HJNO Sep/Oct 2021

DIALOGUE 18 SEP / OCT 2021 I  HEALTHCARE JOURNAL OF NEW ORLEANS Kanter It’s not typically immunity. There’s a pathway set up to help adjudicate peo- ple’s claims of damage from the vaccine, specifically so drug companies will still make vaccines, because oftentimes they’re not as profitable. Sometimes it’s something the government requires people to get, in serving or going to school or so forth, so a separate pathway is set up so that com- panies will still feel incentivized to produce vaccines, even when they’re not specifically profitable. It’s a pretty transparent process, and one of the aspects of it is they tend to pay out claims quickly even if they’re not able to prove that that damage was the direct result of a vaccine. This is something that was legislatively created by Congress, and it’s a system that works well, specifically because we still want drug makers to make certain vaccines, even if they’re not imme- diately profitable. To speak on the larger level, I think the question emanates from someone who might have concerns about what type of side effects people are experiencing from these vaccines. And, I’ll tell you that the monitor- ing system that the CDC and the FDA have is robust. It’s never been more robust than it is right now, and it’s also very transpar- ent, and every serious report of a side effect gets investigated. To date in Louisiana, we have had eight serious side effects from the COVID-19 vaccine, and you define that as a side effect that requires at least one night of hospitalization. We’ve had eight, all eight of those people have been discharged and are doing OK, and we’ve had zero deaths from the COVID-19 vaccines. Editor Some say mainstream media report- ing on COVID-19 deaths is sensationalism at its worst. If you would play armchair quarter- back for a moment, according to the CDC, no Louisiana, Mississippi or Arkansas kids, 0-17 have died from COVID-19. Looking back on it now, do you think the stress or disruption in their lives is a bit out of proportion? Kanter That’s false. We have had individu- als younger than 18 die of COVID. In fact, I treated one myself in the hospital. We’ve had nine people die of COVID who are between the ages of zero and 17. I don’t know what’s listed on the CDC site, but it is listed on the Louisiana Department of Health COVID-19 dashboard. Editor One viral expert I spoke to said he and his colleagues are convinced that the SARS-CoV-2 is a man-made virus because of its ferocity and the ability to attack so many body parts so effectively. Do you agree? Kanter Oh, I don’t know. The origins of how the virus came to be are very much under investigation, and I think there are strong theories out there. There are clearly theo- ries that it emerged naturally, perhaps from some path, or other theories that it was the result of some leak in a lab, whether that was intentional or not. I don’t know, and we might never know. Let’s be honest. We might never know, but that doesn’t change one bit what we have to do now to protect ourselves. Editor The PCR test used to diagnose infec- tions of the virus is said to be as high as 98% false positives for infectiousness. And they’re being discontinued by the CDC at the end of the year. Do you know how many of those tests were given out in Louisiana? And do you have an estimate of the false posi- tives or negative rates our testing in Loui- siana has had? Kanter The ability of a test to have a false positive is a reality for really any test, of anything, including PCR tests for COVID, but it’s nowhere near that number much — much, much less, typically 5%, if that. PCR tests are highly, highly specific. So, it tends to be much less for PCR tests as well. What the CDC did is in February 2020, when there was no testing available here for COVID-19, the CDC developed protocols for a test so that state labs could begin testing and pub- lished those protocols. It was the first test that people could use in the United States, and it took a long time to get. Even though they did it in record time, it still was being developed as COVID was actively spread- ing, particularly in Louisiana. Since that time, many, many other PCR tests have been developed, now being put out there by private companies, not through the CDC. Ayear and a half later, there is less need for this initially developed CDC test that is not really being used now. Now, most people use PCR tests that are being fashioned by private companies, so in recognition of that, the CDC asked the FDA to withdraw the approval. The authorization for that initial test doesn’t affect at all every other PCR tests that remains on the mar- ket. In fact, it doesn’t nearly affect the way that anyone’s getting tested, because almost no one is using that initial CDC test right now. So, the availability of PCR testing, the authorization approval of PCR testing for COVID-19 remains 100% in effect and avail- able, and it says nothing as to the accuracy of those tests, it just speaks to now there are other tests available on the market. These PCR tests remain highly, highly sensitive and very, very specific. We think we have good visibility on the spread of COVID. We don’t think that we have a problemwith the available tests out there right now. Editor What do you think the end game of this pandemic looks like in your best guess that it’s behind us? Kanter I don’t know when it happens, but I really think the only end game for us is get- ting more people to feel comfortable get- ting vaccinated. I think we’re going to con- tinue to have spikes, unfortunately, until we can get a larger number of our friends and neighbors vaccinated. I think that’s unfortu- nate, because it’s no longer an issue of how much vaccine is available; we have plenty of vaccine. Until we can build a level of com- munity protection, we leave ourselves vul- nerable, and we’re experiencing that right now with this Delta surge. n