A COVID-19 summer wave spreading in Georgia and across the U.S. is showing no signs of slowing down.
Dr. Doug Olson, medical director of the emergency department at Northside Hospital Forsyth, says the summertime uptick in COVID transmission has also been felt at his hospital. But the rising cases haven’t translated into an increase in hospital admissions.
“What we’ve seen is a gradual decline in the severity of symptoms,” Olson said.
And even though cases are climbing upwards and it can seem — once again — like everyone knows someone who’s sick with COVID right now, attitudes toward the virus have changed, and many doctors and health experts are reassessing the role of COVID vaccines at this point in the pandemic.
In Olson’s view, seeking out additional COVID vaccines has become less important, especially for those who aren’t at risk of severe illness. A growing number of doctors agree with him.
While the world waits for updated vaccines to arrive, what has become a seasonal summer outbreak continues. The Centers for Disease Control and Prevention no longer tracks case numbers but estimates the trend of the virus spread based on emergency room visits. According to the CDC, in the week that ended July 20, Georgia reported about 1.5% of emergency room visits were diagnosed as COVID, a slight increase from the previous week. Nationally, 1.9% of all emergency visits were due to COVID, also up slightly from the previous week.
The FDA has announced a new COVID-19 shot is expected to arrive in August or September and will better target the more recent variants of the virus. And while the Centers for Disease Control and Prevention has a general recommendation for everyone six months and older to get an updated COVID shot, some in the medical field are taking a less blanket approach.
“I was very pro vaccination in the beginning, because at that point, you know, we had a severe illness and people could end up seriously sick, potentially die or require long term care or, you know, some major risk or complication,” said Olson. “Now we’re dealing with a much milder illness. And this is the tricky part about viruses, viruses like to mutate, and so they evade the vaccines.”
He acknowledges his point of view may be controversial, but said “I think you’ll find in the physician population, that a lot of us are probably not getting the boosters, because we feel like it’s lagging behind the actual variants that we see coming out. If they came out with a vaccine that said, ‘Hey, this is going to be the cure, you’re not going to get COVID anymore,’ I would take it, but that’s not guaranteed by the current vaccines that we have.”
Officials acknowledged the need for booster shots is not as dire as it was a few years ago. For the average person, vaccines now offer an incremental boost in immunity, and its effectiveness can wane after only a few months. But the FDA, CDC and most doctors agree the vaccine continues to be especially important for older adults and those with pre-existing health conditions. Olson agreed that those at highest risk for severe illness or death should still seek a vaccine.
As the virus is continuously evolving, it raises questions about whether it’s practical for young healthy people to get boosted with variant-specific vaccines — especially when vaccine developers can’t keep up with the coronavirus mutations.
In June, the Food and Drug Administration decided to ask manufacturers to change the strain of the virus that fall vaccines will target. According to the CDC, the variant has changed again since that decision was made, but the formula is expected to still be effective. Health officials say even when vaccines are not a perfect match, they can still provide protection against serious illness.
While Dr. Andrew Reisman, a Gainesville doctor, continues to encourage his patients in high risk groups to take the vaccine, he is less adamant now, especially because treatments are available and illnesses tend to be less severe. When it comes to young healthy adults, he is neutral.
“I say, ‘Are you concerned about COVID? Do you want to get the vaccine? Then get the vaccine. If you are not concerned and don’t want to get the vaccine, don’t get it,’” said Reisman, former president of the Medical Association of Georgia.
But that is only part of the conversation. For those who want to skip a COVID shot and downplay the virus, he urges them to be aware of any cold-like symptoms and not assume it’s simply a head cold. He would like them to take steps to protect vulnerable people around them by staying home.
“As somebody who is tasked with protecting people’s health and protecting my patients’ health, it is very irritating to me that some people don’t think about other folks and they are like, COVID is no big deal, but it is far more contagious than other viruses,” Reisman said. “You could end up killing someone who doesn’t have as strong as an immune system as you.”
Credit: Miguel Martinez
Credit: Miguel Martinez
Dr. Jayne Morgan, executive director of health and community education at Piedmont Healthcare, acknowledged the limitations of the current COVID vaccines and that it may not be necessary for everyone at this point in the pandemic. But these are far from easy, one-size-fits-all answers.
“Unless or until the variants change toward causing more severe symptoms, those with advanced age, multiple chronic medical diagnoses, or immunocompromised should have priority,” she said. “There is certainly an argument to be made for the young and healthy to not be vaccinated unless the variants begin to pose a greater threat to health, and/or next generation vaccines become available with greater durability and broader coverage,” she said.
But when young, healthy people can spread the virus even when they don’t get sick, that’s where you can make the case for vaccination, Morgan said.
“There is certainly (another) argument to be made for protection of the elderly and immunocompromised as a priority as we continue in this era of first generation vaccines, awaiting next generation vaccines,” she said. “This doesn’t mean that people cannot have normal lives, but rather that vaccines are helpful to everyone young and old alike. ... What one does, impacts another.”
