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We've made vaccinations free, safe, and convenient.

The vaccine has FDA approval.

Over 200 million Americans have gotten at least one shot.

We've been patient, but our patience is wearing thin.

>> Tom Layson: It's a tale of two societies, the vaccinated and the unvaccinated.

The unvaccinated risk their health and now, in many cases, their jobs.

The vaccinated aren't home free, but life goes on without as much fear of illness or death.

The delta variant is coursing through Western Washington.

Tonight, we talk with State Medical Association President, Dr. Nathan Schlicher, and Dr. Umair Shah, the new Secretary of the Washington Department of Health.

The fourth wave of the coronavirus, the delta variant, is the discussion next on Northwest Now.

[ Music ] >> Tom Layson: The United States has now pushed up past 650,000 deaths due to the coronavirus.

Some parts of the country are besieged by the delta variant, with hospitals overwhelmed.

Here in Washington, 67% of the population 12 and up is fully vaccinated and with the aggressive nature of the delta variant, some models suggest the number of people left to infect around here may be getting small enough to slow the momentum.

But the delta variant drove Pierce County infections to an all-time high between February and July of this year.

And remember, that's without the robust testing needed to catch all of the infection data.

Still, though, 96% of the cases and 94% of the COVID hospitalizations were among the unvaccinated during that time period.

Yes, breakthroughs happen, but the overwhelming odds favor the vaccinated.

People of faith are among those struggling with vaccine hesitancy.

They perceive a bright line between the church and state and between science and the divine.

But as Northwest Now contributor Philip Townsend shows us, two local pastors are lending their voices to the call to get vaccinated.

>> Philip Townsend: If you know the history of Lakebay and Home, you know that independent thinking has a long history here, but so does the Lakebay Community Church, for almost 100 years now, gathering the faithful to build a community.

>> Mr. Whitmarsh: I'm not going to tell them what to do, but I have certainly encouraged them that I believe getting vaccinations is one of the best things that we can do right now.

>> Philip Townsend: But Pastor Dan Whitmarsh says that community is sharply divided and that his views that science reveals God's creative work is why he's backing masks and vaccines, no matter the cost.

>> Mr. Whitmarsh: And there have been some people that have left the Lakebay Church and started attending other churches who have been maybe more open and free on whether or not people need to be masked or vaccinated.

And then we've had some people show up at Lakebay because they thought their churches maybe weren't taking it seriously enough and they heard what we were doing and so they have started attending here and appreciated that.

So there really does seem to be a shifting, a migration that's happening as people find places that are more in line with their own personal values and opinions.

>> Philip Townsend: But opinions on the Key Peninsula and in rural Pierce County in general swing against vaccinations more so than in the urban centers.

That's why government leadership recently convened a Pierce County Associated Ministries Group asking for help in spreading the message that vaccines are safe and effective.

Which is where association director Mike Yoder and Pastor Whitmarsh agree.

>> Mr. Yoder: It is controversial.

In many faith communities, people have, you know, have left, you know, when maybe a congregation has decided to follow the health department's mask guidelines and those are tough things to do.

But you know, sometimes it is hard to do the right thing.

I just want to see faith leaders stepping up and being the community leaders that I think the world is watching and waiting for them to be.

People want to follow strong, moral, sacrificial leaders, and for the most part, the clergy that I know, the pastors that I know are those people.

>> Philip Townsend: The rubber hits the road when Whitmarsh and Yoder work in the community, visiting the Key Peninsula Fire Department, for instance, trying to understand attitudes, what first responders are seeing in the community, and help them help others find their way to vaccinations.

>> Mr. Whitmarsh: One of my arguments all along has been that the church is focusing, the larger church is focusing too much on rights and freedoms and not on, well, how do I lay those aside for the betterment of the community.

And right now, wearing masks, social distancing, and getting vaccinated are the three strongest methods that we have to achieve optimal communal health in this moment.

So I have argued that I think scripturally, there's a really strong call to do all of those things in order to serve our neighbors, in order to serve the vulnerable.

>> Philip Townsend: In the end, pastors relying on the science are staying the course, all while emphasizing what they see as the Bible's mandate to the faithful, and that is to be other-oriented.

>> Mr. Yoder: It's brought some vulnerabilities to light in a new way that I hope, my hope is that we will not go back, that we will say, we've got to do better at caring for people in need.

>> Mr. Whitmarsh: I have hope that there are better days ahead and there's going to be days of laughter and joy and that this will be a distant memory and that we will come out of it better and stronger.

>> Tom Layson: Joining us now is Saint Joseph ER doc and State Medical Association President, Dr. Nathan Schlicher.

