As vaccinations continue to be administered in Sitka and surrounding communities, life is beginning to resume a normal feel. Ending the pandemic for good, however, won’t happen without help — from just about everyone.
KCAW’s Robert Woolsey recently spoke with SEARHC chief medical officer Dr. Elliot Bruhl about the possible end game for the COVID-19 pandemic in Sitka, and how vaccination will play a critical role in bringing it about.
KCAW – What does the end game look like for you? I mean, Dr. Fauci said on NPR yesterday, he thought, if we kept it up, we could sort of be back to where we, you know, back to normal almost in about a month.
Bruhl – Wow. Well, I would certainly defer in all things to Dr. Fauci. He’s, you know, such a highly qualified and physician in the area of epidemiology and infectious disease. But I think in terms of our unique circumstance, in Southeast Alaska, you know, we have isolated populations of people. And then we have people coming in from the outside, which, at times has protected us in the last year and a half. And other times it’s exposed us. And I think one of the things that we see now on the horizon is the possibility of increasing tourism in Southeast Alaska. And with that comes new challenges. But thankfully, we have arrows in our quiver that we didn’t have or understand 18 months ago, or certainly not, even two or three months ago, back at the turn of the new year, when we first started providing vaccine. There was good data about its safety, and the efficacy looked good. Now, after millions of people have been vaccinated, what we know is that that certainly the messenger Rna vaccines are vastly more effective than we ever hoped. So not only do they prevent people from getting sick and landing in the hospital and dying, but the data are now showing that they prevent the spread of the disease, they prevent asymptomatic disease, they’re not perfect in that regard, there’s still a few people who will contract it, but they’re extraordinarily good 88 to 89% effective at preventing asymptomatic disease. And another good thing is that their safety has turned out to be exceptional. You know, the, the really the, the problems we saw in the beginning, which was occasionally somebody will have an anaphylaxis reaction anywhere from once to four times in a million continues to be the case, but we know how to treat that we have the medications on site to treat it when people receive it. So what the end game looks like, is that we manage to vaccinate is substantial enough portion of the population, that epidemic spread no longer becomes realistic. Will that completely eradicate this illness from the Earth or from our country? No, I expected COVID-19 is probably an illness that we’ll continue to deal with, in clinical medicine for some time to come. But in terms of the epidemic spread, if you follow the data, you know, we’re already seeing that we’re as a country on an exponential decline. And, you know, the other good thing about the messenger Rna vaccines in particular is that they continue to be highly effective against all the different variants that have been identified here in Sitka. You know, along with the efforts of White’s pharmacy, you know, we’ve been able to vaccinate a really high proportion of the population, what people in Sitka don’t realize is we’ve been doing the same thing all around the region, we’ve been doing this in the small communities that we care for, we’ve been donating vaccine in some of the bigger communities so that we don’t provide care, like Ketchikan. And Petersburg, so, you know, why would we do that? You know, well, I mean, it’s sort of one of those, you know, rising tide raises all boats, you know, it protects all of us.
KCAW – You know, the closer we get to kind of finishing this, the more intense the resistance, it seems at times the the logic, the illogic of the misinformation seems very high right now, and common sense suggests that if you have concerns about any of these vaccines, you should talk to your doctor. And as a doctor Elliot, what do you tell patients who come in who have read some of these wild things about infertility and changing your DNA,you know, the kind of thing I’m talking about,
Bruhl – The first thing that needs to be understood is that there, there has never been a medication, or a public health intervention that has been more effective at improving the health of human beings than vaccination. And that goes back to the 1790s, when we first started vaccinating people for smallpox, and it’s true, all the way up through the 20th Century. And in all of that time, there has never been a vaccine that has been as intensely studied and intensely monitored for safety as this vaccine. And the data for this monitoring of the safety of this vaccine has been now, not just in a few thousands like it was when it was first released, but in many, many millions of people. And so what do we know from that what we know from that is that mild reactions are common, such as a mild fever, or a sore arm, or some fatigue for a day. But that severe reactions, or life threatening reactions are extremely rare. So as a health intervention, it’s one of the safest things that you can do. And we have good data to support that, as a matter of fact, a huge bunch of those data was just published in the New England Journal of Medicine here in the last couple of weeks. And it’s available to anybody on the web.
