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Transcript of JoCo on the Go podcast 12/30/2020

Theresa Freed 0:00 COVID-19 vaccinations have reached the county and some residents are now receiving their first doses of protection. On this episode, hear who's getting vaccinated and when it will be your turn.

Announcer 0:11 Whether you live in or just love Johnson County, Kansas, JoCo on the Go has everything Johnson County. Here's what's happening and what's coming up in the community you call home.

Theresa Freed 0:24 Thanks for joining us for JoCo on the Go, I'm your host Theresa Freed a Johnson County resident and employee of Johnson County government. Johnson County is following the state's COVID-19 vaccination plan which calls for health care workers and then older adults to get a COVID-19 vaccine. Here to talk more about that is Johnson County local health officer Dr. Joseph LeMaster. Thanks for being here, doctor.

Dr. Joseph LeMaster 0:46 No problem, Theresa. Glad to be here.

Theresa Freed 0:49 All right. So first off, you're actually getting your vaccination today. Or, you just got your vaccination. Can you talk a little bit about how that went?

Dr. Joseph LeMaster 0:59 No problem at all. I could hardly feel a thing.

Theresa Freed 1:02 Very similar to a flu shot, I assume.

Dr. Joseph LeMaster 1:05 Even less.

Theresa Freed 1:06 Wow. Okay. So when you got the vaccination or just prior to it, what kinds of thoughts were going through your mind? I'm sure you weren't without concern. But what are you thinking about?

Dr. Joseph LeMaster 1:18 Well, of course, you know, there has been lots of information going around about people having a vaccine reaction. Remember, though, that the number of people have actually had severe vaccine reaction is extremely low. I think we've had from people that have had severe reactions. It's sort of like six out of a million people who've been vaccinated so far. So the numbers are almost infinitesimal. And much less than other types of vaccinations that have had reactions, which we've been giving routinely, both to ourselves and to our children for a large number of years. So I was really not too concerned, but went through the whole process, just as everybody else is doing.

Theresa Freed 2:01 And I think you mentioned you got the Pfizer vaccine, is that right?

Dr. Joseph LeMaster 2:04 I thought it was going to be the Pfizer, and then that was the information I had, but it ended up being the Moderna. And as with all the other physicians here at KU Hospital, I don't have any choice about which vaccine I get, I get what's there.

Theresa Freed 2:18 So is it pretty typical that if you have any adverse reactions, it's going to happen within those 15 minutes? Or is it possible that it could happen after.

Dr. Joseph LeMaster 2:27 The warnings are that if you've ever had an anaphylactic reaction before, that means where you got a shot, or you had an exposure, such as a bee sting, and you were not able, you were unable to breathe or had a very lot of wheezing, or a lot of hives or something like that, either in reaction to a vaccine or to another type of exposure. The likelihood is that within 30 minutes, anything like that would show up.

Theresa Freed 2:55 And from what I understand they have things ready to go if you if you do have some sort of adverse reaction like that.

Dr. Joseph LeMaster 3:02 Absolutely, they're right there. They're all all of the emergency personnel and nursing staff are right there ready to go.

Theresa Freed 3:08 All right. So why is it so important that health care workers get vaccinated for COVID-19?

Dr. Joseph LeMaster 3:13 Well, health care workers are exposed more because we're taking care of patients in the hospital that have COVID-19, when I'm an inpatient physician, at KU, I'm actively caring for people on inpatient units that we know have COVID. It's different than just being around patients that might potentially have COVID. We know these people have COVID. So the exposure is real. Of course, we still are wearing protective personal equipment, so that that protects us and it has protected me so far. And I believe that that's that we haven't had any incidences at KU of somebody getting COVID from caring for a patient. But that's why we're first in line is because of that.

Theresa Freed 3:57 So since the start of the pandemic, we've been very concerned about the strain on the health care system. And when health care workers have to isolate or quarantine, that reduces the staff available to care for COVID patients and others. And so I imagine that goes into to why it's so important also for health care workers to get vaccinated.

