The Arctic weather dumping snow and ice on Oklahoma, enveloping the state in frigid cold, has been a natural deterrent to gatherings to help further drive down the novel coronavirus' spread.
The Arctic weather dumping snow and ice on Oklahoma, enveloping the state in frigid cold, has been a natural deterrent to gatherings to help further drive down the novel coronavirus’ spread.
COVID-19 fatigue is real, experts say, but so is the virus and its variants, underlining the importance of remaining vigilant and practicing mitigation to exit the pandemic phase. Aside from increasing access to and acceptance of the vaccines, human behavior is crucial to avoid a resurgence by return to prior life too soon.
Dr. Jennifer Clark said the Super Bowl and Valentine’s Day were mitigated to a degree by weather, a shift from watching cases surge after holidays from Halloween through New Year’s Day within the broader surge itself.
“Two very highly socially induced behaviors we have were both kind of mitigated by us having to stay at home during Mother Nature’s lockdown,” Clark said during her COVID-19 presentation Wednesday for Project ECHO. “Hopefully we’ve learned our lesson that quickly reopening and returning to ‘normal social behavior’ does not help us.”
Clark, an OSU professor of health care delivery sciences, pointed to historical research as a predictor of what will happen if we become too lax too soon.
The 1918 Flu Pandemic in Denver had a “double hump,” she said, explaining that deaths quickly skyrocketed a second time when mitigation measures were relaxed too soon after the original peak began to subside.
“Again, taking advantage of Mother Nature’s lockdown, we’ve got to be early, sustained and layered in our mitigation strategies to avoid another surge,” Clark said. “Otherwise it’s going to happen.”
Project ECHO is an effort of OSU Center for Health Sciences to bring health care education to rural and underserved areas.
Gov. Kevin Stitt on Feb. 12 renewed his COVID-19 executive order for another 30 days that limits public and social gatherings to 50% of a building’s or area’s permitted occupancy, as well as indoor youth sports and extracurricular activities.
However, gone are the requirements that bars and restaurants must create six feet of separation between table, booth and bar seating.
“Governor Stitt is encouraged that significantly more vaccines have been administered than total COVID cases, cases have fallen by more than 70% and hospitalizations are down 60%,” Carly Atchison, spokesperson for Stitt, wrote in a statement. “We will continue to encourage Oklahomans to watch their distance, wash their hands and wear a mask so we can get our summer back.”
Dr. Jared Taylor, the state’s epidemiologist, on Feb. 5 cautioned that “if we do things right” we can reach “a new normal” by this summer but that complacency could lead to a “major resurgence” as variants spread, even with increasing vaccinations.
“We could screw it up, and I’m asking that we don’t,” Taylor said. “I’m asking very respectfully and politely that we don’t screw it up. Our actions in February and March and April have an impact on that.
“This is a propagating infectious agent, and the lower level that you start from — if you do start having a resurgence for whatever reason — the lower level you start at the easier it’s going to be to contain and slow those peaks, lower those peaks. So it’s really important that we push through these next several months in order to achieve that.”
The Healthier Oklahoma Coalition — a group of health care professional organizations — also discussed the importance of not letting up Tuesday.
Dr. Stanley Schwartz, an infectious disease expert, said he thinks COVID fatigue is the largest challenge confronting us, given what people have endured for a year.
As an example, Schwartz said he finally went inside a supermarket recently that had signs on its doors requiring patrons to wear masks. But about half of individuals he saw weren’t wearing them correctly — if wearing them at all.
“I think people are just tired and want to get back to life the way it used to be,” Schwartz said. “We’re close to the finish line, and it would be a shame to run out of steam before we cross it.”
Dr. David Chansolme, medical director of infection prevention at INTEGRIS Health, said he is fully vaccinated but still practices the three Ws. The vaccines are a huge morale boost and offer a sense of safety, he said, but individuals should “be your own best advocate” and not let down your guard.
Chansolme recalled the message delivered about masks in September before clinical trials pointed to a 95% effectiveness from the “miracle” vaccines developed by Moderna and Pfizer.
Dr. Robert Redfield testified to a Senate subcommittee that wearing a mask might guarantee better protection than a vaccine, given vaccines could prove to be about 70% effective. The then-CDC director also noted that a vaccine won’t protect him if it doesn’t elicit an immune response, but a face mask will.
“Eventually COVID is probably going to become endemic rather than pandemic, meaning we’ll still see cases sporadically pop up,” Chansolme said. “I don’t think it will be 5,000 cases a day like it was in January, but it’s not going to go away for us in health care, and it’s not going to go away for us in society.
