Support for Arkansas Week provided by the Arkansas Democrat Gazette.

The Arkansas Times and QR FM 89.

Add to low again everyone and thank you for joining us.

The first confirmation of a new and especially dangerous strain of coronavirus was two years ago in Wuhan, China.

It took three months for COVID-19 to travel the 7645 air miles to Pine Bluff, where Arkansas's first case was diagnosed.

It was close, but that patient survived.

As of mid December though some 9000 of his fellow Arkansans have not been as fortunate.

Almost one in five Arkansans or about 600,000 of us have been infected.

Nearly 30,000 have required hospitalization, with 10% of them requiring mechanical assistance to simply breathe, and some of them for the last time came the vaccines.

Finally, and notwithstanding the political debates and the economic controversies, the numbers began to improve.

But now the virus is surging again and worldwide time for us to examine where we are in Arkansas and where the experts believe we're headed.

We're joined by Doctor Jose Romero, secretary of the Arkansas Department of Health doctor Shane Speights, Dean of the College of Osteopathic Medicine at Arkansas State, and Doctor Kelly Farris, CEO of the Lee County Cooperative Clinic at Mariana.

Dr Romero.

Let's.

Let's begin with you.

What do we need to know at this point?

As I mentioned earlier, the numbers were starting to look good and now they're not necessarily back where they were, but the trend lines.

Some of them are not encouraging.

Well, let me begin by thanking you for having me here.

And yes, you're correct.

We were on a downward trend.

It appears now that we are starting to see more cases and more hospitalizations than we had previously.

We continued to have significant numbers of deaths, and this will probably continue as we go forward.

We are watching this very carefully and we're concerned, in part because of the Omicron variant that is.

Being seen in a number of states, including five of the six contiguous states around us, and that means that the virus is here.

We just have to identify it so that we know that it's more transmissible, and it's possible that we'll see more cases and more hospitalizations in the upcoming weeks before we go online with the doctor.

Doctor Meryl.

Let's go with this.

Some graphic information that I think your office has prepared for us, and this the first one has to do with immunizations.

Yes, so the numbers speak for themselves.

We $3.6 million million doses and 1.8 million Arkansans have been vaccinated for those individuals that are in the five and above age group that can receive the vaccine we've administered to approximately 52% a little bit more than 50% of the population are fully vaccinated.

So we've we've been making headway in that area.

We need to get higher.

The national average is about about 62 percent 60%.

OK, and also we've got some some data information record information.

Now about where we stand in some key categories regarding the virus.

Yes, so so as you can see, this is a comparison between last year around this time and and the current numbers and the new cases are down, we're seeing less less cases, but I want to caveat that by saying that last year at this time we were on the upswing of a winter spike.

So these numbers, while encouraging may not reflect what's going to happen in the near future.

So overall, you see that new cases are down, active cases are down reported deaths again, about 1/3 of what we had last year.

And current hospitalizations are about 1/2 so, and ventilator use is also lower than it was last year.

But again, last year at this time we were on the upswing of the winter surge.

Well, and there is this also.

Still about somewhere in the neighborhood of one in five ICU patients is a COVID patient.

Or am I correct there?

About 20%?

I think that's correct.

Most of the ICU beds right now are being occupied by non COVID individuals and that means that you know if we have a surge in cases and we start to use those ICU beds, there may be a if you will a crunch to try to get those patients into ICU beds.

It will also impact those individuals that have other conditions that require ICU care and their beds.

Beds for them will be more difficult to find.

It's also the data also seems to confirm doctor that.

Those who are requiring hospitalization, in fact those who are sick, tend to be overwhelmingly those who are not vaccinated.

That is correct.

So individuals that have not received the vaccines are the ones that are becoming ill being hospitalized and our deaths are still made up primarily and almost exclusively of those individuals that have not been vaccinated or boosted because it's very important now that we all go ahead and move forward and get in addition to our primary vaccinations that we get our boosters as appropriate and in particular.

