CHATHAM CHAT | MIKE ZELEK, CCPHD DIRECTOR

The ‘hard moments’ of the COVID-19 pandemic continue. Here’s a Chatham update.

‘Unfortunately, we are seeing more and more of those who are taking their chances with COVID end up in the hospital.’

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For the first time in three months, Chatham County residents are again succumbing to COVID-19. As the recent surge of cases continues, Mike Zelek, the director of Chatham County’s Public Health Department, responded to more in series of questions from the News + Record about the pandemic, vaccine reluctance, COVID fatigue, masking up, and more.

You’ve been banging the “get vaccinated” gong for quite a while now. How accurate is it to say that “everyone who wants vaccinated has been vaccinated, and everyone who’s not vaccinated isn’t going to budge”? Or … is there wiggle room there among the (still high) percentage of Chatham residents who haven’t been fully vaccinated?

We have seen an uptick in demand for vaccinations since late July, likely coinciding with the rise in cases due to the Delta variant and perhaps workplace requirements. We have also recently experienced a number of hospitalizations, as well as deaths, and I think COVID-19 is hitting many closer to home than it has throughout the pandemic. 

These aren’t just cases in a specific setting like a nursing home — they are widespread and taking a heavy toll. So, I think many are moving forward with getting the vaccine who were hesitant earlier. I hope that continues, because we all want this pandemic to end and to avoid as much heartbreak and loss as possible until it does. We know that vaccinations are our best way to make that happen.

Among the unvaccinated, we anecdotally hear a lot of this: “I’d rather take my chances with COVID than with the vaccine.” They cite some studies showing illnesses and sickness that follow the vaccines, as well as the rate (relatively low, as they will describe) chances of getting seriously sick from COVID. Two questions: What do you say to the unvaccinated among that group, and: is what you’re saying making any difference with them?

Unfortunately, we are seeing more and more of those who are taking their chances with COVID end up in the hospital. This includes younger people, and the average age of those hospitalized from COVID is much younger than it was before Delta and vaccinations. Getting the vaccine is not taking a chance; it is very safe and hundreds of millions of doses have been given in the US.

Knowing we have an effective vaccine and seeing younger, unvaccinated people end up in the hospital is very difficult. We have faced a lot of hard moments over the past year and a half. I don’t think any has been as hard as what we are going through now.

We all have COVID fatigue … but how much of a factor is the unvaccinated just tired of people (experts, the vaccinated, and all the other related messaging) pressuring them to get vaccinated? Is the over-messaging causing the unvaxxed to dig in their heels?

There is a lot of information (and misinformation) out there, and I know it can be overwhelming at times for all of us. But the core message is simple: Vaccines are not new, and they have saved many lives and prevented illness for decades. The COVID-19 vaccine is no different. It is saving many lives and keeping people out of the hospital and off ventilators.

We are all ready for the pandemic to end, and while that can lead to challenging conversations, these conversations between family members and friends are really important to getting us there. I would encourage those who are vaccinated to keep having these conversations and to meet those who aren’t vaccinated where they are at by normalizing the vaccine, talking about their experience, and sharing reliable information. While there can be resistance, I don’t believe these conversations are to blame for people not getting vaccinated. Without them, misinformation and assumptions go unchecked, and this is much more dangerous.

Nearly a quarter of COVID cases in Chatham since early July have been among children under the age of 18. They can’t get vaccinated yet … yet that age population is in school now, in classes (albeit masked). What do anticipate — if indeed we can even venture to guess — for the “under-18” population in terms of infections, illness, etc., until there’s approval for them to get vaccinated?

Most importantly, we need all who are eligible, including those 12 to 17 years old, to get vaccinated. This will help protect those too young to get vaccinated. Masks continue to be very important for all of us, including children, and I applaud our local schools for making the right decision when it came to universal masking.

But it’s typically in the activities and gatherings outside of school where protocols aren’t as strict that we see transmission. So, for the health of our children and to maintain in-person learning, it is important that these precautions that we have been talking about for more than a year be taken. This is especially important with the Delta variant.

