October 2021
‘Today we have a follow-up conversations with Dr. Joseph Chow, Medical Director of WNY Immediate Care and President of TeamHealth Ambulatory Care. We talked to Dr. Chow about COVID-19 myths, symptoms and best practices back in January, and we all know that so much has changed since then with the roll-out of the COVID-19 vaccines, lifted restrictions and new variants. During today’s conversation we will learn some updates around the illness, the vaccines and how to protect ourselves during the upcoming flu season.
It’s still extremely important to receive your COVID-19 vaccine if you have not yet, and for those who are immunocompromised or have underlying health conditions, it is possible to start looking into receiving a COVID-19 vaccine booster shot. As Dr. Chow mentions, it is okay and recommended to receive your flu vaccination whether you have the COVID-19 vaccine, do not have it or will be getting both shots at the same time.’
COVID-19 Vaccine Information:
Pfizer – FDA Approved, two shots 21 days apart
Moderna – FDA Emergency Use Approved, two shots 28 days apart
Johnson & Johnson – FDA Emergency Use Approved, one shot
Welcome to the American Lung Association in western New York Community Conversations. Each month will bring you a few episodes covering different lung health topics that are local and relevant to our community by interviewing experts around the area and digging deeper into the lives of those affected by lung cancer or other chronic lung diseases, through their personal experiences and occupations. Lung cancer is the leading cause of cancer deaths in America for both men and women. People that you know are struggling with lung cancer, COPD, asthma and more every single day. Though most people don’t consider lung disease a top of mind health concern. We hope to change the stigma that lung cancer only affects smokers. That asthma is only a mild issue, that the outdoor and indoor air we breathe doesn’t have an impact on our lung health and so much more. So kick back, relax and get ready to learn.
American Lung Association in western New York Community Conversations is sponsored by independent health. Independent health is extremely active in the western New York community promoting healthy lifestyles by giving people the opportunity to engage in physical activity throughout our cities, healthy meal options and plans and personal health care programs. Visit their website at independent health.org To learn more about what they do and how to get involved with them. Welcome back everyone to Episode 15 of American Lung Association in western New York Community Conversations. Today we have a follow up conversation with Dr. Joseph Chow, medical director of Western New York immediate care and president of teamhealth ambulatory care. We talked to Dr. Chow about COVID-19 myths, symptoms and best practices back in January. And we all know that so much has changed since then, with the rollout of the COVID-19 vaccines, lifted restrictions and new variants. During today’s conversation, we will learn some updates around the illness, the vaccines and how to protect ourselves during the upcoming flu season. Hi, Dr. Chow, thank you so much for joining us again, how are you?
Dr. Chow
Oh, really well, thank you. And thanks for inviting me. It’s pleasure to be here.
Host
Yeah, I’m really glad that were able to kind of follow up with you. As we talked about COVID Such a long time ago, it seems like now that so much has changed. And now we can get different perspectives and some updates from the same eyes, which I think is is just amazing. So since the last time we spoke, like I said, there has been so much change with COVID. And I think the last time that we were talking that COVID-19 vaccine was not even readily available for the public yet. So I know in some ways we have clearly made so much progress. With time comes the opportunity for change and new discoveries. So I’d like to start this conversation off talking about new information that we know about the actual COVID-19 illness, which would include new trends that we’re seeing or new variants, everything along those lines. So would you be able to go over just some of the new variants and trends that we’re seeing?