The older age groups, because we know that the antibody levels fell over time faster in that group than in other groups and and you're you're looking at the slides here, and you can see them, but overall it's overwhelmingly those individuals that have not received a vaccine, and we have a slide, a second follow up slide in and we, in terms of five plus age 5 and over vaccinations, immunizations.

There we are, right?

So this shows our fully vaccinated individuals so 52% and then eleven point or nearly 12% have received at least one dose.

So the summation of of those two is is 63%.

But remember, and more so now with with the concern for Omicron, we want fully vaccinated individuals and fully vaccinated and boosted individuals as necessary in order to protect against severe disease from that variant, right?

Doc spice.

I assume it goes without saying.

That you don't believe, and I'm sure Doctor Romero concurs that these immunization numbers are not what we would like to see, not what you would like to see.

Oh, not at all.

We'd like to see a much higher rate of vaccination.

Certainly here in the state, and even somewhat across the country.

One of the things in Dr. Romero is already kind of hinted to this.

The answer moving forward in terms of the Omicron Variantes booster vaccines, and when we look across the country only about a quarter of the population is actually had their booster vaccine, much lower number.

Even here in Arkansas, and so with the rapid spread of the Omicron variant that we're seeing and just, you have to look any further than what's going on in the UK right now.

It's happening actually, daily we're seeing doubling or almost every two days.

We're seeing doubling of the cases over there in the UK specifically.

In the ages 19 to 28 or 29, the answer is booster vaccine to be able to provide that level of immunity that you need to be able to prevent hospitalization and death.

As Doctor Romero indicated, a moment ago the there, the early evidence anyway, and correct me if I'm wrong.

The early evidence suggests that the Omicron variant is not as as vicious as as devastating.

Anyway, as COVID could be, but they're quite likely will be more of it.

I think we need to be cautious in terms of that data.

It's actually a report just released yesterday by the UK in terms of their evaluation in the Omicron variant that they're seeing there in a surge of cases.

And at this point.

Their data shows that they don't see a significant difference in terms of severity between Delta and Omicron.

Now that's cautionary, that's an initial report that came out, and we all know how sometimes initial data can be proven wrong, but we have to go with the data that we have in front of us, and that actually just came out yesterday, so I think we just need to be careful.

The biggest thing is is probably how it evades immunity right now in terms of the Omicron variant, and for those individuals that have been infected with COVID or the delta variant, or any of the other variants previously, you may not have the immune state.

That you really need to overcome not being severely infected by the omicron, and again just to underscore Dr. Romero already said the answer to that is vaccination, and specifically booster vaccines.

Kelly Faris over there in the delta and in other areas of Arkansas where the tend to be rural, low income and to harbor many communities of color.

It's been a continuing source of frustration to you and other health workers about the lower levels of immunization and.

Effective measures to prevent infection.

Are you making headway over there?

Unfortunately, it continues to be a big problem for us in the delta, particularly.

And we think about it on a.

Racial aspect, but I believe poverty plays a big part in that issue.

So 26% of our county living part poverty and and that's across racial lines.

And so I I think that's a big issue that education is a big factor for us in this area and people not understanding the severity of COVID the need for the vaccine and.

And just having that inability to understand the way they should and that socioeconomic status plays a big part in it.

Well, Doctor Ferris what?

What do they tell you when you offer you and your your staff when they offer immunization inoculation and they decline?

What do they tell you why they tell us that the vaccine was was created too quickly?

They tell us they want to wait.

And see what it what happens to other people.

Same thing with people with the booster shot.

I I hear it even from health care professionals that they do not want to get their booster dose they want to wait and see even have after having their first and second dose.

I've heard many misconceptions but that biggest one is not believing the vaccine.

Should should be utilized so quickly.

And doctor spines and Doctor Romero, both.

We've we've been over this before, but I suppose it's worth going over again.

It's often cited to the FDA approval for this is still conditional, correct?

So I'm not sure who's who's gonna answer this, but.

These vaccines have been approved by the FDA for use in the age groups and and they have undergone scrutiny by.

