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Scott Webb: There's only one way to defeat COVID-19 and its variance. Everyone who is eligible must get vaccinated. The vaccines are safe, effective, and free. And joining me again today for part two of this series to emphasize these points and more is Dr. Mahendra Poudel, he's an infectious disease specialist with SVMH.

This is Ask The Experts, a podcast from Salinas Valley Memorial Healthcare System. I'm Scott Webb. Dr. Poudel, thanks for joining me for part two of our COVID-19 updates. You know, the decision to have our 13-year-old vaccinated was not an easy one, mainly due to concerns we had over the possible long-term effects of the vaccine. But what are you hearing from other parents who haven't gotten their eligible kids vaccinated yet?

Dr. Mahendra Poudel: It's kind of the same concern that you have. Are these vaccines safe for kids? What are the longterm effects? I think what we need to understand is if the kids get COVID, the long-term effects of COVID could be, you know, pretty nasty. We don't really know for sure, but we're getting these reports of hundreds of kids being hospitalized along the non-vaccinated states. Their pediatrics ICU's are getting filled. They need to transfer kids out of state. More than 300 kids have died from COVID-19 in United States only. So, definitely, these numbers are shocking and alarming as a parent.

Now, coming back to the vaccine, it is safe, I think it's absolutely safe and it is also based on clinical trials of kids where we're not extrapolating data from adults and saying, "Okay, we can just use the adult data on kids." That is not true. These vaccines have been studied in kids older than 12 years old. And we have enough data that these are safe and effective. And mRNA vaccines again, when you go to the basics, mRNA is a protein that just helps your body code a spike protein antibody. And once that is done, the protein gets destroyed in your body. And your body has a mechanism to completely wipe the mRNA out. And there's no reason that these vaccines are going to have long-term side effects. I know I was hearing reports of infertility and cancer and all the other things. But absolutely, I have no data to suggest that. And based on the science, it doesn't look like anything of this sort is going to happen. So I think these vaccines, again, they're very safe and effective even for the children, older kids.

Scott Webb: Yeah, I think you're right. And I'm so glad you went back over what mRNA vaccine, like what that really means to people. And yeah, I know you and I have spoken before, and it's good to go back over that because, you know, I'm paraphrasing now and I'm not an infectious disease specialist as you are. But my understanding basically is that you get the vaccine and it tells your body, "Here's this thing you're looking for. And here's what you need to do to fight it." And then it gets trashed, it goes away. It doesn't stay in the body the way maybe other vaccines do. So the potential for, as you say, you know, cancer or infertility or all the other things that we've heard and read on social media is very unlikely because that's just simply not how mRNA vaccines work, right?

Dr. Mahendra Poudel: That is absolutely true. I think you hit it right on the nail, is this is how these vaccines work. And, you know, once mRNA does its job, it gets trashed in the body.

Scott Webb: Yeah, amazing. One of the maybe arguments against masks or vaccines during this time from some people has been that the CDC has changed. Originally, "Ah, we don't need masks." Then, "Well, maybe we should consider masks." So my feeling is that scientists, that doctors, you know, as we get more data and more information, they can change their minds and they can change their opinions and recommendations. So the CDC now has gone back to the indoor masking policy, which I'm glad to hear and seems appropriate in light of the Delta variant. But what would you say to people who say, "Yeah. Well, the CDC, you know, they've gone back and forth. How do we know what to believe?" What would you say to those folks?

Dr. Mahendra Poudel: I think what we have to understand is science is really dynamic. And as we get more information, as we get more data, we're going to have to change these recommendations based on what studies show and what evidence we have. And as you can see from the beginning of the pandemic, we're learning new evidence and we're making recommendations based on them. And this is exactly what CDC is doing too. As we get more data, as we get more evidence that there may be breakthrough infection in vaccinated individuals, or even if they're asymptomatic and vaccinated, you can still have very high levels of the Delta variant in the nasopharynx and transmit to people around you.

When CDC got that data, they made this decision in the best interest of the public. I know, you know, things get politicized nowadays, but I think where they're coming from is based on data and evidence, which is again, it's very dynamic. And as we get more evidence down the road, these recommendations may change. And I know it's confusing and sometimes frustrating with changing guidelines and recommendations, but that's the world we live in. And if you look at how quickly these evidence are coming, it's unbelievable. We're getting evidence very fast. And the recommendation are also changing. So it's a really liquid situation. And I would consider putting your trust in CDC and the trusted people in the community leaders like your primary care physician, your doctors, and listen to them, listen to your public health officials, and follow recommendation provided by them.

Scott Webb: Absolutely. And I also like to listen to Dr. Poudel, as I think everybody should. And you're so right, it's dynamic, it's fluid. It's based on science and data and that's going to change. That's what dynamic and fluid is. It's going to change. Recommendations will change. And as you say, CDC is always making the recommendations in the best interest of all of us. And even though it can be confusing at times, I just have to put my trust in the science, in the data, in the CDC, in Dr. Poudel, you know, in the experts.