Dr. Joseph LeMaster 4:16 Absolutely, um, you know, the the most important thing, of course, remains even after the vaccine, that we continue doing everything we have been doing in terms of, of wearing masks and social distancing, and all the rest of it.

Theresa Freed 4:32 And so what kind of response Have you seen from health care workers? I know that there are some who are probably somewhat reluctant to get the vaccine, but are you seeing a sense of relief or excitement or what's happening there in the hospital?

Dr. Joseph LeMaster 4:44 Oh, all of that. I have not talked to any healthcare workers or heard of any healthcare workers who are saying I'm not getting the vaccine as far as I've been contacted as far as that goes, we've actually had people contacting us saying, "When can I get the vaccine?" So it's more the other way around people are wanting to get it excited about getting it, want it to be possible for them wondering when it's going to be possible for them?

Theresa Freed 5:08 I know that vaccine is fairly limited right now, are all healthcare workers already vaccinated? Or is it still happening kind of a on a slow, slow rollout?

Dr. Joseph LeMaster 5:17 Well, it certainly is on a roll out. And of course, there are certain places where it's happening and others where it's not, you know, not every doctor's office has got it and is and is giving it. So we're obviously giving it to public health department, it's being given at KU hospital, and at certain other places, there are our clinics where you get an appointment to be able to do that kind of vaccination. You know, in the time when it's your appointment, when I when I got here today, there was a queue, a line, to stand up, they checked me in and there were people in front of me and people behind me, and they're just running people through as quickly as they can safely. So there's, it's we're doing it as fast as we can, but there's still a lot of people to vaccinate. And as you say, somewhat limited supply. Thankfully, the president signed the the stimulus bill, which also will help us with the rollout of the vaccine to some degree. So it's all proceeding, but it's just gonna take time to get everybody done.

Theresa Freed 6:17 In addition to being the local health officer for Johnson County, you you work as a physician in the hospital, can you talk about your role? And that's, that's where you're at right now. Right?

Dr. Joseph LeMaster 6:26 That's right. One of my other roles at KU hospital is I'm an inpatient attending. That means I work both with residents and training on family medicine and directly with patients in the hospital, taking care of COVID patients as well as other patients on a routine basis. So that's part of my other roles that I do.

Theresa Freed 6:46 So you've really seen firsthand how this this pandemic has impacted individuals and their families. Can you talk a little bit about that?

Dr. Joseph LeMaster 6:55 Yeah, it's really very sad to see now. I'm not an ICU doctor, I'm there are different levels of inpatient attendings taking care of people. So remember that when you get sick, and you have to go into the hospital with COVID, if you are having low oxygen, not everybody ends up in the ICU. So the group that I work with, they're taking care of the patients, before they get sick enough to have to go into the ICU, if it takes them a while to get to that point. And then after they come out after they're doing a little bit better, but even the patients that we're taking care of who are not in the ICU, and are this not the sickest patients are really pretty sick. They've had they have very difficult to control oxygen levels, some of them have had problems with kidney failure or stroke, or other types of severe problems that have to do with a blood clotting effects of COVID. So we are taking care of some some of the sickest patients, we ever take care of are COVID patients.

Theresa Freed 7:54 And people have kind of described the pandemic as is a marathon. So how how much of an impact has this had on health care workers where they're just not getting a break?

Dr. Joseph LeMaster 8:02 Well, I think it's been extremely tiring for all of us this year. You know, we've had to take our breaks or in our vacations in, in, in turn, you know, teaming up with other people so that we got any kind of a break at all. Thankfully, we have got a really supportive healthcare system. But we have had problems maintaining staff. And the main problem we've had has not been because people couldn't get away on vacation, but because people were getting sick too much. At the same time, people were either exposed to COVID, or themselves had COVID or other illnesses. So we weren't able to staff, the ICU and the hospitals in the way that we needed to that is getting a little bit better recently, we've had a little bit of a breather because of the the surge that we expected to happen after Thanksgiving was not as bad as we thought it was going to be. But it was still bad enough. And so we're still battling of the problem of not having enough staff.

Theresa Freed 9:00 All right, and back to talking about the vaccine rollout. Next up, are residents and staff of long term care, is that right?