What is the reality of the situation across the system and on the ground at hospitals, when it comes to the delta surge?

Are we going to see the army coming and setting up cots again or not?

Where are we?

>> Dr. Schlicher: Well, we're at a point that is a new record high.

The delta variant surge that we have now, and this is even before we see the Labor-Day spike and the return-to-school spike and the 60,000-fans-in-a-stadium spike, which thankfully, at least here in Washington, we've got masks for, but one only needs to watch the Seahawks game and road teams and see no masks in stands.

We are sitting at a level that we have never been at before in hospitalizations.

And the thing I try to tell people is, as a country, we have built a health system that runs at about 95-plus percent capacity.

We don't have excess for pandemics.

We've seen that when hurricanes have hit.

We've seen that in 9/11.

We've seen it time and again.

And this pandemic now is taking up 20 to 25% of all hospital beds.

We don't have 25% of our hospitals filled with any other disease right now, period.

So that's the kind of strain it's putting on a system that's not designed to fundamentally increase like that.

>> Tom Layson: I'm going to hit you now with the big question, because I know people watching this, myself included, ask themselves this question and ask this question of the medical profession, in terms of ethics.

If you have a group of people who, you know, in effect are hitting themselves in the toe with a hammer and taking up hospital space and somebody else who's in a car crash or sick or injured comes in and gets turned away, and it hasn't happened en masse yet, but there are anecdotal cases starting to show up.

How in you-know-who's green Earth is it ethical to turn away somebody who is accidentally or unfortunately found themselves into a situation, as opposed to somebody who's taken up a hospital bed because they were too pigheaded to get a vaccine.

That is.

>> Dr. Schlicher: It's a fair question and it goes to the compassion fatigue I think you hear about from a lot of people on the frontlines of this pandemic, and I think a lot of citizens that are, like, I want to get back to my life.

I want to get back to normal.

I want to get the surgery that I need or my loved one needs.

They want some normalcy in life.

And I understand it, but what I also tell people is in medicine, we've committed to always doing the right thing to care for everyone, and the rationale is this.

Much of what we see in medicine is the result of choices we make in our lives, right?

Most car accidents occur because of drugs or alcohol by one party, not the person necessarily that was hit, or texting or other distractions, in some studies, you know, 50 to 80%.

So again, that was a choice that was made that we know is wrong.

Not getting a vaccine is another choice that's made that we know is wrong.

You know, smoking we know is unhealthy for you.

Drinking too much alcohol we know isn't healthy for you.

Eating too much, obesity, diabetes, et cetera, is not good for you, right?

So if we start to draw lines and say, well, you made a choice, then where does that stop, versus saying we take care of everybody?

Now we do have to triage, which means we have to sort, which means that you may not get the care as timely.

And as you mentioned, the anecdotes, you know, a gentleman that needed surgery for a gallstone and his pancreas.

That was posted in a closed community among ER docs and the news article actually referenced it, where the doc was trying to crowdsource an ICU bed for this gentleman and finally found one in Montana, from Texas.

The gentleman unfortunately died.

So it is happening.

We're blessed right now in Washington that we're not experiencing that firsthand, but you just need to go to Idaho and see that they're rationing care right now.

So I don't think that future is out of it, but I think we will always ration care as a profession, as a state based upon the needs of the patient, not necessarily just the choices they've made, because we've all made bad choices in our life.

Our job is to try to help everybody to the best of our ability.

>> Tom Layson: Right.

And I think just being first or the guy who got there first is a very poor ethical basis upon which to make a decision.

>> Dr. Schlicher: Correct.

And that's why you may wait a long time if you're there for your toe pain in the ER.

In contrast, you know, if you're there for.

>> Tom Layson: Or how about a heart attack?

>> Dr. Schlicher: Heart attacks generally go towards the top of the list at most hospitals.

Now it's a standard to get an EKG within 10 minutes, regardless of when you come in, and we have processes to make sure that those things happen to try to identify the sickest.

It's not a perfect system, because not everybody is going back immediately.

But again, we've been fortunate to be able to treat everybody to the best of our ability in Washington, not 100% perfect, but to stretch as we can.

I think the next wave we see of this challenge is that it's not necessarily a space problem.

You mentioned tents.

Tents are one piece of the equation.

>> Tom Layson: Yeah.

>> Dr. Schlicher: It's a people problem.

>> Tom Layson: Yeah.

>> Dr. Schlicher: And we're running out of people to care, not care in emotional sense.

Care in a physical sense.

>> Tom Layson: Provide care, yeah.