The Food and Drug Administration and also by the CDC and they continue to go through scrutiny, and so they're being watched very carefully to identify adverse events.

They are safe overall.

As you may know.

Yesterday, the Advisory Committee on Immunization Practices from the CDC made a recommendation that there be a preferential use of the mRNA vaccines.

That is to say, to using the Pfizer and Moderna vaccines, and that is based on signals.

Without a safety signals that were identified, so I think the public needs to understand that these are extremely safe vaccines and that they're constantly being watched, and that these signals are triggering more in depth evaluation of the vaccines, and then recommendations are made on top of that.

Yeah, and to Doctor Spice as well, there was some news coverage early Friday or Thursday night and Friday about the J&J.

The J&J version of that individuals may.

May prefer the two others.

The two other options.

Yeah, absolutely, and I and I would certainly concur with that.

I think the M RNA vaccines seem to be kind of the name of the game.

We talked about.

COVID Steve.

I do want to kind of step back to one thing that Doctor fears brought up that I think is a salient feature that is going to continue to be a part of the conversation even well after this pandemic.

And it's really our education and what I mean by that is we should make sure even in the K12 setting, that really you know all graduates understand the importance of vaccination, the importance of you know virus versus bacteria.

I mean, a lot of these things to be honest with you.

The three of us take for, you know.

Just take for example all the things that we learn in medical school.

Even before that, I mean we take for granted that information 'cause we deal with it every day.

It's not common knowledge and I think having these face to face conversations are sometimes difficult because of where the starting point is.

We go ahead.

I'm sorry.

No, that's that that was.

That was the point.

There I again, I just I think she's spot on in terms of of how much we need to work for future pandemics.

In terms of vaccination and the importance of that, I think we've got some things we can do in the K12 arena to help that.

From a clinical standpoint, all three of us is this the new normal?

Are we going to be in perpetuity looking for a new variant, and are we going to have to keep our own personal awareness?

Our own hygiene?

For that matter?

At at a higher level than we have been accustomed to in in previous decades?

I'm also I think we come, we go ahead.

No, no, please go ahead.

I'm optimistic that that this is nothing new normal, but that's just me.

I want to be optimistic, I don't I I don't want to think about the fact that I have to continue to wear a mask in large groups.

I have to limit where I go.

I mean, I I was kind of a hand washer anyway, so that's not anything new, but always worrying about that next variant.

What you know?

What are we going to see coming down the Pike?

I'm hopeful that we're not.

And you know, the early models were suggesting that we would hopefully be seeing the end of this pandemic, or somewhat of the end gear in the spring of 2022 and end of the summer.

And obviously the the asterisk was, you know, assuming we don't see a variant.

And now here we are, it's just hard to tell.

It's going to be a roll of the dice, and in terms of the variance that come after this, are they stronger?

Are they harder?

Are they weaker?

Or is it something that becomes more of a of a common cold as opposed to increasing hospitalizations and deaths?

I don't know of anybody knows it.

I'll say probably anybody, if anybody does know on this group is going to be Dr Ramirez.

I'll be curious to hear his thoughts on that, but I'm going to take the optimistic road and hope that that that's it's sooner or later will be out of this.

Well, Doctor Romero, your colleague just kicked it over to you.

Sure, thank you so you know, I, I think this virus is going to become endemic, meaning that it's going to be here for a long time in the future, which means that we're going to be seeing cases well into the into the coming years.

Unfortunately, variants are going to arise, and they're going to continue to arise until we have a worldwide distribution of enough vaccines to keep the tamp down.

This virus, so we can expect another variant sometime in the future.

We have to be prepared for that, and we can use what we already know.

To combat that variant.

I think that our approach to to how we're going to deal with these viruses in a social environment will also change.

I mean, I think the the using a mask for some of us will be part of our normal tire as we go into the winter season when we start to see more of these respiratory viruses.

So I think there will be a change.

Do I think it's a drastic dire change?

No, but I think there will be a change just like there has been in Asia, for example, or in the Pacific Rim where a mass are now considered.