Dr. Joseph LeMaster 9:10 I think some of that is starting today. My understanding is that CVS and Walgreens have got the vaccine now, and that they're starting that rollout today. So that should we should start seeing some of that happen directly through them. They are not arranging that. directly through the county, they have direct contracts with the state. So that are happening with each of the of the nursing homes, long term care facilities. I've got contracts with CVS or Walgreens to get that vaccine. So that's already starting, as far as I'm aware is starting today.

Theresa Freed 9:43 And how important is it for that population to get vaccinated? You know, second in line, essentially?

Dr. Joseph LeMaster 9:49 Oh, well, I mean, it's extremely important, as you know, the predominant the largest proportion of deaths in Johnson County and the Kansas City area among people who have come COVID within that population, those people that are over 70, over 80 are much more likely to to die if they are hospitalized with COVID. So it's extremely important. We've also been battling outbreaks in those long term care facilities right from the beginning of the COVID. outbreak and continue to do that. So that's an important group of people to get vaccinated as quickly as possible.

Theresa Freed 10:24 All right, and just as a reminder, this is not like the flu vaccine, and that you actually have to get the two doses to get your full protection. Can you talk about that?

Dr. Joseph LeMaster 10:32 Right. So the vaccination, as soon as it happens, starts working in your immune system. And so you're not instantly protected from COVID. The moment you have the vaccine, it takes somewhere in the neighborhood of 10 days for that immunity to rise up to about the point of about 50%. And then when you have a second vaccine, it goes up to 95% protection. So it's it's happening as a result of your immune system gradually building up its response to that that protein so that if so that the antibodies are there. And if you get exposed, then afterwards to real Coronavirus, then your body is ready to react about that. But the second vaccine increases the amount of response up to that 95% efficacy that we've been talking about.

Theresa Freed 11:28 All right. And just last question, I know that it's critical for the population to get get vaccinated because we need to reach herd immunity. Can you talk about what that is and why that's important?

Dr. Joseph LeMaster 11:39 Right. So what herd immunity actually means is that there are enough people with immunity either having had the vaccine, the vaccine or the disease itself. So that the the virus as it's spreading through the population can't find enough people that still are susceptible to it. And so it can't propagate through the community anymore. There's not enough people who are still susceptible for them to have enough contact with each other frequently enough for that to keep going. You know, we talked, we talked right from the beginning about this basic reproduction rate, which means how many, how many people will be infected by a person who's got COVID. And you want that to be less than one. And when we get to herd immunity, which is about 60 to 80%, it's really difficult to know with this vaccine, exactly what percent, it will need to actually cause things to start falling apart for the virus as it were. But we think that that will that once we get to that proportion of people who've been vaccinated. Plus, we still have people who are have have had the virus or have been asymptomatically infected didn't know it. So there's a small proportion of those that contribute to that immunity. As soon as we get to that point, then we'll have herd immunity. And hopefully that reproduction rate will drop. And we'll see the numbers just start dropping really, really quickly. After that it should flip back down to maybe even less than where we were in March.

Theresa Freed 13:08 All right, and we all want that for sure. So when it's your turn get vaccinated. Right? And we also have with us Dr. Ryan Jacobsen, thanks for being here.

Dr. Ryan Jacobsen 13:18 Absolutely.

Theresa Freed 13:19 All right. Well, first off, can you just remind us of your role with the county?

Dr. Ryan Jacobsen 13:22 Sure. I'm the medical director for the fire and EMS agencies in Johnson County.

Theresa Freed 13:27 Okay, and so this episode, we're talking about the COVID-19 vaccination and among the health care workers getting vaccinated this week, the EMF staff, can you talk about that?

Dr. Ryan Jacobsen 13:38 Yeah. So it's exciting. Part of the way we fix this pandemic is hopefully get as many folks vaccinated as possible.

Theresa Freed 13:45 And I know we talked many months ago when the pandemic initially hit about the process of screening to to gather more information during those 911 calls about potential COVID patients. Can you talk about how that's kind of evolved?

