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COVID-19: Two Paths Forward

COVID-19: Two Paths Forward

Dr. Allen Radner collaborated with Dr. Mark Carvalho and submitted the following opinion piece to media outlets for use and publication. It will appear in print and online starting Friday July, 23.

COVID-19: Two Paths Forward

Everyone wants to be done with the devastating medical, social and economic consequences of this pandemic.  Unfortunately, there is little reason to believe that the virus that causes COVID-19 is ever going away.  The question is how we can successfully mitigate its presence and move on.

Early in the pandemic we hoped that COVID-19 would disappear. Nineteen months into the pandemic, however, the virus hasn’t disappeared but has progressively mutated into increasingly more infectious variants.  It is quite likely that everyone who hasn’t been vaccinated will ultimately be infected with COVID-19.  (By example, prior to the development of a measles vaccine it was believed that up to 98% of the population became infected.)

The majority of those infected with COVID-19 (as with measles) survive with self-limited infections.  Unfortunately, a small percentage of those infected with either illness die or are left with debilitating problems.  A small percentage of a large population translates to frighteningly large numbers of avoidable illnesses and deaths.

Remarkably, we have the opportunity to choose our path forward. With the introduction of safe and effective COVID-19 vaccines we can choose from two options - vaccine induced immunity or the immunity conferred by infection.  One clearly is a more difficult road.

By every marker, the risks of complications and deaths from a COVID-19 infection exceeds the risks of vaccination. Additionally, as immune dysregulation is a component of a COVID-19 infection, the immunity from an infection may not be as robust as the immunity from a vaccination (hence the recommendation to vaccinate individuals who have had an infection). Critically, while the vaccines are not 100% protective, those vaccinated who become infected have milder illnesses.  Greater than 90% of the country’s current hospitalizations and deaths have occurred in unvaccinated individuals. Overwhelmingly, in our county, current COVID-19 hospitalizations are occurring in the unvaccinated.

While the  rapid development of an effective vaccine should be celebrated, our evolving understanding of the virus coupled with the ease with which disinformation can be disseminated has instead undermined popular confidence in scientific messaging. Given the advantages of vaccine induced immunity, however, the overwhelming majority of US healthcare workers have chosen this path.  At the Salinas Valley Medical Clinic and Montage Medical Group, 166 physicians have opted for and strongly encourage vaccination for their patients. Currently there are tens of thousands of unused vaccines in Monterey County.  Vaccines available, at no cost to patients, to everyone 12 years of age and older.

We will ultimately get past this – the question is how many unnecessary lives will be lost because we took the more difficult path.

Allen Radner, M.D.

CEO, Salinas Valley Medical Clinic

CMO, Salinas Valley Memorial Healthcare System

Mark Carvalho, M.D.

CEO, Montage Medical Group

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