Morning Medical Update Friday 7-16-21

For the first time in more than a week, The University of Kansas Health System reports a slight decrease in the numbers of COVID-19 patients today. 32 patients with the active virus are being treated, down from 37 yesterday. Still, the numbers are the highest the health system has had since February 19. 12 of today’s patients are in the ICU, up from nine yesterday. Three of those patients are on ventilators, down from four yesterday. Ten other patients are still hospitalized because of COVID-19 but are out of the acute infection phase, up from seven yesterday. That’s a total of 42 patients, down from 44 yesterday. HaysMed has four active patients, up from two yesterday.

On today’s Morning Medical Update, Dr. Steve Stites, chief medical officer at The University of Kansas Health System, joined us at the desk to help answer questions, along with Dr. Nathan Bahr in Infectious Diseases, filling in for Dr. Hawkinson. Dr Kevin Ault, who serves on the Advisory Committee on Immunization Practices also joined us to explain how the CDC puts together the vaccine policy for the United States.

Before getting to the questions, Dr. Stites had this stark assessment: “We’re in trouble, Kansas City.” The numbers are up all over the Metro, and he says we have a tough combination of too many unvaccinated people, masking requirements that have for the most part disappeared, mass gatherings and the more aggressive and easily spread Delta variant. He worries that with area hospitals already bursting at the seams from regular patients, a big surge like the one in Springfield would be a disaster, with no place for new COVID-19 patients.

Dr. Ault said COVID-19 has a serious effect on pregnant women and their outcomes and stressed the most recent data shows the vaccines are safe for pregnant women and their babies. He explained how the vaccine approval process works and described how he and his committee work to make sure they are safe. He says with 157 million fully vaccinated Americans and only 4,700 breakthrough infections, mostly very sick people to begin with, the vaccines offer good protection against severe outcomes and death.

Here are the media and community questions in the order the panel addressed them, followed by the short answer. Time code for the question is in parentheses. See the video for their full answers and comments.