The risk of a serious problem from COVID-19 is a real risk for many, many people, and the risk of that problem is much greater than the risk of taking the vaccine. And then the other thing is that we all have a duty to protect our elders and the vulnerable people in our population. So while most of us only have a small risk for somebody who has lung disease, or diabetes, or many other conditions, including pregnancy, the risk of COVID-19 is grave. And we need to protect those people. And we all do our part by getting vaccinated. So not only is it a medically good choice for each of us as an individual, but it’s also it’s also our civic duty.
KCAW – What about kids? Elliot, I know for a long time, people were saying that kids weren’t really at risk from COVID-19. Why should we put them through the trauma of being vaccinated? What’s your medical advice there?
Bruhl – Oh, my advice as a parent is ‘Because I said so.’ But, I’ll say, you know, the reality is that while there is there is a reduced risk of mortality or grave illness amongst youngsters, the reality is that we really do need our kids to go to school. You know school is important to our children, and it’s important to our community. If our schools aren’t functioning, our businesses aren’t functioning. If our schools aren’t functioning, as parents, we’re going crazy. And really, it’s not a sustainable situation. Having our young people vaccinated improves not only the safety of the schools, but our ability to keep our schools open because otherwise, necessarily, you know, they’re they’re a place where kids congregate, which becomes a potential. Once COVID-19 gets into a place like that, then it can spread. And once again, it can spread to the vulnerable members of our community and keep the pandemic rolling. So there’s lots of good reasons to vaccinate our kids and not least of which is that we love them and we want them to stay healthy.
KCAW – You’ve probably encountered vaccine hesitancy just in your medical practice over the decades.
Bruhl – Yeah. I think there’s some other things that can be said about the vaccines that you know, as a as a physician, and as a scientist, which all physicians are trained as scientists as part of our training. The technology that we rely on in medical and medicine is complex and at times, it’s overwhelming. But it also we have a, we have a culture of science in medicine that forces us to look at both risks and benefits. And we do that very carefully. And nothing that we do in medicine is risk free. So it doesn’t matter if we’re talking about going into surgery to have our appendix removed, or taking a medicine for our blood pressure, or taking a vaccine to prevent an illness, all of them carry some small amount of measurable risk that we examine with data collection. And, and we look at that carefully. Now, sadly some of us have cancer, and we take serious drugs to treat cancer, those drugs are not without a risk. But they, they also carry potentially great benefits. Many of the types of science and technology that we’ve used to develop these vaccines are precisely the same methods, and knowledge that has led to the development of fabulous treatments that we have now for many diseases, like breast cancer, or colon cancer, and so on. And, and so it’s not that this is something foreign, or, you know, that dropped out of the sky. These are actually, when medical science developed these vaccines here in the last year, they were standing on decades and decades of research and development that’s gone on before. One of the things that is so hopeful about this is that in the future, if there are other diseases that that we encounter, this reassures me that we have, we have the knowledge and ability to to confront those diseases effectively. Here it is, it’s right in our hands, we have to use it.
The last thing that I’d say, Rob, is that it’s okay to have misgivings and questions, and your your doctor or nurse practitioner or physician’s assistant is more than happy to talk with people about specific concerns, and to discuss those and to address them. Sometimes having that conversation in private is the most important part for everybody.
KCAW – For many, just the idea of a global pandemic is kind of confronting, this thing that’s facing us that we can’t really control, and then just this the mass effort to get people vaccinated is almost the same sort of thing that you feel like you’re being propelled to do something you just don’t really know if you want to face it. But talking to folks like you, I think is really is really reassuring and good information.
Bruhl – Yeah. You know, one of the most common things I’ve heard Rob, you know, from younger people is why should I bother? This doesn’t really affect me, this is not really dangerous to me. And, you know, the reality is, it is affecting you. It’s affecting you and the economy and our ability to go forward and and we all have a civic duty to participate in solving this problem.
KCAW – Elliot, thank you very much for your time today.
Bruhl – Rob. It’s good to talk to you. It’s nice to see you and yeah, hope to see you again soon.
