Straight Talk from a Doc on Covid, Vaccines

Separating facts from fiction

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By Jonathan Laine

Sheesh. Times are trying! We have a pandemic that is raging. Most of the summer we had smoke so thick that it was dangerous to go outside. I think we are safe from floods, but the locusts could be next?

So, what does the current situation with Covid-19 look like? There are constantly a plethora of news stories on the pandemic, information that’s often contradictory and confusing. So let’s get some facts straight: Essentially all the infections now are from the highly infectious Delta variant. Thirty percent to 50% of people who get Covid-19 have no symptoms, yet can still transmit the virus. Many vaccinated people can develop the Delta variant, but very few vaccinated people develop severe disease. Of those patients who require ICU care or die, well over 90% are not vaccinated.

Children get infected at a similar rate as adults, and can spread the virus, yet very few children develop severe disease. At press time, 6.4 million children in the U.S. had developed Covid-19, but only 700 had died (1 death for every 10,000 infections). The Pfizer vaccine was recently approved for children 5 years and older in a smaller dose. Why would a parent consider vaccinating their children? It will help prevent transmission to susceptible members in our society, as well as prevent outbreaks and subsequent school shutdown when that occurs.

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The CDC also just approved booster shots for people 65 and over, or 18 and over with underlying medical conditions, as well as for those who work in a high risk setting such as education, public transit, grocery, or health care. They have said it is okay to mix and match, meaning you can get a booster with either the same vaccine as you previously had or switch to another one.

Does requiring masking and social distancing intrude on your social liberties? Of course. And our society has many such limitations. If you are late for work, can you drive 70 mph through the neighborhood? Of course not! We have accepted this limitation to allow our society to be safer.

When is Covid going away? Never! We have only eliminated a single virus from the planet: smallpox. We still have occasional outbreaks of measles in the U.S., and polio is still prevalent in some countries. (The reason we do not have polio in this country? … Vaccines.)

So it makes sense that if we cannot end it, then our only other option is to find a way to live with it. To use my speed limit analogy again, we could make our roads infinitely safer by simply cutting every speed limit in half (12 mph in a neighborhood, 35 mph on the highway). But that would have significant detrimental effects on everyday life. With Covid-19, since we cannot realistically eliminate it, we must find a middle ground that minimizes our risks but also allows for society to function at as full a capacity as possible. The three strategies that most decrease the risk of Covid include vaccines, masking, and improved indoor ventilation.

Lastly, remember that there is a significant effect of Covid on our medical community. At the beginning of the pandemic, there was no hesitation among Tahoe Forest personnel to come to work. This was when we didn’t know how it was spread or if we were going to bring it home to our families. And there was no vaccine on the horizon! Now almost all the very sick Covid patients we care for are unvaccinated, and we continue to care for all our Covid patients, but honestly, it is scary for our staff.

I wish to thank all Tahoe Forest staff for allowing us to treat all our patients, and please note that we need everyone for our hospital to work, including nurses, registration, housekeeping, security, engineering, dietary, pharmacy, technicians, social workers, medical assistants, administration, lab, PAs/NPs, and physicians.

~ Jonathan Laine, M.D., is an emergency physician and a 31-year Truckee resident. He was previously the medical director of emergency medicine at Tahoe Forest Hospital and is currently serving as chief of staff.

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