Dr. Chow
Yeah, sure. No, you’re absolutely right. It seems like it wasn’t actually that long ago. But so many things have happened since then. And so kind of from a timing standpoint, it does feel like it was more right around the early part of the year. And so when you take a look at that span, a lot of things have happened. And we’ll talk a little bit about the variants and maybe some of the other aspects of COVID. So in the beginning, there was one strain, which we’ve now named all the strains, not by geography, but really by Greek lettering. So alpha delta, there’s new ones that are new, there’s lambda. So there’s other variants that are always coming. With that variance. Right now, as we’re talking in September, the Delta variant is the most predominant variant that we’re seeing, at least in this country. And incidentally, down in the southern hemisphere. Now we’re seeing other variants called lambda. And so this is not actually surprising, or unusual to see variants as well as mutations. I think when we take a look at the science of, of mutations, viruses actually mutates on a regular basis. And so even if we think about the flu, for example, the food’s gonna change every year. And there’s certain years where it just changes a great deal, in which case, the vaccine doesn’t work as well. And so every few years, every several years, you always hear about, wow, that was a bad flu season. And why is that? It’s because the viruses have changed enough to evade the vaccines. And so having these viruses change and mutate like this is actually not surprising. And so kind of flashback to when we first started with the Alpha variants. You know, the alpha was novel who was new to us, and some of the typical symptoms that we saw, you know, the cough, the shortness of breath, you know, the loss of taste and smell with a delta, we still see much of this, but what we’re finding also is, we’re learning and it could be just learning more about the variants, because now we have, you know, over a year and a half experience, that we’re in a better spot of understanding what kind of symptoms and it does seem like the symptoms can be fairly broad, with these variants, and including the ones that I mentioned before, but it can be actually, you know, things that are a little bit more subtle, you know, fatigue, I’m seeing more recently with a Delta variant, um, certainly a lot of younger people because of the vaccines, and we’ll get to that in a moment. But that’s something that you know, fatigue, runny nose, sore throat, still cough, certainly the loss of taste and smell. So you can you can see that, you know, with as we get to know, these variants more and COVID a bit more, we’re seeing that can that it can present differently for different people. And that’s why it is, it can be difficult to discern between COVID. And other viral illnesses, such as the flu strep, RSV, add no viruses. And so that’s where talking to a clinician, as well as getting a task and really help decipher between those. And I think if you add on top of that, since we spoke last time, now we do have vaccines, and that was something that was just getting rolled out the first time. And now this country has, you know, adequate vaccines for anybody who wants it. You know, certainly we’re seeing people who are Vax, who are not vaccinated, still getting those symptoms, we’re starting to see some of these cases where even if you do if you were vaccinated, especially if it’s starting to the immunity may start to wane after about a month, they may still get some cases of COVID. But their symptoms tend to be more mild symptoms that we talked about some fatigue, you know, stuff Enos, maybe some cough, we’re starting to see some people who are testing positive with those, I think I’d be remiss if I didn’t say though, even if you do catch these, catch these variants with the vaccine, the vaccine is still very effective at its primary job, and that’s to prevent death, as well as hospitalizations. And so there’s still great reasons to use the vaccine. So with that, I know that was kind of a mouthful there about variants, and And so essentially, the symptoms between them can be still fairly similar. You know, they can have other, you know, additional symptoms, that can be a little bit more subtle. But right now, certainly talking to clinician getting testing is going to be the best way to really diagnosing COVID.
Host
Thank you. That was great. I think that was a really amazing, just kind of full circle conclusion on all of the variants, kind of the descriptions and bringing a right where I was going to go next with the vaccination status and everything like that. So as you said, we really can see that the vaccines definitely do seem to be helping to lower the severity of symptoms for those who have received the full dose in what seems like you’re saying, so far, most of the variants that we’ve seen, this has been the case, would you be able to give a rundown of what vaccines are currently available, a little synopsis and summary of what the vaccines are, what they’re made of why someone should receive the vaccine. I know, we definitely still have some, some listeners or people here in the United States that are very hesitant. So even though we have talked about this, I think a while before just kind of bringing it back here would be great, too.
