CMO Update August 3, 2021 A friend of mine told me this weekend about his niece, who was a healthy nurse in FL. She contracted COVID last November prior to vaccine availability and was hospitalized. Her lung condition worsened to the point she was in the ICU and on ECMO (a machine used to remove blood from the body, oxygenate it and then infuse it back in) for 5 months. Last week she received a double lung transplant, which saved her life but at the cost of lifelong immunosuppressant medications and the associated risks of infections and other medical complications. I share this sad story because I honestly don’t want anyone else to suffer such a fate, which is almost 100% preventable with vaccination.   COVID-19 vaccination has been safely administered to almost 350 million Americans and >2 billion worldwide. The risk of any rare side effect is miniscule compared to the many serious risks of coronavirus infection.   Vaccination affords 25-times protection against hospitalization and death if infected.

The good news is that under-vaccinated regions of the US are now leading the country in the number of people getting a first dose of vaccine...reflecting that people understand the urgency of getting vaccinated as infections surge and hospitalizations rise.  The increase is concentrated in the Southern and Central parts of the U.S., with the highest daily rate of shots happening in places like Louisiana, Arkansas and Missouri – states that have had some of the lowest rates of vaccination in the eight months since vaccines became available.  U.S. has administered more than 700,000 COVID-19 shots for four consecutive days for the first time "in a long stretch," while data indicates more American adults are receiving their first dose "than any time in the past 8-10 weeks.

All 50 states saw increases in cases last week, spurred by the highly contagious Delta variant; deaths seem fairly stable as most elderly and at-risk adults are vaccinated but deaths always lag behind hospitalizations by several weeks and are still >2,000 per week.

CDC research indicates vaccinated people with breakthrough Delta variant infections still carry high viral loads and can readily transmit coronavirus, even to other vaccinated people (although they rarely get sick themselves).   Evidence includes an outbreak in Provincetown, Mass., where Fourth of July festivities have led to 882 cases as of Thursday. Nearly 75% of those people were fully vaccinated.  As a result, CDC recommends all people, including the vaccinated, wear masks indoors in public spaces in high-transmission communities. This also applies to our clinics where for now we remain masked at all times during patient care.  This map shows how nearly every geographic region in our QualDerm markets is at high risk for Delta transmission.

Federal, state and local governments have begun requiring vaccination. Nearly 60 major medical groups, including the American Medical Association and the American Nurses Association, said it was an ethical obligation to make sure that all health-care workers were vaccinated against the coronavirus as the virulent Delta variant drives a new surge of infections.   Many hospitals and health-care systems have announced in recent weeks that they would require vaccinations for their workers, just as many do with flu shots.   QualDerm continues to strongly recommend vaccination of all team members for the health and safety of our vulnerable patients and family members, like children who don’t yet have access to vaccines  Obstetrician groups recommend COVID-19 vaccine for all pregnant women. Both the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine “recommended COVID-19 shots for all pregnant women, citing concerns over rising cases and low vaccination rates.” The groups “said vaccinations in tens of thousands of pregnant women over the past several months have shown the shots are safe and effective during pregnancy.”  Given the growing awareness of the Delta variant’s higher contagiousness and recent surge in cases, more patients have begun asking our staff members about their vaccination status. The question arose about how best to script a response that is legal and sensical.  This article does a good job addressing this question. Bottom line is that HIPAA protects health privacy for both patients and staff so there is no obligation for an employee to disclose vaccine status, although they may offer that information voluntarily.  For a patient inquiry, I would suggest the employee either disclose their status if desired OR simply state “Our practice is following all CDC recommended safety precautions to maintain your health, but my own vaccination status and medical history is a personal private matter.”    Please continue to take care of yourselves and send questions to health@qualderm.com. Together we can get through this recent Delta surge, especially if everyone understands that vaccines are the best way to get back to normalcy.   Sincerely,

~ Dr. A

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