The Delta variant is a monster and our last weapon is the unvaccinated

An illustration of coronavirus spike proteins

Oh, how the tide has turned. Three months ago, COVID was ravaging my homeland, India. The Delta variant was burning through the country like an uncontrolled wildfire. People carted dying relatives town to town, desperately seeking hospital beds or a whiff of oxygen. A cousin in India said, “COVID is not taking lives, just the beds. Lack of oxygen is taking lives.”

I watched India’s suffering unfold and felt guilty for living in one of the world’s most resourceful and scientifically advanced countries. My homeland was floundering, but at least my other homeland — the U.S. — was finally on track.

104 million Americans had been vaccinated. The Pfizer vaccine alleviated the worst outcomes of the B.1.1.7 and B.1351 variants. Adolescents aged 12-15 were gearing up for vaccine eligibility within days, and the CDC was reporting the U.S. could see a sharp decline in COVID cases by July if nationwide vaccinations continued. Health care workers had proper PPE, millions of people were getting vaccinated each week, and infection rates were declining steadily. We could finally see Spring’s light at the end of the year’s tortuous dark tunnel. Our country was in the home stretch.

Now the Delta variant is here and I have to wonder, Who were we kidding? We don’t live in a world where vertical borders prevent airborne particles from crossing time zones. Planes and boats carry viruses from one country to the next like microscopic stowaways. The virus doesn’t abandon ship. It mutates, and adapts, and colonizes.

We had a real chance to strangle this monster, to show the rest of the world how it was done, to help them all in the process. We let that chance slip away. Not everyone and not everywhere, but enough people got complacent. Some waited for herd immunity to carry the load—a number that crept from 60 to 70 to 85 percent, depending on what you read and when you read it—and others just figured it would pass. Now the Delta variant, the same one that tore through India and Great Britain, has twisted out of our flimsy grip and is roaring with laughter.

How did this happen?

Misinformation. Political discord. Vaccine hesitancy. The bottom line is our vaccination rate faltered. The CDC reported that on August 1, 2021, approximately 400,000 Americans received their first COVID dose. While that seems high, it’s less than a quarter of the peak in mid-April. We haven’t maxed out eligible people (only 58.1 percent of eligible people were fully vaccinated as of a week ago). We’re maxing out the number of people who know COVID’s real repercussions are far worse than the vaccine’s feared ones.

The U.S now has the third-highest rate of vaccine skepticism among 15 of the world’s largest economies. Our vaccine surplus is so large the FDA extended Johnson & Johnson’s vaccine expiration dates to avoid throwing out perfectly good doses. Less than a week ago, President Biden announced the U.S. has donated and shipped more than 110 million doses to 60 countries. While I applaud the humanitarian effort, I question the fate of those doses if the 41.9 percent unvaccinated eligible people in our country had wanted them.

It makes me wonder: Why does science take a backseat to unsubstantiated pseudoscientific claims?

Spreaders of vaccine disinformation fill their social media accounts with statements questioning COVID’s existence and purporting unproven treatments (never mind the fact that we wouldn’t need treatments if COVID didn’t exist) with little to no peer-reviewed scientific research to support their anti-vaccine claims. According to Imran Ahmed, CEO of the Center for Countering Digital Hate, twelve people — the “disinformation dozen” — produce 65 percent of the shares of anti-vaccine misinformation on social media platforms.”

Is it easier for some to believe that a science-backed treatment is inherently more dangerous than an unknown herb plucked from a field? Perhaps. But what do they say to the approximately 216 kids hospitalized daily in the U.S. over the past week, particularly in areas where vaccine coverage is low? Bad luck? You weren’t strong enough? What would have made them stronger?

Yes, there are measures underway to increase vaccinations—full FDA approval, social media crackdowns on misinformation, and government, companymilitary, and college mandates. But let’s be honest, many Americans are fighting these measures, as they will fight future mandates, and the next vaccine.