>> Dr. Schlicher: Yeah, because they are being asked to do double time, multiple shifts, all of that, and there's a certain point where you can't be on the front lines of a battle for 18 months and keep going at two and three times normal speed.

>> Tom Layson: Let's talk about staff and the toll this has taken on them, not only, as you mentioned.

from the workload in this endless, you know, it's been fight or flight for a year and a half for a lot of people in the profession.

>> Dr. Schlicher: Yeah.

>> Tom Layson: But not only that, but the abuse that they're taking.

When I look at public-health officials and doctors and nurses and people who got into this job for the express, no other real rationale exists, other than helping people, and the abuse they're taking.

Are you surprised by that?

Are you disappointed by that?

Are you shocked by that?

Are you ready to hit somebody in the mouth over that?

Where are you coming from?

>> Dr. Schlicher: Well, I've been an ER doc a long time, so I've lived with that abuse maybe a little longer than others.

We take care of those that are usually in the worst days of their life, and many people choose not to respond ideally in those moments.

I've probably been called every derogatory comment in the book that apply to all genders and all races.

So I have compassion for people at their worst.

I would say I'm disappointed that it's become the public dialogue when it's not the worst day of your life, when it's okay that this become normal conversation.

And I think that's the disappointing thing, and because of the echo chamber of social media, we have people willing to say things that they would never say to your face and be unwilling to have a rational conversation.

Because at the end of the day, everybody is welcome to their own opinions.

They're not welcome to their own set of facts.

And we know what the facts are about the disease and about the vaccine.

And I will say this, that I think a lot of healthcare workers, as much as we may express some emotional fatigue about it, I think it's equally as hard once most of the people that are vaccine hesitant get COVID and are in the ICU and dying.

Almost every one of them regrets their decision not to get vaccinated.

>> Tom Layson: No doubt about that, I'm sure.

>> Dr. Schlicher: And so that becomes hard, to just watch somebody die of a preventable disease who, in their final moments, says, "I made a mistake."

And that's heart wrenching to watch.

>> Tom Layson: What is the situation, your estimation of the importance or lack thereof, of breakthrough cases on immunized people?

>> Dr. Schlicher: It's important in that it does take up a small space in the hospital.

It's less than 5% of cases, in most of the studies, when you look across the country, but it's there.

It's important because it also takes out, back to people.

If we as healthcare providers are getting breakthrough cases, we're now pulled off the frontlines and so that's less people to staff the ER, less people to staff the ICU, less people to deliver the care.

So it does matter, but what I can say is that when you look at those that are getting the breakthroughs, and there was a recent study that kind of redid some of the data from Israel, and really said it's, the delta wave itself is a little stronger at breaking through and that most of the people that are getting really sick despite being vaccinated were immunocompromised for other reasons.

They've got rheumatologic diseases, they're on immunosuppressants, they've got cancer.

They're not a healthy 29-year-old, unfortunately.

So what I say is the breakthrough cases are real.

They are not a sign that the vaccine doesn't work.

They're a sign that it doesn't work the same for everyone.

>> Tom Layson: Right.

And, you know, there's hasn't been a vaccine yet that's been batted a thousand.

>> Dr. Schlicher: Never has been, so this is arguably one of the closest that we've had and what's amazing about it is that it is doing so well despite the disease rampaging through our community, meaning there's just a lot of spread, and the fact that it's mutating and that we're seeing these new variants.

If you think about things like measles, we talked about those [inaudible] an outbreak on Vachon Island of 20 kids in a small cluster, but A, there's not a lot of disease transmission in the community to keep spreading it and B, it's a small cluster that's unvaccinated and it hits up against that vaccine wall and gets pushed back in.

We have right now tremendous community spread, a much higher unvaccinated quotient.

And still, despite that, the vaccine is holding very solid against that right now.

>> Tom Layson: Last 30 seconds for you, predict the future with the delta variant.

Is this going to peak and we're going to roll over and have another break here for a while before mu or something else comes out or no, we're going to get to herd immunity the hard way with this one, with delta?

>> Dr. Schlicher: Well, the modeling right now that's out from IMHE and others, as well as some of the data that's out of the UK and India, really says that we may go back down, but we will never return to the low level of cases that we had in the summer and in between our prior peaks last year.

And that's a terrifying thing.

If you look at our health system, it probably means about 15% of our beds filled with COVID patients.

That is, again, an unsustainable level which puts pressure on the rest of the system for every heart-attack victim, for a car accident, for someone need a cancer surgery.

So that's the frightening thing.

The plateau is not sustainable.

Scary thing is mu and every variant that's coming after that.

We continue to let it mutate and that's what scares me.