We are hearing (personally and anecdotally) more than ever now about vaccinated, masked, mostly isolated people contracting COVID — from sources they can’t fathom or trace. A lot of “I have no idea where I got it.” What does that say to you as a health expert? — and what does that mean for those among us who are vaccinated?

When there is transmission at the levels we are currently seeing, it is often difficult to identify the source. This is what we refer to as community transmission. It is also why we continue to strongly encourage everyone to wear a mask in indoor public spaces, and also be mindful of the environments you are in. Delta is that infectious.

The good news is that vaccines continue to be very effective against severe illness and death, which is what they are designed to do. That said, we are seeing more breakthrough cases, and that is why the FDA and CDC are considering recommendations for booster shots. We expect to hear more soon about booster shots and will share any updated guidance or recommendations with the Chatham community as they come.

Anything new or different in your advice about getting tested (under what circumstances should people get tested) or isolating after exposure?

Given how widespread COVID is, testing is especially important. If you are unvaccinated and a close contact to someone who is positive, you should get tested and you must quarantine. If you are fully vaccinated and are exposed to COVID, while you do not have to quarantine, you should get tested 3-5 days after exposure, closely monitor for any symptoms (and isolate if you have any), wear a mask when around others, and be mindful of the environments you are in. For example, I would recommend avoiding large gatherings or spaces where it is difficult to maintain distancing, especially indoors if possible.

 Chatham County doesn’t yet have a mask mandate, but many public places (retailers, etc.) have “masks required” signs as you enter. Even so, you still see many unmasked people in Chatham County not socially distancing. What’s your reaction, messaging about that?

Treat every setting as if there is someone there with COVID, which is unfortunately not too far-fetched at the moment. No one wants to become infected and have to isolate, let alone get sick and risk exposing their loved ones to COVID. Masks that are properly worn and well-fitting continue to work well against COVID. Respect our local businesses and neighbors by wearing a mask until this current spike passes. 

Chatham recently saw its first deaths related to COVID in many months. As hospitalization and death rates increase, what kind of urgency are you and your department feeling?

After going close to three months without a death from COVID, these recent deaths have hit hard. Given what we are seeing with Delta and hospitalizations, we expect there will be more deaths before the current surge ends. Since Delta began to take hold, we have been feeling a sense of urgency to increase vaccination rates to prevent as many hospitalizations and deaths as possible. We have also been ramping up testing options as demand greatly increased. It is a serious situation, and one none of us want to be in.

 “My body, my choice.” How do you respond when someone says that about masking?

Like smoking in public, it is a choice that affects others. Take masking in schools, for example. With the updated school guidance, if masks are worn consistently and correctly, students do not have to quarantine for in-school close contacts. So, if I send my child to school with a mask on and he ends up having COVID, the children around him would not miss two weeks of school if they were also masked. However, if he were not masked, even if they were, those children would have to quarantine. That affects the children, their families, and the ability to sustain in-person learning. And, of course, it puts them at higher risk of getting infected.

 How is local hospital capacity looking?

... (Chatham Hospital) has been very stretched recently. Regionally, hospital systems are facing long wait times and very difficult situations. It is important to remember that there are other health emergencies beyond COVID, and when beds are filled with patients with COVID, there may not be room for those who need other critical care.

 What do you make of these unusual sudden (after two months or so) and hard-to-quantify reductions in cases and transmission rates in some parts of the country and the world?

We are all hoping Delta cases are nearing their peak, but we are far from being out of the woods. There is a lot of uncertainty, especially at the local level. We are also headed into the fall and winter, which is typically when respiratory viruses spike (think last January). Places like the UK saw an initial sharp drop in cases, but cases never returned to baseline and are now rising.

But let’s end on some good news: Our behaviors affect the outcome. If we continue to see vaccination rates increase, along with mask wearing and avoiding situations where COVID is known to spread easily, our future will look better. Unlike last fall, we now have a safe and effective vaccine. We just need everyone eligible to get it.

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