Standard use because of the SARS pandemic that occurred in early the stars, one pandemic that occurred earlier this this century.

So I think there's gonna be changes.

We're gonna see more respiratory disease in the future and there is going to be, I think, unfortunately continued deaths due to this virus until we have sufficient numbers of individuals vaccinated against it.

Well, it may be the point here to kind of sidestep for a second to say that this is also as doctor, both doctors, I think, pointed out we are entering the seasonal flu.

Season not speaking specifically of COVID-19 or any of its variants, but I hesitate to say run of the mill flus, but the seasonal variety that we we see every year, so that raises the stakes, III should think for each individual as well as the clinical community.

Dark spots yeah, absolutely.

It's a matter of fact.

Even in my own clinic, I still see patients regularly.

I saw flu and COVID in my in my own clinic.

Typically we're seeing flu A, which luckily right now the vaccine, the flu vaccines that are out there protecting against the strains that we're seeing circulating.

So and I hate to sound like a broken record.

We go back to vaccination.

We know.

Vaccinations work, we know they reduce the incidence of hospitalization severity.

ICU stays in debt, and so I think vaccinations will continue to be part of the conversation.

In terms of allowing individuals to lead somewhat of a normal life, but one of the biggest concerns we're seeing now and again, not trying to kick it back too much to Doctor Romero, but what the data is showing is that we could be in a rough spot here in January where we're seeing this surge of cases of Omicron are already circulating delta variant, as well as an increase in influenza cases.

Those three kind of trifecta diseases together could seriously impact our hospitals and their ability to take care of people.

Let me go to Doctor Ferris here because you have in the Delta and other predominantly rural parts of Arkansas, you have a shortage of clinicians and in some cases facilities.

So to use a base phrase that's a double whammy you're looking at.

Absolutely absolutely a double whammy.

And while we do have a shortage of clinicians and in access we have plenty of vaccines, we have plenty of tests and so I want the people in our Community and across the state to understand that the tests are available.

The vaccines are available, there is no longer the need to wait two or three days for an appointment to get a vaccine or two, or three days.

For an appointment to get a test, you can get a an at home COVID test and I had one of my staff joke yesterday that she's having a Christmas dinner at her home with her entire family coming to town.

They're just so sick of not being able to get together and she said I'm just going to have to get a bunch of those at home test kits and hand them out at the door.

She was joking, but you know, it's a thought.

It's a thought when.

And come January, I am afraid to see what happens after this holiday season.

Well, Doctor Romero following up on Doctor Ferris there and I think doctor spots alluded to this a second earlier.

A year ago we were the system was in danger of just crash, simply crashing all the metropolitan hospitals or every hospital across the state was jammed to the rafters.

Staff couldn't get any sleep.

Is it possible that we could see?

That attain that level again.

Of stress, unfortunately?

Unfortunately, yes it is.

It's very possible if we start to see an increase in the number of Delma crown cases, although it may have milder disease overall, you're still going to have more individuals that are infected, and some of those individuals are going to progress to hospitalizations.

If we have a surge in influenza cases, that will compound the issue and that could bring us to the point where we overwhelm the system.

We have come very close on two occasions the winter surge.

And the summer surge in overwhelming the the bed supply and the vent and vent well the bed supply here in the state and I'm concerned that we could again approach this or this time actually overwhelm the system.

The other thing I want to do is focus on the pediatric population.

Because, you know, we have vaccines now available for that group.

11 to 18.

That is, the pediatric and adolescent group.

We have a single pediatric hospital in this in this state, which is a blessing and at the same time a disadvantage.

There are only so many hospital beds available for children.

If we start to have more cases of children that have either flu or influenza, which flu or COVID which are vaccine preventable at this time, the hospital capacity could be overwhelmed.

So again, I want to encourage parents to consider seriously vaccinating their children.

It is important both for flu, influenza and for the COVID vaccine.

These are safe vaccines that are effective.

They prevent infection, they prevent death.