Dr. Chow
Yeah, sure. And I’d like to maybe start and even then, from a vaccine standpoint, just a general statement, you know, these vaccines that we have available right now, whether it’s the mRNA, or the adenovirus. So the mRNAs are the Pfizer Maderna that we’re hearing about that, that are the two shots and more the adenovirus is a different vector of presenting the vaccine. And that’s the Johnson and Johnson when I when we talk about these vaccines, these vaccines are really, you know, very effective, really outstanding that we’ve not seen before. I always give a comparison of if you think about the flu vaccines that we’ve had now, for decades and decades, those are probably it could be anywhere between 40 to 7040 to 70% efficacious, have a rate around that 70% 60 70% On a good year. So when we talk about these vaccines that have just come out, you know, over the past year, you know, having efficacy rates in the 90%, you know, mid upper 90%, or even in the 80% that is really pretty astounding. And these are fantastic vaccines. Someone actually made a great analogy when we talk about these vaccines. It’s like asking, you know who which one is the smarter neuroscientist or astrophysicist right there. My goodness. They’re all very smart. And these are something that these vaccines are all very effective, not only at preventing certainly the prior variants, but at this point Knock on wood, it does seem to be effective against the Delta variant and potentially some of the ones down the road. And so to ads, you know, so from a vaccine standpoint, very effective, really incredible that we have these so early. And now that we’ve had, you know, hundreds of millions of doses that have been administered, we do see that, you know, the side effect rate is actually very low with all of these vaccines. And so, I know we will, we’ll get it a little bit into, you know, some of the differences, but really, the end result is these are really effective vaccines. And to add to that, I know some of the questions people have said, well, I will I had COVID, the disease itself, I should be protected. It seems if you have had COVID, if you’re infected with a specific variant, let’s say, the alpha variants, when the vet when the actual virus changes and mutates to, let’s say, to the delta, even if you were infected with let’s say, the Alfa COVID and developed antibodies, you really don’t have great protection against the delta. So you can’t really say I’ve had it before. Therefore, from now on, I’m going to be protected, it’s not the case, when you do get the vaccine specific, you know, when you do get these vaccines, they will provide you more at that broad protection, more so than just what’s what we call natural immunity. So I think there is definitely, you know, a point to be made there, even if you’ve had COVID, before the disease, it is still worthwhile to get these these vaccines that are out on the market right now. Because it can give you that added layer of protection, and it can actually protect you against variants that your original infection may not protect against. And so, you know, we get between, you know, the differences between the vaccines, certainly the the mRNAs, the Pfizer, as well as the majority have been in the news most, because now they’re, you know, becoming FDA approved with Pfizer, they’re getting they seem like they’re kind of winning the horse race of getting to the lower age group with it does look like the, you know, Pfizer may go down first meaning going down in the age groups down to, you know, school aged kids, probably first with the five to 12 year olds, and then we’ll see about six months and up. So the timing on these is likely going to be either late fall, early winter, for the age groups between five and 12. If all goes well, and then possibly next year, and the first half of next year, for the younger age group, again, we’ll see what happens. But it seems like they will be approved, at least emergency use authorized for those age groups and modernas likely to follow, you know, Johnson and Johnson a little bit of a different vaccine. It is a one dose vaccine right now, but still, you know, very effective against preventing against disease. And I know, some there has been, you know, talk about well, it’s not quite as effective as the others. You know, that’s something that again, when we talk about the rates that are still in the, you know, 70 80% range, that’s still awfully good. And keep in mind, because it was, it did start some of its clinical trials later than the other two, it had to undergo trials against newer variants, you know, higher different strains. And so that may have skewed that percentage a bit. But nonetheless, when we talk about these high percentages, you know, even with all these vaccines, they’re still really heads and shoulders above any vaccines that we’ve had, certainly with the flu. Those are the vaccines that are available here in this country. There’s other vaccines and not that other countries are using, those are more likely to be less effective, actually, than the ones that we have. So I think the ones that we have available in the United States are really the really great two vaccines to be used right now.
Host
When I really look back and see the progress that we’ve made with the vaccines over the past year and a half or so, and just kind of hearing you break it down the timeline like that right now, it really is amazing what we’ve been able to do. I also really liked that you touched on the difference between somebody having had COVID-19 already and then being protected against the variant that they had, versus getting the vaccine and being protected from what we’re seeing against most of the variants. So I think that’s extremely important. And it does seem to make a lot of sense, but probably something that I myself or others may not have really thought about in that way. So I hope that people are able to take something away from that too.
Dr. Chow
Yeah, I think we’ve all heard people say, Hey, I had it, so I’m all good, or I think I may have had it so I think I’m good. So you know, even if you did have it, you can certainly get additional protection if you get the vaccine so yeah, no, that’s it. That’s a great point.
Host
Now that we are reaching higher rates of vaccination status in the country, I know we are approaching we are getting to the point of herd immunity, but we are not quite there, which is why we are seeing more restrictions and changes coming up this summer and fall again, would you be able to touch again on what herd immunity is and why it’s important for everyone who can get vaccinated to get vaccinated?