>> Tom Layson: Joining us now is Dr. Umair Shah, the new Secretary of the Washington Department of Health.

Talk to me a little bit about the delta variant.

Are you surprised by it?

You know, I'm not an epidemiologist, obviously, but my thinking was always that viruses started out deadly and bad and then they evolve, they realize, and I'm personifying there a little bit, that they won't survive and replicate if they kill their hosts.

So they become endemic, and the sharp edges come off and before you know it, it's the common cold.

This doesn't seem to be going that way.

What's your take on this?

And am I wrong about how viruses evolve?

>>Dr.

Shah: Well, I think viruses actually can start off deadly, but they can also start off very mild and then have a strain.

I think the key is on viruses is that they're constantly mutating.

They're constantly changing.

They're constantly morphing.

They're trying to pivot, because what you just said, they're trying to find a way into the human host.

They're trying to figure out a way, or the animal, depending on what the issue is, right?

And they're trying to get in and whatever they can do to be better at doing that, that's how they mutate, and that's what eventually takes over, right?

It becomes more of a pattern or a strain that allows you to actually have sickness and illness and all the bad things that viruses do.

And so that's what happened here, is that you had COVID-19, and then you essentially, you fast-forward a year, year and a half later, two years later, and you have a different strain.

This strain, we have a lot of different strains we're looking at, but this strain, particular, is more contagious, more infectious.

It's actually two times, at least two times more infectious than the strain we saw previously.

And while it's not more deadly, more virulent, what we call, the problem is that when you're more likely to be able to infect people, guess what?

Some of those people are going to get sick and really sick, and that's really the concern.

>> Tom Layson: So here's the tough question for you, because I'm asking you to query your gut a little bit.

>> Dr. Shah: Yeah.

>> Tom Layson: Vaccines are safe and effective.

They've taken the sharp edges off a lot for the folks who get them.

Do you believe, though, that ultimately at the end of the day, this is going to be endemic, and everybody is going to have to get a case of COVID-19 in one form or another?

>> Dr. Shah: Well, I don't think everybody, but I do think that endemic is a really important word in in public health, because what that means is that we're going to be living with this virus for a long time coming.

The question is, how do we go about protecting ourself from that very virus?

Do we all get sick, and sick meaning some portion are going to get really sick and are going to get hospitalized and are going to die.

Are we okay with that?

Or are we?

>> Tom Layson: Doing it the hard way, in other words.

>> Dr. Shah: Or are we going to protect ourselves, right?

Wearing a mask or staying away from people or, and actually, it's more of an and/or, and it's more of and, getting vaccinated.

Because ultimately, we know vaccines work.

They're safe, they're effective, and guess what?

They're going to protect us from the bad, you're still potentially going to get sick, but you're going to get protected from the really sick part, hospitalizations, ICU, ventilators, death.

And that's a pretty good thing for us to want to protect ourselves from.

>> Tom Layson: One would think.

>> Dr. Shah: One would think.

But the way this has played out has been anything than that.

>> Tom Layson: So let's talk about that.

You bring up masks and vaccines and how it's played out.

Are you surprised by the fact that public health has become another, you know, basically a battle in the culture wars and politics?

A lot of public-health officials around the country, as you well know, you read the journals and the trades and watch the news, they've been persecuted, threatened, run out of town on a rail.

Whoever thought that running public health and trying to help people was going to turn into that kind of a career?

What's your reaction to that?

Are you is appalled by that as I am, or what is your thinking?

>> Dr. Shah: Well, surprised but not shocked.

So my whole career in public health, it's just been, you know, almost 20 years now, is been really about public health is inherently political.

We know that.

There is a political angle, because when we make decisions, when we make recommendations, we give guidance, ultimately, somebody is going to say, "I don't believe you," or "I don't want to believe you," or "I don't care what you're telling me.

We don't really think you have any right to tell us something."

That's what's really been not shocking to me, but what's surprising to me is how far it's gone in the middle of a pandemic.

If you remember, remember that movie, Will Smith and "Independence Day?"

Remember the one where you know, like, the whole world was, had these aliens and we were fighting this, you know, alien that was going to sort of take over all of the world.

We all got together, right, in that movie.

It was a movie, but everybody got together.

It didn't matter what country you were from or what you looked like, what the color of your skin.

Everybody got together to fight the common enemy.

That's what, to me, this virus is.

It's a common enemy, but instead of in that movie where everybody banded together to fight the common enemy, we are fighting each other.

That's the part that's surprising is that I wish people would zoom up to this, you know, thousand-miles-up level and look down and say, gosh, if we were really faced with a global pandemic, are we going to do everything we can to fight it together?