It has to be frustrating to clinicians, practitioners, of every discipline that they want, particularly epidemiologist that the one best way to halt a pandemic is to immunize as many people as quickly as possible.

And yet there remains enormous cultural and political resistance to to that, too, to immunization Dr Spice.

You've alluded to this before it's got to drive you up the wall.

It's beyond frustrating.

It really is when we talk about that's almost it's own.

Separate pandemic is the amount of misinformation that has spread rapidly through social media and over the Internet that truly is affecting people's decision making.

I mean, I was on the phone just just the other night with a patient of mine and you know their child had been infected.

I've been working with them for a long time to try to get try to get the person vaccinated and they, you know, didn't want to because of all the different misinformation they were reading.

Back to what Doctor Mary said, these vaccines are safe and effective.

Billions of doses have been given worldwide on these vaccines, and they're safe and effective, and this is the way to prevent severe disease hospitalization and death.

And so it's just it kind of blows my mind that we're still this far into it and now looking down the barrel of another variant that could overwhelm us, that we're still really having these debates in these conversations, and it all boils down to the spread of misinformation.

There's a lot of psychology behind it.

There's a lot of.

Fatigue after Ferris?

You know, kind of alluded to that in terms of her, her colleague that's going to have you know family over for Christmas.

I mean, I think that's a lot of households not only in Arkansas, but certainly across the country that are just so tired of this and they just want it to be over.

But it's not and and the disease doesn't care as as my my oldest son always reminds me facts don't care about your feelings.

Doctor Romero I have to say some are you and other physicians in positions of public responsibility at at the university level and in government.

Some of this frankly vitriol, is aimed directly at you.

How are you bearing up?

How do you deal with it?

Well, well, I think that those of us that that are in positions like this understand that that we are going to be the target of a lot of frustration.

A lot of dissatisfaction with the current situation.

We look at it as as as something that comes with this position that as long as I am following the science policy following good policy and looking out for the health and welfare welfare of our citizens.

It's tolerable, and and it's I accept it, but I believe that our decisions have been scientifically based.

Have been policy based and are for the good of the population.

We are always willing to modify as necessary, but to date our decisions have been for the best for the public doctor, Kelly Farris.

We've got family.

It's the Christmas season.

Within days we've got all families gathering close proximity to one another.

It's a great season, doesn't necessarily need to be a dangerous season.

Doctor Ferris.

It does not need to be dangerous.

We can still enjoy our families.

We can still be cautious.

We can, if you know you have symptoms of flu or COVID.

Don't take that chance of coming around your other family members and you know you're symptomatic.

We can still get together with our families and wear our masks.

Wash our hands.

Just be careful.

Be cautious, be cognizant of what we have been through these last two years.

Everyone is tired of it, but we can do our part to even outside of being vaccinated, which is the number one thing that could help us right now.

But if you're not going to be vaccinated.

It at least be safe in other ways.

Doctor Spice, I can't imagine you'd argue with any of that.

No, not at all, and I want to reiterate something that Doctor Romero mentioned, and I know Doctor Ferris Limited as well.

You got it for all three of us.

I'll speak for all three of us.

We make the best decisions we can based on the best available evidence at the time, and you're taught that as a physician.

That's what goes through your training so that the patients sitting in front of you want to make the best decision for their health and for their welfare.

Based on the information you have at the time you make that decision, and I can speak for all three of us that we're doing the exact same thing for our community, for our state and for our regions.

Whenever we provide that information regarding COVID vaccination, how to keep your family safe, how to keep yourself safe.

But I'll go back to what you already asked earlier.

There's certainly a lot of frustration on our part as we continue to try to do that, to have to be honest with you, individuals not qualified to make those comments.

Trying to really undo what we're doing.

Got into there because we're out of time.

Doctor Romero Dr Spice Doctor, Ferris all forever.

Thank you very much for your time.

Thank you for coming on and we'll see you in the in the new Year.

Be safe.

Thank you for joining us as always.

Next support for Arkansas Week provided by the Arkansas Democrat Gazette.

The Arkansas Times and QR FM 89.