EVSLIN: April crucial for putting pandemic behind us

There were good news items in the first few days of April, and they were about immunizations.

• The state Department of Health Kaua‘i District Health Officer, Dr Janet Berreman, announced that starting April 5 immunizations will be available to all people on Kaua‘i over the age of 16;

• The CDC announced that full immunization allows one to travel with lower risk (but still not advising travel and still need to wear masks);

• The CDC announced the results of a study that showed that the Moderna and Pfizer vaccines not only prevented hospitalization and severe illness after two shots in 100% of people, and prevented even mild symptoms in 95%, but it appears to even prevent catching the virus for 90% of the people. This is a very important study (and we need more to prove it). The original studies showed people were prevented from becoming symptomatic but did not prove if people did or did not have the virus. This new study actually showed that 90% were protected from even catching the virus. The Johnson and Johnson vaccine appears to be very good, also. It also appears to prevent death or hospitalization in 100% of people and only requires one shot. But because it is new, it does not yet have enough research on its ability to prevent infection;

• There have also been over 100 million vaccinations given for COVID in America. Most of these shots have been Moderna or Pfizer (and just recently Johnson and Johnson), and the shots continue to appear to be very safe.

This brings me back to April. On April 5, Kaua‘i re-enters the state Safe Travels program. Trans-Pacific travelers can avoid quarantine with a single negative pre-flight test. Also on April 5, our schools enter a new phase of in-person learning. This might all seem like very good news also, except that the evidence increases daily that the world is in a race between vaccinations and the variants. Variants of COVID are emerging rapidly around the world, and are being blamed for surges in Europe, South America and the U.S. These surges are worse in Europe and Brazil, where vaccination efforts have been much-less successful. The news about COVID is not nearly as good as the news about the vaccines.

• Dr. Rochelle Walensky, the new head of the national CDC, said she was very worried about letting our guard down too quickly, as the variants can be so dangerous. She actually said she “had a feeling of doom;”

• Hawai‘i is showing evidence of cases surging, which is being possibly fed by these new variants. Hawai‘i has had triple-digit increases in new cases over the past week, and in the end of March had the highest percentage increase in hospitalizations of all the states in the U.S., and about the 13th-most-rapid increase in the percentage of new cases. To be clear, our state numbers are still good compared to much of the country (except for Maui), but trends are important, and this is a worrisome trend;

• A new study in one of the world’s most-respected medical journals also reported that a single, pre-travel testing program, such as the Safe Travels program, only prevents 36% of those who might be infected and not detected from coming into an area. If you are tested in the early stages of the disease, your test will be falsely negative;

So, we are truly in a race between travelers bringing in the virus (and the variants) and the immunizations protecting us. Kaua‘i is starting the race with a head start. Our island has been one of the safest places in America during the pandemic. And thanks to the state DOH, the hospital systems and the other immunizing locations, we also have one of the highest immunization rates in the country. One of the reasons we have done so well is that we had so few people sick with COVID on Kaua‘i that our energies could go into vaccinating. We have done more than 39,000 immunizations on Kaua‘i. The DOH at its Kaua‘i War Memorial Convention Hall has immunized over 23,000 people in just that location.

The goal for each of us in the month of April (and after) should be to get immunized as soon as you can, and to encourage those whom you know to get immunized also. All eligible adults should get immunized, but particularly consider getting immunized if you are over 60 or of any age and have medical conditions such as being overweight or diabetic or have high blood pressure or moderate to severe asthma. I also suggest that school staff, people who interface with visitors and parents with dependent children place a high priority on getting fully-vaccinated. Please join us in being part of the solution to putting COVID behind us and returning to a pandemic-free world.

If you go to the kauai.gov/vaccine website site you can find information about the vaccines and get help with making appointments.

The race between the variants and the vaccines is very real, and together we can win it. We already have a head start. I believe we should all thank Mayor Kawakami and Berreman for leading their teams and the people of Kaua‘i into this head start.

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This column represents a sharing of information. No content on this column should ever be used as a substitute for direct medical advice from a family doctor or other qualified clinicians. Lee A. Evslin, M.D., is a board-certified pediatrician and fellow of The American Academy of Pediatrics. He was a former health-care administrator at Wilcox Medical Center, and periodically writes a column for the Garden Island.