Dr. Ryan Jacobsen 13:58 Yes, so the pandemic has offered us the opportunities to expand and do things that we normally would have never done. And one is to do some enhanced caller interrogation through dispatching the 911 center and certain call types, difficulty breathing, certain sick or ill subjects, fever, those types of complaints will get flagged basically by the dispatch center, that this patient could have COVID or COVID-like symptoms are present in that facility, or by that caller. So that alerts the fire and ambulance crews that are responding that there's a potential COVID patient there. So it's just one extra layer of precaution that the dispatch center is able to offer to the providers to help keep them safe.

Theresa Freed 14:41 All right, well, we talked to Dr. LeMaster a little bit earlier in the episode and he got his vaccination today. Very excited to do that. I know you recently got your vaccination. Can you talk about how long it's been since you had that and then any, you know, impact from that?

Dr. Ryan Jacobsen 14:56 Yeah, I got it two weeks ago, almost two weeks ago. And no different than a flu shot or a typical vaccine, just a little bit of a sore arm. And that lasted for maybe a day day and a half, like a typical vaccination would happen. I've had zero symptoms or any concerns about it since so it went very smoothly. And that's what I've heard from all of my colleagues and peers across the country who have been getting their vaccines, their health care workers, nobody that I've heard of, has had any complication or side effect other than a sore arm.

Theresa Freed 15:25 All right, and you still have your booster to get Is that right?

Dr. Ryan Jacobsen 15:28 Yes. So 21 days for the Pfizer vaccine, and 28 days from Moderna. There's a little bit of wiggle room around that. But yeah, there's a booster required.

Theresa Freed 15:37 And I know we've had some people have some questions about how they'll be notified or when they need to go in to get that booster. So can you talk about that process? A little bit? Yes.

Dr. Ryan Jacobsen 15:48 So part of that the obligation is on the the administrators of the vaccinations to make sure that they have enough vaccine on hand to get the second follow up booster shot. For instance, my shot was at the University of Kansas Medical Center. And we you make the second appointment at the time, you're there to ensure that you've got the right timeframe, and that they've got the vaccine for you to get your second dose. So it's a fairly logistically challenging problem, specifically for long term care facilities. How do you get folks that are in and out of facilities that may get one shot? How do you follow up and get the second shot? There's a lot of discussion regionally about how to get these logistics and operations done. But I'm confident DHE and Johnson County can get this done.

Theresa Freed 16:34 Alright, so very important, though, that people continue to follow the safety precautions, as this rollout is happening. Is that right?

Dr. Ryan Jacobsen 16:41 Yeah, we don't know the effect of the vaccine on transmission. And so there's really no data on that if you're vaccinated. After you get your booster and you develop some immunity, hopefully, what your ability to transmit, as we just don't know that there's no scientific data to show that. And until we get, you know, millions and millions and millions of people across the country, vaccinate and get more data on this, you know, this the same guidance still stands.

Theresa Freed 17:06 Alright, just last question, what's your message to our listeners about getting the vaccine?

Dr. Ryan Jacobsen 17:14 I'm cautiously optimistic. I'm very much in support of vaccines. And I think they have done a lot of great things for the world over the past decades. And I think this is one of the only ways that we're ever going to open back up and get back to normal. I'm excited it did feel like we were going on the offense briefly and doing something aggressively to kind of get us back to where we used to be, which is I think everybody's golden hope is to go to concerts, go to games and family gatherings and all the things that you longed for. I can't wait for that to come back. And this is one of the ways one of the boxes that we tick to get back to doing that. So hopefully, you know as the spring and summer approaches, and we get the community and we get the country vaccinated. I'm hopeful that we'll be able to fix this.

Theresa Freed 18:02 All right, perfect, great information and great message there. And for more information about COVID go to our website at jocogov.org/coronavirus. Thanks for listening.

Announcer 18:12 You just heard JoCo on the Go. Join us next time for more everything Johnson County. Have a topic you want to discuss? We want to hear from you. Follow us on Facebook and Twitter at JoCoGov. For more on this podcast visit jocogov.org/podcast. Thanks for listening.