January 2021, almost one year into the global pandemic, Random Lengths News spoke to Dr. Jessica Kiss of Palos Verdes Medical Group about the state of Los Angeles County’s health. Hospitals were operating at dangerously close to full capacity while frontline healthcare workers were triaging what seemed like an endless line of COVID-19 patients fighting for their lives. Patients who needed medical care for anything other than COVID-19 often had to be turned away. [As of Jan. 17, 4,564 people with COVID-19 are currently hospitalized in Los Angeles County].
If that sounds familiar, that’s because we’re reliving it. It was a grim existence. Yet, as the pandemic persists, some parts of the United States and California in particular gained greater control over COVID-19. This was possible through treatments and ongoing research in medicine and science, including vaccine trials. But we also reached this point because people have become educated, armed and remain committed to the rituals of maintaining their health and that of those around them via COVID-19 vaccinations, testing, social distancing, masking and hand washing.
In December, Dr. Nava Yeganeh, MD, MPH medical epidemiologist with the Acute Communicable Disease Control Program, Department of Health, framed how far we had come since one year earlier.
Over the past year, we are so fortunate to have gained access to an incredibly safe and effective vaccine in protecting our children from serious short and long-term complications from COVID-19.
Furthermore, these vaccines have allowed the children in our community to return to a more interactive and joyful life, from attending in person school to participating in social events, sport teams and extracurricular activities important for their development and growth. In Los Angeles County specifically, we have administered over 590,000 doses given to 12-17 year olds, meaning that over 78% of our teens have had 1 dose of vaccine. We also have vaccinated 16% or 146,000 of the 5-11 year olds. These vaccines have been our most powerful tool in reducing the risk of getting and spreading COVID-19.
We strongly encourage that everyone 5 years and older gets fully vaccinated or receives their booster dose as quickly as possible to reduce transmission of the virus.
Now, amid the highly transmissible Omicron variant, cases are again soaring. As recent history shows us, we have learned collectively how to navigate through the COVID-19 pandemic. Yet, here we are. RLN revisited Dr. Kiss initially to discuss the progress we’ve made. The doctor also spoke further in light of the current surge that Los Angeles is gripped in.
Endemic versus Pandemic
The doctor said COVID-19 will unequivocally become endemic, meaning it’s natural to, native to, confined to, or widespread within a place or population of people.
“We’re not there yet because of the consumption of resources associated with it still,” Dr. Kiss said. “We’re at a point where all the hospitals are just getting pummeled.”
She explained COVID-19 can’t become endemic until we’re past the point of medical staff getting killed or getting sick from COVID-19 themselves. Also, part of reaching the point of endemic will be the increased availability of antiviral drugs like Paxlovid and Xofluza which you take upon onset of the flu.
“We will get there with COVID-19 when we have enough of those resources, which we just don’t yet,’’ Dr. Kiss said.
Mother and Doctor
Dr. Kiss is a mother of four who specializes in family medicine. Through her Instagram account at askdr.mom, Dr. Kiss brings medical facts helping people make educated health choices with no judgment. She shared a critical development in the fight against COVID-19 with RLn. The doctor discusses enrolling her four children in vaccine trials in order to help facilitate the research necessary to immunize all children, ages 5 to 12, and the importance of it.
Vaccine Hesitancy
There are still discrepancies in the number of vaccinations received, now with children too, in Black and Brown communities. When it comes to vaccine hesitancy, in general, Dr. Kiss addresses the conversation head on.
“When people historically judge others for their beliefs whether they are misplaced or otherwise, we don’t have a conversation about what the concern is,” she said. “… We all want the same things for each other. We want happiness and health. When I come at it from that standpoint of, ‘let me hear what your concerns are so we can talk about them together,’ instead of saying ‘what you’re saying is not valid,’ we are open to conversation at that point. That’s the start of it.”
Dr. Kiss acknowledged that there are many deep-seeded cultural concerns there too. Medicine as a profession has not done a good job of taking care of minority patients. They have reason to distrust the medical community. We have not earned their trust, she said, because we haven’t taken care of them very well.
“I understand where it’s coming from,” she said. “When you look, particularly in the Black community, this is seeded all the way back to the Tuskegee [syphilis study] treatment during syphilis research. The mistrust is very real. I find the first thing is addressing the elephant in the room and meeting people where they are ready to hear things is the most appropriate thing and not judging them for not being ready.”