Dr. Chow
Yeah, sure. Herd immunity. So when we think about maybe even taking a step back, we take a look at the the viruses and how it spreads these viruses needs humans to continue and propagate and expand. And so if you get vaccinated to consider that, you know, a shield or protection, so the virus would not go to you. And so the less people that the virus can actually, in fact, essentially, you close the virus off. And what we find is, in the ideal scenario, if we do get herd immunity, if we do get any uprising in the viruses, would be really confined to small pockets that you can really manage a lot easier than an entire country having, you know, hotspots. And so the vaccines, what that helps do is it actually helps prevent you from getting infected. So the virus has essentially nowhere else to go. And so if you think about herd immunity, herd immunity means, again, enough of the community of the populace that is vaccinated or have some kind of protection. And again, we just touched it a little bit upon the Protect protection you get from natural immunity. But that’s only for that specific strain. So in general, the more people who have protection and again, ideally through the vaccine and not disease, the more people that are protected in that sense, you can essentially snuff out the snuff out the virus, it’s not a perfect, hey, it’s going to may go away completely. But ideally, that would be the case. And so, you know, there’s percentages out there about what percentage of the community needs to be vaccinated. I know earlier, CDC had recommended Dr. Fauci somewhere in the 80%, or even 90%. I think that’s a pretty lofty goal. I think it’s a great goal to try to get to, we’re certainly falling short of that right now. You know, so that’s something that we may not get to that percentage, but what I would say is, I don’t think there’s going to be a magic number. Why, you know, by if you say, Hey, I got to 65 or 70, we’re all good. I think, really, the message should be every shot counts. And so if everybody is able to get vaccinated, and if we can continue to improve those vaccination rates, and I think with that, you know, we certainly the people who really wanted it early on in the pandemic, you’ve heard of people traveling hours away, you’ve heard of people trying to do anything to get it, and then that wave of people who got it, you know, they did get it. And Now certainly, I think there’s a group of group of people who need to be convinced or need, you know, education, and certainly they have their own beliefs. And I certainly respect that also. But if there’s any kind of information that we can give to say, Hey, this is the facts about the vaccines, the facts, even looking at, you know, who’s getting infected, who’s going to the hospital who’s dying from COVID, overwhelmingly, it’s the it’s patients who are unvaccinated who are falling into that category. So I think that the numbers themselves right now should speak to the efficacy. But the more we can get the vaccination rates. And so, you know, the FDA approval, I think was a great, you know, boost, you know, boost No pun intended. But that I think was a good boost. I think as we are able to expand this to, you know, children, I think that’ll be another great boost. And certainly having, you know, credible sources of information. And that can be your doctor that can be your local health department or CDC websites, I think these are all sources that you can derive from to really make an informed consent. And so every shot does count. And so every shot will get us closer to some form of herd immunity. So you know, that’s really going to be our way out of this pandemic.
Host
I definitely agree. And I will make sure to, as always link information in the description to Lung Association resources around the vaccine around vaccine tracking everything you need to know FAQs, everything like that. So hopefully anybody who is listening to this and wants to learn a little bit more hesitant still can have their in and get some more information. So you mentioned a little bit about people who in the very beginning, we were running all over trying to get the vaccine, becoming the first ones to get the vaccine, which was very exciting. And now looking into the future. I know as you have mentioned, we’re not sure exactly how long the protection from the vaccine is lasting whether it’s eight months around there. So talk about vaccine booster shots have been in conversation for all three vaccinations, if I’m correct, would you be able to touch on when those might be available, what they would entail and everything that we might need to know around around booster shots.
