: Well, as always, I appreciate both of you taking time out of your day to talk to us to answer people's questions. Our panel today, Dr. David Pate, former CEO of St. Luke's Health System and a current member of the Idaho Coronavirus Task Force, along with Dr. Joshua Kern, Chief Medical Officer for St. Luke's Magic Valley, Jerome and Wood River. Thank you both so much. Always appreciate you and your advice and wisdom.

Dr. David Pate: Thanks, Gemma.

Dr. Joshua Kern: Thank you, Gemma.

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.