And one of the things I've heard from experts was that the incidence of flu last year was like next to nothing because of masks and distancing and washing our hands and so on. So what do we think we're going to be facing this year as we head into flu season? I know, I can't believe we're already talking about the flu, right? But what are we anticipating as we head into the fall, head into flu season? Is the recommendation still, you know, if you're sick, stay home, or if you're sick and you have to go out, wear a mask? What's your sense of what the flu season's going to bring this year?

Dr. Mahendra Poudel: Yeah, you know, it's really hard for me to predict what's going to happen just because we've seen again and again with this COVID, we really are not sure which way it's going to go, how much hospitalization we're going to see. One thing that I'm emphasizing again and again is to get vaccines if you're unvaccinated against COVID-19.

Coming back to flu, we prepare every year for the flu season. This season, we're hoping that it's going to be like the last season. But again, in medicine, hope is not a thing, but we got to prepare based on the resources we have and we are going to be prepared for this flu season, especially with flu vaccines. We're going to run flu vaccine clinics for our community. We're going to make sure our employees get vaccinated as soon as flu vaccines are available. We will keep our employees informed in terms of the time and the place to get vaccinated. And as the indoor masking guidance is in effect, that should not only help COVID, but also help flu and other respiratory viruses.

And before I forget, I do want to add that there is an increasing number of a different viral infection called RSV, which is usually seen in kids in winter. And because of the changing dynamics of the pandemic, we are seeing RSV infection at a very unusual time, that is summer, which is really unheard of. So masking and getting a flu shot and avoiding crowds should help the flu numbers to stay low. But we are going to be prepared the best we can.

Scott Webb: Yeah, you are. And I'm glad you mentioned the clinics, because I know that those vaccinations are going to be free starting in October, and there would be more information as you say about dates, times, locations and so on. So great to hear as always that Salinas Valley Memorial Healthcare System is doing its part for the community as they always do.

As we get close to wrapping up here, doctor, and this has been amazing as always speaking with you, it seems like the pandemic started another pandemic and that's the people are delaying medical care. Let's go over that again. We don't want people delaying care for emergent things, right? Serious things, whether it's a stroke, heart attack, whatever it might be. Like you can put off your plastic surgery. You don't need to have that done during a pandemic. But we really want people who need medical care, urgent medical care, we want them to go to the hospital, right?

Dr. Mahendra Poudel: That is absolutely true. And we are at a capacity that we can handle non-COVID patients. And every patient that comes to our emergency gets screened for COVID-19 if they're symptomatic, or if they're being hospitalized through the emergency. So if you have COVID, then you go to a completely separate unit in our hospital and rest of the hospital is COVID-negative patients. And we are constantly delivering the care we do with surgery, with hospitalization. And waiting home to delay your care can often have deleterious effect, meaning we have seen patients who have come here with extremely complicated gallbladder infections come here with heart attack or, you know, foot infection and gangrene that we needed to do more than what we would do if they had shown up early.

So at this point, what I would really want to advise our community members is please do not delay your care. All your primary care offices and emergencies, they are equipped to take care of non-COVID patients. But we do have COVID-19 cases rising, but not to the rate that we had in December, January, and February. And that is because significant population has been vaccinated and those vaccinated folks should not end up in the hospital and we have enough capacity to take care of you at the hospital, in our clinic, in our emergency room. So please seek medical care if you need to. And we have enough resources to take care of you.

Scott Webb: Yeah, you definitely do. And, again, this has been a pleasure to speak with you. One of these days, we're going to talk about something other than COVID and the flu. But it's so great to have you on. You're such a great guest, so knowledgeable and compassionate. As we finish up here, I want to hear it in your own words. What's your messaging? What are your takeaways for folks when it comes to COVID-19, the vaccine, Delta variant, masks? I'll give you a chance here to put a period at the end of the sentence.

Dr. Mahendra Poudel: We have a very powerful tool to get this pandemic under control and that is the vaccine. And these vaccines are highly effective, very safe, they're free of cost, they're easily available. And please, if you have not been vaccinated, I really urge you to get vaccinated so you can stay safe, stay out of the hospital, keep your family members, your community and your coworkers safe. So again, I can't emphasize how important it Is to get vaccinated. So there's only one answer to keep yourself safe and get this pandemic under control, the vaccines and the vaccines and the vaccines.

Scott Webb: That's it. You're absolutely right. And so great having you on. You're such an awesome guest and couldn't say it better myself. The only way we will come close to really reigning in COVID-19, the Delta variant, future variants, is the vaccine, which we have. It's safe, effective, free. Please, everyone, get vaccinated. Dr. Poudel, thanks so much for your time today as always and you stay well.

Dr. Mahendra Poudel: All right, man. You too.

Scott Webb: For more information, visit svmh.com. And if you found this podcast to be helpful, please be sure to tell a friend, neighbor, or even a family member and subscribe, rate, and review this podcast and check out the entire podcast library for additional topics of interest. This is Ask The Experts from Salinas Valley Memorial Healthcare System. I'm Scott Webb. Stay well, and we'll talk again next time.