Dr. Chow
Yeah, it seems like there’s there’s always new information about the boosters. And again, you know, that’s something that in the science and information as they come in, this is how we make our decisions. But booster shots, I think this is something that we even talked about even you know, when the vaccines came out, am I going to need another one, this is going to look like the flu. You know, at that point, really, it’s hard to predict, right, it’s hard to predict how efficacious it’s going to continue to last, the recommendations. We found that certainly for people who are immunocompromised, who may not mount a good response to the vaccine, a good or prolonged response to the vaccine. So you were talking about people who have, let’s say, who are on chemotherapy, who or who have a weakened immune system, they will need a booster. And with that, for example, the mRNA is with Pfizer, even though you had to, you can get a third shot and and that should be available right now for the community. As we talk about more of a broad requirement for boosters, again, there’s new information that’s coming out all the time, but the recommendation had been after eight months to get a booster for the general populace. And so the reason why eight months was chosen was because we found that many of the vaccines, the mRNA vaccines, after about that eight month period, some have what’s called the neutralizing antibodies. And so that’s the one that really fights the virus, some of those levels can decrease. And so even though at eight months, even though you will have a decrease in the amount of these neutralizing antibodies, it’s still will protect you very well against hospitalizations, and death. However, you still may be able to get what’s called these breakthrough infections that we’re hearing where you can still get COVID, but your symptoms are likely going to be more mild. And certainly you’re still protected against hospitalization and bad outcomes. And so the reason why that eight month was, you know, kind of chosen was because right around that right around that time, again, not a specific, you know, specific eight months, but right around the time, we find that some of the protection may wane but again, protection, Wayne towards getting infection but not, but you’re still, you know, relatively well protected against the hospitalizations as well as death. So again, this news could change, you know, even, you know, even the course the next few months, but that’s our best look right now at boosters. So, if you have the ability to get the booster, certainly if you’re immunocompromised, that’s a great idea to do. And we’ll learn more about how long all these vaccines will last, you know, in the near future, but at this point right now, once it does get approved for eight months, I think it’s something that if you’re able to get then you should do so thank you
Host
definitely. And we will, again, make sure to share information kind of the same way that we did in the beginning of when the vaccines came out about just the different types how you can go about getting your your third shot your booster shot. And I know we’ll chat a little bit at the end of this episode about what Western Europe immediate care is doing with the vaccines as well. So we’ll have all that information available, too. Before we round out, I wanted to touch a little bit on the upcoming fall and winter months, which as we know, and you mentioned in the beginning is RSV season flu season, a time period that we do see a lot of respiratory illnesses happening in general, in your opinion, what is your current outlook for this coming flu season? And how would that impact COVID-19? It’s kind of along those lines? Should people still plan to get their flu shots and their COVID-19 vaccine booster or first vaccine shot? How would all those play into each other?
Dr. Choq
Yeah, there’s there’s a big question mark about that, unfortunately, that, you know, what remains to be seen really, you know, weed I’ve heard from, there’s not going to be much of a flu season at all, much like last year, too, you know, people are Coiny it can be a twin Demick, where you have flu coming back as well as COVID. So, you know, typically around this time of year in the fall is when we should start thinking about flu shots and you know, the flu season, as well as our species. And we do know that this year, and especially some of the southern states in the United States, we did have a spike in RSV. And so typically, that’s a little bit that’s earlier than expected. And so with, you know, the addition of masks as well as the viruses, it seems like other viruses, so to speak, may not be following the same time rules as they had been the past. And so we did have an RSP spike. Earlier this summer. I think the fall season we can expect a normal RSP but again, we’ll have to see from the flu standpoint again last year, we really didn’t have very much flu and even looking at the southern hemisphere. We did not seem to have a great flu season then it seems to be tracking along that line. Now that is definitely not a definite this point I think it still remains to be seen. So in light of that we talked about flu shots, should we still be getting flu shots this year? The answer is yes, we should still be in many places right now, including our facilities at Western Europe community care, we actually just got our flu shots in. And so if you if you are able to, please make sure you get your flu shots to, you know, the good if there is any good from pandemic and learning how to control infections, you know, masking washing the hands, and staying home, if you’re not feeling well, I think is going to help the flu season, then I think we saw a lot of that last year, too. I think that contributed a great deal as people, you know, again, staying, saying to themselves wearing their mask and social distancing, that probably had a positive effect on keeping the flu numbers low. So you know, that’s another element that may affect what the flu season looks like this year. But, you know, when we think about all the infections that are out there, just because COVID is top of mind does not mean that flu is not out there does not mean that strap is not out there or RSV, or add no virus or a whole host of viruses. So how does it all mixed together, it can be confusing, it can be confusing. And so talking to your doctor about your symptoms, you know, getting getting testing is again going to be the best way of figuring out exactly what you have. And because the treatment can be different for you know, the different viruses, it’s important to, you know, get a get a good grasp as you can of what diagnosis you have. So rudas remains to be seen, but the best thing you can do is still get your vaccines and you can get the COVID as well. You know, if it’s time for COVID Booster, as well as your flu shot, you can you can get them both at the same time. Just do it in different arms.