Instead, we're seeing the opposite.

>> Tom Layson: Yeah.

Apparently not, is the answer.

Do you see a world coming at some point, kind of two worlds, the vaccinated world, the unvaccinated world?

Passports, no admission.

Job, not so much.

Do you think we're heading there, or do you think, like, alluding back to a previous question I asked you, at the end of the day, we're going to get to herd immunity one way or the other, the easy way or the hard way, and that's going to fade?

What's your, read your crystal ball?

>> Dr. Shah: Yeah, my crystal ball keeps changing because things changing, right?

I mean, I think what we have to remember is that this has become a really not just a political tug of war, but it's become a health and medical tug of war.

And that's what I think people forget.

So I'm the Secretary of Health for the great state of Washington.

I'm also a physician.

My entire career I did not think that, you know, when I was talking to my patients in the emergency department and my patient would, you know, have a high blood pressure and I would say, oh, you know, Mr. Jones, you know, I've going to give you a blood-pressure medicine, metoprolol.

This is what it's going to do and all that.

And my patient says, "I don't believe you.

I don't agree with you.

I read something on the internet."

And that's been the political nature of this.

So I was quoted as saying that I worry that we're going to become a tale of two societies, vaccinated, thereby protected, for the most part, from serious illness and death.

Unvaccinated, unprotected, putting people at risk for getting hospitalized.

And we're seeing anywhere between 10, 20, 30 times the risk of being unvaccinated being hospitalized than if you're vaccinated and protected.

Those are pretty good odds.

When you look at over 90, 95% of the people that are in our hospitals from, you know, from COVID, they're unvaccinated.

Those are pretty good odds, and yet we're at this place where we're continuing to fight it.

So I think to answer your question, yes, I do think we're going to see all the way skirting to the very edge of just seeing so many different, whether it's government, private-sector companies, you know, people that are just going to say, look, if you're going to come and work for me.

Look at the NFL.

>> Tom Layson: Or come visit.

>> Dr. Shah: The NFL is a prime example.

You've got teams that have got to do various things and the Seahawks, great example of how they have done the right thing to get people and players vaccinated.

But you're actually having teams that are going through COVID protocols that are putting them at a competitive disadvantage from the other teams that have people and players who are vaccinated.

You're going to see more and more of that, that companies and private sector, as well as public sector, are going to say, gosh, if you're vaccinated, you're giving us a competitive advantage, so I want to make sure we encourage you to get vaccinated.

>> Tom Layson: Based on the context of us having this discussion today, which is a little bit in advance of when the programs air, just due to the nature of our production here at KBTC, do you see this peak continuing to climb?

Does it look like we're maybe rounding it a little bit on delta variant?

Another crystal-ball question for you.

>> Dr. Shah: So as of mid-September, I guess the way I would answer it, is that we're at an incredibly high number, so even if we're way up here and we start to see this and even this.

>> Tom Layson: That's still high, yeah.

>> Dr. Shah: It's still very, this is the highest it's ever been, and I'm talking about community cases, even though we've had a drop off in testing, so that should worry us, as well, and hospitalizations.

>> Tom Layson: Do you think we're heading for a Houston-like crisis?

Is the army going to come back here and set up field hospitals again?

Do you think that's a possibility?

>> Dr. Shah: I hope not.

I hope not.

We need to do everything we can to support our healthcare providers.

And I've said this all, you know, as a doc, I'll say this all the time.

You know, it's great that people are thinking and saying, you know, great job to our healthcare heroes.

I'm so happy that people are recognizing what the healthcare system, by the way, and the public-health system, both healthcare and public-health workers have been working day, night, weekends, holidays.

But ultimately, if you want to thank someone, don't just thank them by baking them cookies.

Thank them by getting vaccinated.

Thank them by doing the right thing.

>> Tom Layson: People with no backgrounds in how to learn or science are doing research and relying on social media to guide them to dangerous veterinary-medicine and conspiracy-driven folk cures, rejecting a proven, safe and effective vaccine.

My bottom line?

This country isn't capable of beating a pandemic.

We're going to have to learn to live with it and accept the fact that almost 60% of the people in this country are willing to risk their lives and the lives of others at the altar of proud ignorance or unfounded fear.

How we reconcile over these kinds of divides is beyond me.

But for those of you watching this program, get that booster and hang in there.

I hope this program got you thinking and talking.

To watch this program again, or to share it with others, Northwest Now can be found on the web at kbtc.org and be sure to follow us on Twitter @northwestnow.

Thanks for taking a closer look on this edition of Northwest Now.

Until next time, I'm Tom Layson.

Thanks for watching.

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