Transcription:

Melanie:    Welcome to expert insights with the Carle Foundation Hospital. I'm Melanie Cole, and I invite you to listen as we examine the COVID surge and give a vaccine update. Joining me is Dr. Robert Healy. He's the Chief Medical Quality Officer for the Carle Foundation Hospital. Dr. Healy, it's a pleasure to have you back with us again. You are such a great guest and we have done a few of these COVID shows and now we're updating this one. So I'd like to start with the surge information. Can you share current surge plans? How are you preparing for this second wave? Are we sure there is one? Are we ready? What's going on right now?

DR Robert Healy: As you said, we're going to update. We probably could update on COVID every day. It just, things change that quickly sometimes. I do think we are seeing a surge and I believe we'll see an even greater surge in the next few weeks as the people who did gather at Thanksgiving, did what the virus does best, which is spread it around.

And I think we'll see more cases as time goes on here over December. And, we'll be used to getting warnings about our Christmas gatherings and other holiday gatherings at the end of December. So it's definitely, the surge is there. Interestingly in the last couple of days, the numbers look to be a little better. But by better, it just doesn't seem to be as overwhelming as it may have been. so for example, in the spring at Carle Foundation Hospital, we had something like 15 patients a day would be hospitalized for COVID and maybe half of those would be in the ICU. What we're seeing now is more like consistent 70 patients per day, being in the hospital. And a lot of them, it seems they come in they need hospitalization, they need oxygen therapy and other therapeutics, but then we're able to discharge them. but we still have maybe a lower percentage, but still a good number in the ICU. And those people that have to be in the ICU tend to be there a long time before they get better. If they do.

Melanie: Wow. That's quite a statistic. You just said Dr. Healy. So how do you see this playing out? Discuss a little bit for us, what you know about timeline and implementation of a vaccine? What do we know if anything, as of now?

DR Robert Healy: I think there's a great hope on the horizon. Both the Pfizer and the Moderna vaccines seem to have really great data. They're actually meeting this afternoon, the national body is looking at the data for Pfizer and I suspect or I expect that they'll get approval for emergency use authorization, soon within the next couple of days.

And, we keep in touch with our other health systems in the area and also our public health experts in the area. Just had a meeting with them today and they think that within a number of days, we'll have a supply of vaccine available for the first round of vaccines. maybe within the next week or two.

So exciting news. We've been planning on it for a while. We've been hoping the vaccine would prove to be effective and it seems like it is. So at least the first vaccine from Pfizer, which is the messenger RNA type of vaccine, which is unique. It's also unique in that it needs to be refrigerated, pretty industrial strength refrigeration down to negative 90 degrees.

So we've been planning. We have the right refrigeration in our hospital and pharmacy and, planning on getting that supply and then start giving it to - we'll get direction from this, from the national bodies. But most likely first responders and the doctors and nurses and teams that work with COVID patients on a day-to-day basis.

Melanie: Well thank you for saying that and how that's going to be implemented. So what is the standard for this vaccine? What would you tell people that may be hesitant or nervous about it as it's just coming out and we're not going to have a whole lot of outcome information and clinical data on it?

DR Robert Healy: Yeah, I think that there'll be a group of people that say, give me anything that might help. And, I’ll put my arm out there and get that shot. There'll be a group that probably wants to wait a while and see what happens, then there's going to be that group that just doesn't trust either the healthcare system or vaccines in general.

So it's going to be, one quote I've seen a lot lately we all have is a vaccine is great, but it doesn't work until we actually get it into someone's arm. I wish I knew the future. I wish I could be more reassuring that, hey, they've done a study on tens of thousands of people, for months and that's good enough.

We just don't know. We don't have enough data to say what happens after six months, after 12 months. But we do have the fact that the virus is spreading and spreading, pretty well, which is bad. And I know from my point of view and when I'm going to tell my patients and my family is that I would recommend getting it if it's available.

Well thanks for that. Melanie: So update us on appropriate therapeutics that you're using as of now. You mentioned that some people are able to now go home, some are in the ICU. What are you doing for patients that's maybe a little bit different than the last time you and I spoke, as you said, we could update these pretty much every day, but what are some of the lessons that you've learned along the way and how we're treating it?

DR Robert Healy: I think two things that have been exciting lately. one is, and a lot of places are doing this, but, Carle, we have a program called COVID At Home. We know enough from the spring and summertime and fall experience, that if someone comes to the emergency department and they're positive for COVID and they're sick, but they're on the edge of whether to be admitted or not; we're better able to keep those people in their homes now. And we give them a kit that includes a thermometer and some educational material and an oxygen oximeter, which measures your oxygen on your finger. They go home, we contact them on a daily basis. They have a number to call in case they have any symptoms whatsoever, that change. And we've been able to treat over a hundred people that way, just avoiding them being admitted to begin with, which is a great thing because it leaves the beds open for the really sick people who need them. So that's an exciting thing that we've been doing. The second really exciting thing is therapeutics and that's the monoclonal antibodies. There's two different products out there now, one from Eli Lilly and one from Regeneron. And we started to do that infusion. It's a one-hour infusion through an IV line, and then we watched people for an hour afterwards. The studies look hopeful that a patient who is at risk, say they're over 65 or they're an older person with hypertension or diabetes or heart disease; if they get these monoclonal antibodies quickly within three to seven days after they get symptoms and have a positive test, we might help them to be able to prevent them from having a real serious case that would need to be hospitalized. So those are two really positive things that we've seen Focusing on treating our patients the best and that would be to keep them out of the hospital, if at all possible.

Melanie: Absolutely. And as we wrap up Dr. Healy reiterate to the Carle community, what you're doing to keep the community safe, informed, educated, and even you can speak a little bit about Tele-Health and if you think you're still going to be using this and how that has really augmented your therapeutics for COVID.

DR Robert Healy: Tele-Health. We use it a lot. It kind of slowed down as things seem to slow down. I think It'll come back, and we'll use a lot more for routine office visits for, the COVID At Home project where people can be in contact with one of our doctors on a daily basis. I think a lot of our visits will switch to virtual health in the next month or two is my gut feeling and we're ready for it.

We know, from our experience before when it's the right thing to do. And when it's not, in other words, sometimes you gotta be seen and we're gonna make all the precautions we can and have you be seen the safest as possible. So Tele-Health is important and will be more so over the next few months, I believe.

I think that really the way we try to keep everyone safe and we've communicated as much as we can. We share data as much as we can. We have a new tool available on our website, carle.org. And if you go to the COVID-19 area, it's a daily chart or PDF file of how many people are in our hospitals, all five hospitals in our system with COVID.

How many of those are in the ICU and what our positivity rate has been in our testing. And I think that's helpful to follow along. The other thing we do is we really focus on the basics, making sure everyone washes their hands, making sure that people stay as distanced as possible, at least six feet away from others and making sure that everyone wears the proper masking when they're in the regular community and the upgraded, masking that they do in the hospital and clinics as well as eye protection.

Melanie: It is absolutely great information vital for all of us to hear these updates from you, Dr. Healy, so come on again, as we learn more about the vaccine and the surge, and hopefully you'll come on and give us some really good news about it going downward. So thank you again for joining us. And that concludes this episode of Expert Insights with the Carle Foundation Hospital.

For a listing of Carle providers and to view Carle sponsored educational activities, please visit our website@carlconnect.com for more information. We hope the information gained will be applicable to your work and life. If you found this podcast informative, share on your social media and be sure to check out all the other interesting podcasts in our library. I'm Melanie Cole.