Q&A with a Doc: When COVID-19 hospitalizations rise, deaths rise

Daily COVID-19 cases have climbed over 60 in Lycoming County and hospitalizations have reached 23 as of Sept. 14.

The state recorded seven COVID deaths in August and one death so far in September.

A divided country grapples with concerns about the COVID-19 vaccine, masking mandates in schools and the government’s power over private businesses.

On the PULSE sat down with UPMC Dr. Rutul Dalal, the region’s expert in infectious diseases to get a COVID-19 update about current numbers and vaccine concerns.

Q. What does the COVID pandemic look like right now? 

A. We are definitely seeing a big surge in COVID patients now. Just to give an example with regards to death rates, at the beginning of summer we were around 300 to 350 deaths a day across the country. At the height of the pandemic, which was last year, we averaged around 4,100 to 4,200 deaths a day. 

We are slowly inching up and my gut feeling is by September 30, if 60% of the country’s population is fully vaccinated, which we are right now at around 55%, we will still see around 1,200 deaths, a day on an average, which is still around 25% to 30% of what we saw last year, but it’s four times more than what we’re seeing right now. 

So, the rates will go up. First the cases go up, four weeks after that hospitalizations go up, and on average four weeks after that the death rates go up. 

We are at that stage of increased hospitalizations, and unfortunately, death rates also will follow. 

Q. How many new COVID patients are unvaccinated? 

A. America currently is divided between two groups: One is a vaccinated America and the other one is unvaccinated. And as long as we have a fair bit of the unvaccinated individuals, we will keep seeing new variants and that will probably, unfortunately run the COVID pandemic as long as we do have unvaccinated individuals. 

We just see completely unvaccinated individuals, and even among the vaccinated individuals which we see up there with very, very mild symptoms. On my watch so far nobody has perished with regards to having a vaccine and having COVID. Of course, comorbidities also play a big part like obesity, but now we’re seeing more of a relatively younger population, between the age groups of 35 and 55, getting the COVID infection. 

The Delta variant is completely rooted now in our country. We are seeing a lot of new infections because of the contagious nature of it. Because of the increased transmissibility. 

Q. Can a person get COVID after taking the vaccine? 

A. Breakthrough infections are definitely common. But at the same time, one should remember that these same individuals, because they’re having mild symptoms, can also spread them more easily because they might just think they have a cold or allergies. So they have to be careful about that irrespective of their vaccination status. 

I hear a lot of chatter about why get the vaccine if you are probably going to get the infection anyways? The bottom line is, decreased severity. And that really changes the paradigm. We have seen individuals who are young and healthy and unvaccinated get COVID infection, but three or four months later they succumb, or they get severe issues with regards to the thromboembolic phenomenon in which you get blood clots, either into your lungs or people die of sudden heart attacks.

So even though you think you survive the COVID infection, there are still things to worry about, especially among unvaccinated individuals. 

Q. What does COVID look like among school children?

A. Last week there were 250,000 new infections among school kids across the country. Now, of course, above the age of 12 we do have vaccines available for kids. 

First of all I would like the parents to ask their kids to get vaccinated. Second of all, as you know, the data shows that in less than 12 years of age, kids are getting infections from their adults. I would suggest that, even if people do not want to get vaccinated or want to wear a mask I would say at least not for themselves think about the small kids at home, because you can harbor the infection and asymptomatically transmit it to your kids who are under the age of 12 or kids who are unvaccinated.

From the medical perspective, I can say that masking definitely helps. We have had healthcare staff doing 12-hour long shifts with a much more robust mask like N95, which is much stronger than surgical masks, and they have used the pulse oximeter, which is a device to check the oxygen saturations, and it doesn’t fall at all. So, obviously even putting a full day’s work in with the mask on which is much more durable, does not really affect your oxygen saturations. 

I just want to add to that, because there were certain reports coming out from other countries in Asia such as India, in ways that black Mucor like mucormycosis or black fungus used to come with people wearing masks for prolonged periods of time. That was true but there is a caveat over there: People were using cloth masks, people were not washing them for days, the weather was super humid, you sweat a lot. And there were reports in which people were wearing the same mask 10 hours a day for 10 days in total. So obviously that is a breeding ground for having fungal infections. So, the arguments which I had read were about having black fungus mold infection, but that was because of a certain reason. Cleaning your mask properly, using them diligently, as well as cleaning them properly is definitely going to keep you away from all of those kinds of bad infections. 

From the medical perspective I would say that it’s perfectly safe to wear a mask. And I think that will create an atmosphere in which people, kids, will remain safe. They won’t get the infections from others or take it home, or vice versa, taking it from home into the school arena, and giving it to others. 

Q. Will there be vaccines for children under 12 soon? 

A. Pfizer is working diligently for vaccines over the age of six months. Moderna is also going to work on it, but they are aiming at an older group between 5 and 12. Both of these companies in addition to of course Johnston and Johnston and other vaccine companies are working for it. And the CDC and the FDA are working on the approval process and I think before the end of this year, we will have at least an emergency use authorization for those kinds of vaccines under the age of 12. 

Q. How do you address concerns about the vaccine? 

A. The biggest thing I do is ask the question why. And when I get a specific question from them, I will try to answer that question. Now, very likely just recently, in the last couple of weeks we saw Pfizer vaccine getting a complete and full authorization. There are still so many people who are not willing to take the vaccine, irrespective of their full authorization. The biggest thing which I’m seeing is that it is introducing certain things in your body which are either going to cause you to have cancer, infertility or it’s like a tracking device. 

Now, having a small particular protein subunit of an inactivated vaccine vehicle is completely innocent, to get into your body. It dies within a few hours of it being in your system. It just drains your memory cells and your white blood cells and defense mechanism to fight it, when it comes knocking on your door.

When you have a killed a particle of a protein subunit, which actually trains the virus to produce more cells of it. You can imagine the miniscule amount of stuff entering into your body, and that to have a completely killed inactivated vehicle, in which the vaccine is given is completely safe. 

In fact, people have not heard much about the mRNA vaccines, because they were never used before. Among all the vaccines we have so far, I can tell you, science has shown that these are the safest vaccines. 

Q. Are there side effects to the vaccine? 

A. Now, will there be side effects, rarely yes of course there will be. There’s nothing in this world which does not have side effects. Tylenol has side effects. You’re looking at risk and benefits. I think it’s way easier for you to get the vaccine and prevent yourself and your loved ones from getting this dreaded infection because the virus does not differentiate.

We have seen weird things. We have seen 30-year-olds marathon runners succumbing to the infection and dying from it, and probably a 65-year-old who is a smoker still making it out. So there’s no way to differentiate who is going to live and who’s going to die. The best bet you can do is get the vaccine and then hope for mild infection, which usually happens.

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  • On the PULSE

    On the PULSE is an online media outlet in Northcentral, Pennsylvania. We specialize in in-depth journalism, human interest content and video features. Our mission is to build engagement in community through local news.

On the PULSE

On the PULSE is an online media outlet in Northcentral, Pennsylvania. We specialize in in-depth journalism, human interest content and video features. Our mission is to build engagement in community through local news.