Host
Thank you. That’s great to know, I know, you just mentioned that Western, our immediate care would be able to give the flu vaccine soon. And I know that you also offer the Pfizer vaccine now. So as you’re mentioning how it is important for people to start getting their flu vaccines again this year, and people could schedule both of them around the same time, it seems like how can someone go about scheduling and receiving those vaccines at your facilities?
Dr. Chow
Yeah, those are those are the you know, the vaccines are available for walk in. You know, certainly for flu, we’ve always done walk ins we’ve done flu clinics before with COVID. You know, the you know, the demand right now has not been terribly great. But hopefully we’ll find that the demand will start going up. And so we welcome patients to come in walk in to get the vaccine, it may, it’s still a good idea just to give our facilities a quick call to see if we have, you know, the vaccines because the vaccines need to be refrigerated, need to be open, and you have to use it within a certain time period. So we certainly would want to try to control people who are coming into around the same time so that we don’t have to waste any vaccine. So it’s always a good idea, especially with the COVID vaccine to give a quick call before you come. And just to make sure that we have them. And so we can, you know, get people together, group them timely spaced out, but enough so that we don’t have to waste any, because it’s really disappointing to have to waste some of these vaccines. But nonetheless, we do have them available there. You can feel free to go to our website or give her office’s a call when they become available. But we do have the COVID Right now I do know that I do know the flu vaccines have come in just recently. And so we’ll be opening, opening these up to the public very soon.
Host
That’s perfect. Thank you. And I will also have western New York immediate cares phone number and website below so that anyone can access them as well. So thank you so much for going over some of the new updates for seeing a lot about the vaccines. I think it was really important to touch on this again, I think it was time. So is there anything else that I missed that you would like to make sure you get across or that we have our listeners now?
Dr. Chow
Yeah, I think this is something that we’re all in it together. Certainly, you know, the vaccinations, masking social distancing are certainly going to get us to the point that we want it to get to us. But we’re all in this together. And this is something that will get over, you know, we’ll get over this current surge, certainly in our areas up here in the Northeast for probably bracing for it right now. But if there’s any kind of glimmer, some or facilities down in the south, who were really hit hard by the surge are just starting to, you know, see some of those numbers decline right now. So it’s always good to have hope. And I think even through this surge, the surge will come in and you know, it’ll go and we’ll get over it. But we need to make sure we’re doing the right things. You know, keeping everybody healthy. So there will be hope. And I think we will you know, get through this all together.
Host
Yeah, absolutely. Thank you so much for that. And as I said, thanks for joining me. We’ll talk to you hopefully sometime soon.
Dr. Chow
Thanks. My pleasure.
Host
Thanks again, Dr. Chow for circling back with us on such an important topic. We truly value having you and western New York immediate care as a partner during this time and receiving accurate updates from the same trusted source. As mentioned it’s still extremely Important to receive your COVID vaccine if you have not yet and for those who are immunocompromised or have underlying health conditions, it is possible to start looking into receiving a COVID-19 vaccine booster shot. As Dr. Shell mentioned, it is okay and recommended to receive your flu vaccination whether you have the COVID-19 vaccine, do not have it or we’ll be getting both shots at the same time. To stay updated on COVID-19 Vaccine Information and the status of our country, you can head to our website linked below. In our description. You will also find the three available vaccine options and a link to Western New York immediate care where you can schedule an appointment or talk to a representative. As always, make sure to follow our Facebook accounts at LUNG FORCE walk buffalo fight for air climb Buffalo and fight for air climb Rochester stay safe and healthy and we will talk to you next time.
Transcribed by https://otter.ai
About the Lung Force Podcast Series
Welcome to the American Lung Association’s official LUNG FORCE Podcast Series from Buffalo, NY and sponsored by Independent Health! Lung cancer is the leading cause of cancer deaths in America for both men and women. People that you know are struggling with lung cancer, COPD, asthma and more every single day. Each month, we will bring you a few episodes covering different lung health topics that are local and relevant to our community, by interviewing experts around the area and digging deeper into the lives of those affected by lung disease.