(3:05) Is there anything we’re learning so far about how COVID reacts to people who are fully vaccinated once they test positive? You can still test positive after vaccination, but you are protected from hospitalization, critical illness, and death. You can also still spread the disease.
(6:20) Is it more or less likely that I could have COVID and not know it if I’m fully vaccinated? It’s more likely you won’t know. Even if you have mild symptoms, the answer is to get tested.
(7:30) Are unvaccinated people responsible for the higher positivity rates in Kansas and Missouri and do businesses need to resume mask mandates like they have in Los Angeles? Unvaccinated people, along with the highly contagious Delta variant are to blame. If things continue to get worse, with numbers rising exponentially in Kansas City, and Springfield running out of hospital beds, we may have to go back to mask mandates.
(12:40) Why can't immunocompromised people here in the states get a Pfizer booster shot like they're getting in Israel? I'm tired of masking and isolating to stay safe. Israel has different circumstances, though the ACIP committee did discuss this recently. Immunocompromised people should still wear a mask. It’s tough to talk about a third shot when half the country has had zero doses of the vaccine.
(17:05) I got the J&J vaccine in March. Can I get a mRNA shot at any time? Should I do so to better protect myself? We need more data before making any recommendations.
(18:35) What are the financial costs to people who refuse to get vaccinated? Are taxpayers footing the bill for anti and hesitant vaxxers who end up in the hospital or can't work? The average hospital cost for a standard medical patient is $15,000 to $20,000. COVID patients cost nearly double at $30,000 to $40,000. We all pay for it in the form of higher insurance rates.
(21:00) Does blood type have anything to do with how resistant a person is to COVID-19? Is this an urban myth or being studied? It’s being studied but there are no definitive conclusions yet.
(21:55) Is the Delta variant more deadly if it is also more contagious? Do you still have deaths from COVID-19 at the health system? The health system still has deaths, the last one on July 8. The Delta variant is more contagious, and thus causes more deaths, but is not necessarily more deadly than the Alpha variant.
(23:05) When will a vaccine for children under age twelve happen? Where are we in the process and what are the next steps? It’s still being evaluated by the FDA, but we’re still a few months away.
(23:50) Do you have any hospitalized patients who had COVID-19 before and have it again? Not currently, but have had some in the past who have other severe chronic illness.
(24:30) The ZOE COVID tracker from the UK shows the top five symptoms from the Delta variant as headache, runny nose, sneezing, sore throat and loss of smell. That differs from the top Alpha variant symptoms of loss of smell, shortness of breath and fever. Do symptoms for Delta and Alpha variants present the same in the U.S.? The differences are subtle but for the most part the same.
(25:15) The CDC and W-H-O monitor variants around the globe to determine the most dangerous. The U.S. classifies the variants as 1) a variant of interest 2) a variant of concern and 3) a variant of high consequence. Why is Delta only a variant of concern? What are the differences in classifications? The reason the variant is not listed as “high consequences” is because the vaccines still work.
(27:40) Early in the pandemic you advised family gatherings to avoid family style eating. Is this still a concern with the newer Delta variant that spreads more easily? It all comes down to whether you and everyone in your family is vaccinated. If so, all are safe.
(28:50) The J&J vaccine changed my menstrual cycle. How safe is the vaccine for women planning a family or for young girls? Menstrual changes are biologically plausible from any vaccine, but there are no long-term consequences.
(30:45) A couple in their 70’s wants to visit their new grandchild, but the wife was exposed to a known case of COVID. They are all fully vaccinated. Should they wait? To be safe, wait ten days to make sure everything’s OK.
(31:50) Do you think events will be shut down and we’ll go back to the way we were? It all depends on our social level of responsibility and what happens with the numbers. We’ve said all along, “We’ll know more in two weeks than we know now.”
(35:30) Is testing for the Delta variant any different? It’s the same test.
(36:10) My brother’s family is not vaccinated because they believe the vaccine does not clear the body, leaving components inside forever with possible future side effects. None of the three vaccines cleared for emergency use has a mechanism to do that. The body will naturally clear it. For those who know of Snapchat messages, the vaccine works like that, and disappears after using it.
(38:30) Why does it matter if I get vaccinated? The risk of catching the virus is the same! That’s a false premise. The risk is not the same and goes down dramatically with vaccination.
(39:40) Do we know how much previous infection prevents against the Delta variant? Not much at all.
(40:25) Is regeneron a less effective treatment in people with co-morbidities like obesity? It was really targeted for that. Studies show it works well for high-risk people.
(41:50) After the FDA approves the Pfizer vaccine, will doctors be able to use it off label to give a third booster to those with chronic illness and the immunocompromised? Doctors have that authority, but Pfizer and Moderna have data on this that they’ll present soon.

Monday, July 19 at 8:00 a.m. is the next Morning Medical Update. Chiefs training camp in St. Joseph is just around the corner. We will hear from the head team orthopedic surgeon, our own Dr. Paul Schroeppel. He also has a great patient story involving a student athlete to share.

ATTENTION: media procedure for calling in:

The meeting is available by Zoom, both video and by phone. To join the Zoom Meeting by video, click https://kumc-ois.zoom.us/j/7828978628

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The feed is also available via TVU grid. The TVU source is UoK_Health and is being made available to all.

Feel free to send questions in advance to medicalnewsnetwork@kumc.edu.