Only two things can change how non-vaxxers perceive COVID vaccines: education and trust. We need to sincerely hear their reasons, and then gently clarify misinformation—vaccines don’t introduce disease into our bodies. They stimulate our immune systems to obtain immunity without getting the disease. Vaccines don’t alter our DNA. Their safety has been tested. Medicines have potential side effects, but illnesses have definite ones. COVID kills indiscriminately; vaccines don’t.

Trust is harder. How can we help people trust these vaccines? I suppose on a deeper level, it’s more about trusting the people that make the vaccines. Big pharma, for-profit companies—sure, they are the money makers. But behind the scenes, the vaccines are created by men and women who’ve accepted the charge to make this world—not just individuals—safer and healthier. They’ve spent years studying, researching, and testing potential vaccines with dedication and patience, including the mRNA technology in COVID vaccines. Just because the COVID vaccine’s rollout was fast-tracked to combat the pandemic doesn’t mean the scientists cut corners in designing and testing it.

Unfortunately, we don’t have the luxury of slowly educating and gradually building trust. COVID is terrorizing our planet now. The world is shaking its heads at the U.S., wondering what happened. We were supposed to be the leader. This morning, an aunt in a small town in India sent me a WhatsApp message: “I have taken the vaccine … the positivity rate has gone down … I am worried for America … how r u?” I don’t know. America, how are we? It’s not too late to destroy this monster, but if the unvaccinated remain unmoved, it will be soon.

Navigating a Post-Covid Path to the New Normal with Gist Healthcare CEO, Chas Roades

https://www.lrvhealth.com/podcast/?single_podcast=2203

Covid-19, Regulatory Changes and Election Implications: An Inside ...Chas Roades (@ChasRoades) | Twitter

Healthcare is Hard: A Podcast for Insiders; June 11, 2020

Over the course of nearly 20 years as Chief Research Officer at The Advisory Board Company, Chas Roades became a trusted advisor for CEOs, leadership teams and boards of directors at health systems across the country. When The Advisory Board was acquired by Optum in 2017, Chas left the company with Chief Medical Officer, Lisa Bielamowicz. Together they founded Gist Healthcare, where they play a similar role, but take an even deeper and more focused look at the issues health systems are facing.

As Chas explains, Gist Healthcare has members from Allentown, Pennsylvania to Beverly Hills, California and everywhere in between. Most of the organizations Gist works with are regional health systems in the $2 to $5 billion range, where Chas and his colleagues become adjunct members of the executive team and board. In this role, Chas is typically hopscotching the country for in-person meetings and strategy sessions, but Covid-19 has brought many changes.

“Almost overnight, Chas went from in-depth sessions about long-term five-year strategy, to discussions about how health systems will make it through the next six weeks and after that, adapt to the new normal. He spoke to Keith Figlioli about many of the issues impacting these discussions including:

  • Corporate Governance. The decisions health systems will be forced to make over the next two to five years are staggeringly big, according to Chas. As a result, Gist is spending a lot of time thinking about governance right now and how to help health systems supercharge governance processes to lay a foundation for the making these difficult choices.
  • Health Systems Acting Like Systems. As health systems struggle to maintain revenue and margins, they’ll be forced to streamline operations in a way that finally takes advantage of system value. As providers consolidated in recent years, they successfully met the goal of gaining size and negotiating leverage, but paid much less attention to the harder part – controlling cost and creating value. That’s about to change. It will be a lasting impact of Covid-19, and an opportunity for innovators.
  • The Telehealth Land Grab. Providers have quickly ramped-up telehealth services as a necessity to survive during lockdowns. But as telehealth plays a larger role in the new standard of care, payers will not sit idly by and are preparing to double-down on their own virtual care capabilities. They’re looking to take over the virtual space and own the digital front door in an effort to gain coveted customer loyalty. Chas talks about how it would be foolish for providers to expect that payers will continue reimburse at high rates or at parity for physical visits.
  • The Battleground Over Physicians. This is the other area to watch as payers and providers clash over the hearts and minds of consumers. The years-long trend of physician practices being acquired and rolled-up into larger organizations will significantly accelerate due to Covid-19. The financial pain the pandemic has caused will force some practices out of business and many others looking for an exit. And as health systems deal with their own financial hardships, payers with deep pockets are the more likely suitor.”