Covid-19 Q&A with Dr. Angelique Campen (part 7)
Dr. Angelique Campen is an ER doctor at Providence Saint Joseph Emergency Department, a Clinical Instructor of Emergency Medicine at UCLA Medical Center, and the CMO and Founder of Vital Medical Services. Follow her down to earth evidence based information at @glamERdoc.
1. It seemed like as more people got vaccinated, we were heading back to "normalcy," until the Delta variant emerged. How has the variant affected things from your view in the ER?
Only about 50% of California are vaccinated. I have seen a huge spike of patients in the ER. I have yet to have to hospitalize any children or vaccinated people. All the people I have had to hospitalize are unvaccinated. Vaccinated people can still get sick, although their symptoms are much more mild.
2. What types of patients are you seeing with covid now, in the ER? Seems like last year it was mostly people with some type of pre-existing condition and/or the elderly. Has the demographic of the population group getting Covid expanded? What impact is Covid having on young people that it wasn't last year?
I am seeing mostly unvaccinated patients in the ER: all ages, all ethnicities, and often previously healthy without any underlying conditions. I would estimate that most of the people I am seeing now are younger, probably because geriatric aged people have been vaccinated.
3. Seems like everyone has had it up to here with masks, and recently LA county mandated they be worn by everyone inside, or at outdoor gatherings of more than 10,000 people. What is your personal view on masks, who should be wearing them and when? And do you have strong feelings on a regular mask, N95 or the "gaiter" variety?
A regular mask that covers your nose and mouth is a must, even if you are vaccinated. I use myself as an example. Every day at work I care for and am exposed to multiple covid patients. I always wear a surgical mask. I have not gotten sick. That shows you the power of wearing a mask and keeping your hands clean. Masks are not necessary when you are outdoors and not close to others or if you are in an enclosed area alone (like a car).
4. What would you say to vaccinated people who say, "I've got nothing to worry about, I don't need to wear a mask." And, what would you say to unvaccinated people who say, "There's no pressing reason for me to get vaccinated, I'm healthy, and if I got it I likely wouldn't become very sick.”
I would say, “Come to work with me just for one day and see for yourself!” Vaccinated people get sick, just not as sick. However, we don’t know the long-term effects of covid (long hauler syndrome) so it’s best just to avoid catching it altogether. As for unvaccinated healthy people, covid is so very random. I see young healthy people fall very ill to the disease and die. The fear in people’s eyes when they are short of breath and sick is unforgettable. Over and over people sick in the ER ask me if I can vaccinate them, but at that point it’s too late.
5. Is your view more optimistic or pessimistic that the worst days of Covid are behind us? Do you sense Covid is just something we will be dealing with well into the future?
I don’t think it’s over yet. I predict a bump in cases as kids go back to school and bring it home to their unvaccinated family. Additionally, as long as we have a high transmission rate and high number of unvaccinated people, we will see the creation of new variants (variants happen when the virus replicates over and over). Vaccination protects against future variants while previous infection only protects you against that specific type of covid virus.
6. The people who first got vaccinated are approaching the one-year mark, and there is talk of a booster shot. What's your opinion on people getting revaccinated or getting booster shots? Have you treated anyone in the ER with a reaction to the vaccine?
When it is my turn, I will get a booster. Many of our other immunizations (hepatitis B, tetanus, polio) are done with two initial shots and then a third delayed shot that gives you a more robust immunity (antibodies and B cell response). I feel covid will be the same. Anaphylaxis (allergic reaction) appears to be approximately 0.2 per 100k vaccine. I have taken care of 2 of these cases. Mostly people get a sore arm and body aches. In comparison though, among the known infected, hypoxic lung complications in previously healthy persons appears to be 5% for adults (0.5% for children) and death appears to occur in about 1/4 of those hospitalized.