Dr. Kiss said her goal is for patients to feel empowered that they have accurate information to make the best choice for their families. To do this she provides medically accurate resources, which include places that patients can research which are safe — rather than just googling, listening to what the neighbor said, or what they read on social media about it.
Cost of COVID-19 Deniers
COVID deniers are a hard group for Dr. Kiss — the people who she describes as engaging in willful ignorance.
“It’s what you would call fixed delusion [being certain of a fixed, false belief and not persuaded by any arguments to the contrary] in mental health,” Dr. Kiss said. “I know some very intelligent people who are still convinced to this day there is a microchip in the vaccine which has been widely debunked. These are very well-educated people holding these beliefs and it is doing damage for so many reasons because many times these people come off as authority and they are very compelling and convincing.”
The cost is that we are still in this pandemic, the doctor said, because people put out false information willingly, only to deter people from something that they don’t want to understand.
“It is truly the reason we are still in a pandemic phase of this illness,” she said.
Progress Report on LA County
Dr. Kiss said the speed at which Los Angeles County responded to vaccination really is a testament to how it has performed better than other areas.
As of the week of Jan. 2 in LA County, 80.1% of residents have received at least one dose and 71.6% of residents are fully vaccinated — or about 6, 965,589 people. As of Jan. 14, Public Health reported 27,942 people have died of COVID-19 in LA County.
“Did we have a resurgence over the summer?” she asked rhetorically. “You bet we did. But the vast majority of those hospitalized and who died were unvaccinated and unfortunately, the reality is the remainder of those who passed or had severe illness had secondary illness. They were immunocompromised, they were weak because they were elderly or very young.”
It wasn’t uncommon to see 30 year-olds in the hospital with no other illness and their only risk factor was being unvaccinated, the doctor recalled. The fact that LA County pushed to do the right thing, in vaccinating she said, really paid off in spades.
“The continued masking has paid off not just for COVID-19 but for other illnesses,” the doctor said. “Our other illnesses were down when people masked consistently. And holding people accountable for how their health matters to other people around them has really put us in a better position this winter. We are not in a good position but we are in a better position for sure.”
Further, Doctor Kiss noted that the LA County Department of Health “really got out there.”
“I had the privilege in February to volunteer as a physician at The Forum vaccination site,” Dr. Kiss said. “We vaccinated 2,000 people that day — 2,000 in one day. I walked almost 20 miles pacing between cars. LA county was a well oiled machine when it comes to the Department of Health providing vaccination.”
Virulence and Information
The doctor said with the Omicron variant, even if it turns out that it’s going to evade vaccination, getting vaccinated is still key.
“The reason is, the more people we get vaccinated, we reduce the spread in general of this virus, which reduces the ability of it to mutate over and over again and make these super variants. At this moment we know that it spreads more quickly between people because of these mutations.”
In December the doctor noted we didn’t know if it’s more virulent — causing more severe illness, but early evidence out of South Africa showed that may not be the case. But she’s certain that things that have worked consistently for us are mask use, hand washing, getting COVID-19 tests when you have any symptoms and staying home and away from people who are sick.
“Talk to other people around you and find out where they’ve been, what they’re doing. Having that conversation is going to empower everybody to remain healthy,” Dr. Kiss said.
On the Omicron Variant
“Bananas, there’s no better word for it,” Dr. Kiss said. “We know that the longer it takes for people to get vaccinated, the more this virus replicates, the more opportunities for these types of things to happen. This will not be the last variant. This hopefully will be the last variant for the moment that is like this, and give us a chance to breathe and regroup. We don’t want people going out there, deliberately getting [COVID] because still, long haul COVID is real. We don’t know those consequences. We don’t want our kids to live those consequences, 30-40 years from now. We don’t know what they are.”
The doctor is hopeful. She said it looks like Omicron will peak in the next several weeks and that we have a grace period at least in the spring but nothing is certain — we don’t know if there’s another variant. That’s what was happening with Delta, she noted, “Then Omicron came in and just took us all back out,” she said.
Details: www.instagram.com/askdr.mom and www.VaccinateLACounty.com