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(3:05) Is there anything we’re learning so far about how COVID reacts to people who are fully vaccinated once they test positive? You can still test positive after vaccination, but you are protected from hospitalization, critical illness, and death. You can also still spread the disease.
(6:20) Is it more or less likely that I could have COVID and not know it if I’m fully vaccinated? It’s more likely you won’t know. Even if you have mild symptoms, the answer is to get tested.
(7:30) Are unvaccinated people responsible for the higher positivity rates in Kansas and Missouri and do businesses need to resume mask mandates like they have in Los Angeles? Unvaccinated people, along with the highly contagious Delta variant are to blame. If things continue to get worse, with numbers rising exponentially in Kansas City, and Springfield running out of hospital beds, we may have to go back to mask mandates.
(12:40) Why can't immunocompromised people here in the states get a Pfizer booster shot like they're getting in Israel? I'm tired of masking and isolating to stay safe. Israel has different circumstances, though the ACIP committee did discuss this recently. Immunocompromised people should still wear a mask. It’s tough to talk about a third shot when half the country has had zero doses of the vaccine.
(17:05) I got the J&J vaccine in March. Can I get a mRNA shot at any time? Should I do so to better protect myself? We need more data before making any recommendations.
(18:35) What are the financial costs to people who refuse to get vaccinated? Are taxpayers footing the bill for anti and hesitant vaxxers who end up in the hospital or can't work? The average hospital cost for a standard medical patient is $15,000 to $20,000. COVID patients cost nearly double at $30,000 to $40,000. We all pay for it in the form of higher insurance rates.
(21:00) Does blood type have anything to do with how resistant a person is to COVID-19? Is this an urban myth or being studied? It’s being studied but there are no definitive conclusions yet.
(21:55) Is the Delta variant more deadly if it is also more contagious? Do you still have deaths from COVID-19 at the health system? The health system still has deaths, the last one on July 8. The Delta variant is more contagious, and thus causes more deaths, but is not necessarily more deadly than the Alpha variant.
(23:05) When will a vaccine for children under age twelve happen? Where are we in the process and what are the next steps? It’s still being evaluated by the FDA, but we’re still a few months away.
(23:50) Do you have any hospitalized patients who had COVID-19 before and have it again? Not currently, but have had some in the past who have other severe chronic illness.
(24:30) The ZOE COVID tracker from the UK shows the top five symptoms from the Delta variant as headache, runny nose, sneezing, sore throat and loss of smell. That differs from the top Alpha variant symptoms of loss of smell, shortness of breath and fever. Do symptoms for Delta and Alpha variants present the same in the U.S.? The differences are subtle but for the most part the same.
(25:15) The CDC and W-H-O monitor variants around the globe to determine the most dangerous. The U.S. classifies the variants as 1) a variant of interest 2) a variant of concern and 3) a variant of high consequence. Why is Delta only a variant of concern? What are the differences in classifications? The reason the variant is not listed as “high consequences” is because the vaccines still work.
(27:40) Early in the pandemic you advised family gatherings to avoid family style eating. Is this still a concern with the newer Delta variant that spreads more easily? It all comes down to whether you and everyone in your family is vaccinated. If so, all are safe.
(28:50) The J&J vaccine changed my menstrual cycle. How safe is the vaccine for women planning a family or for young girls? Menstrual changes are biologically plausible from any vaccine, but there are no long-term consequences.
(30:45) A couple in their 70’s wants to visit their new grandchild, but the wife was exposed to a known case of COVID. They are all fully vaccinated. Should they wait? To be safe, wait ten days to make sure everything’s OK.
(31:50) Do you think events will be shut down and we’ll go back to the way we were? It all depends on our social level of responsibility and what happens with the numbers. We’ve said all along, “We’ll know more in two weeks than we know now.”
(35:30) Is testing for the Delta variant any different? It’s the same test.
(36:10) My brother’s family is not vaccinated because they believe the vaccine does not clear the body, leaving components inside forever with possible future side effects. None of the three vaccines cleared for emergency use has a mechanism to do that. The body will naturally clear it. For those who know of Snapchat messages, the vaccine works like that, and disappears after using it.
(38:30) Why does it matter if I get vaccinated? The risk of catching the virus is the same! That’s a false premise. The risk is not the same and goes down dramatically with vaccination.
(39:40) Do we know how much previous infection prevents against the Delta variant? Not much at all.
(40:25) Is regeneron a less effective treatment in people with co-morbidities like obesity? It was really targeted for that. Studies show it works well for high-risk people.
(41:50) After the FDA approves the Pfizer vaccine, will doctors be able to use it off label to give a third booster to those with chronic illness and the immunocompromised? Doctors have that authority, but Pfizer and Moderna have data on this that they’ll present soon.