“That doesn’t mean we’re going to have to be on the lockdown that we’re on now, but it does mean that this is probably something that’s here to stay. So there are some things we have to kind of think about in our daily inventory that are going to be here for awhile.”
As part of a new normal, another aspect of the disease to reframe is how we begin to view and treat COVID-19 as a chronic condition.
Dr. David Kendrick, Department Chair of Medical Informatics at OU School of Community Medicine, said he deals a lot with chronic diseases as a practicing physician.
Kendrick said he’s turning attention toward providing long-term monitoring of the population’s health, from utilization of care and medications to stroke and pulmonary embolism “and other things that seem to potentially come along with these infections.”
“Maybe we’re going to have enough variants come along that you’ve got a different flavor of the COVID vaccine coming every year,” Kendrick said. “It’s not known yet. In addition, we’ve got the potential comorbidities from having had COVID-19 that we still aren’t quite sure of the long-term effects.”
Is Oklahoma’s weather artificially depressing COVID-19 numbers in the state?
More guidance for Oklahomans signing up through the state COVID-19 vaccine portal during Phase 2
Who is eligible currently?
On Feb. 11, Gov. Kevin Stitt announced teachers and school staff would become eligible Feb. 22 for COVID-19 vaccines, as well as Oklahomans of all ages with co-morbidities. The comorbidities, or medical conditions that denote high risk of death from COVID-19, include but are not limited to hypertension, diabetes, chronic vascular disease and other heart- and liver-related conditions
Officials have assured pre-K-12 school staff who are not classified as teachers, such as bus drivers, that they will be covered due to their high-risk positions; about 89,000 individuals are estimated to be eligible in this category.
Still eligible to make appointments: health care workers and those 65 and older
I have comorbidities - what do I need to do?
Beginning Feb. 22, residents under 65 with comorbidities will be eligible for a vaccine, estimated at 1 million Oklahomans.
The state plan include lists of issues that put people at increased risk of severe illness if they were to contract COVID-19. Those include asthma, cancers, cardiovascular disease, chronic kidney disease, chronic liver or renal disease, chronic lung disease, diabetes, Down syndrome, heart disease, high blood pressure (hypertension), obesity, suppressed immune system.
No documentation is required by the state to prove a comorbidity. Patients being vaccinated through pandemic providers including doctor's offices and pharmacies may have their records checked to confirm eligibility.
What determines how many appointments are available?
The state is reliant on COVID-19 vaccines supplied by the federal government; officials reportedly are notified of shipments one week at a time. The limited supplies make it logistically impossible to schedule vaccinations weeks in advance. Oklahoma officials hope for a policy change that resupplies be based on states' “burn rate,” of how many shipped doses are distributed promptly.
States and tribal leaders are receiving federal shipments of vaccines based on population, OSDH leaders have said. Oklahomans with a CDIB card would go to a tribal health care center for vaccines.
I signed up at vaccinate.oklahoma.gov but never got an email confirmation of any kind — what should I do?
Confirmation emails are sent out in batches; users should receive one within 24-48 business hours of registering. “Emails are sent out over a span of time in the order in which registrations occurred,” the state said. “As a result, some emails may be delayed.” If you've waited at least 48 hours without having gotten a response, it could mean a data-entry error was made by the user during registration.
State and county health officials also have said most of these issues are resolved when the user checks their junk mail folder for messages flagged as spam.
I’ve been told I can make an appointment, but I went to the portal and there were none available within 100 miles — what do I do now?
First, if the portal has a link that says "No appointments available," click anyway. Possible glitches in the system might result in that message showing up even when appointments might be open outside the user's immediate area.
If you're still coming up empty, bookmark and keep checking the “Click here” link emailed to you, says deputy OSDH commissioner Keith Reed. The link does not expire and is the only method to check for appointment availability. No further emails will be sent.
When will new appointments be added to the online portal as the state is updated on the supply of vaccines expected to ship from the federal government?
A new round of scheduling should be available on the portal every Thursday. Starting 5 p.m. Wednesday through Thursday morning, new appointments are uploaded for distribution pods, said Mindy Spohn, OSDH vaccine facilitator.
Tulsa Health Department did not add appointments Feb. 10-11 for the coming week due to inclement weather.
Someone I know is unable to go online to access the vaccination portal — how can they make sure to get an appointment?
The state recommends that those unable to access the online portal ask a family member or friend with internet capabilities to assist them with the registration process.
Some churches have stepped up to help people without internet access register on the portal, as well as those who need a foreign-language interpreter. State officials have said a Spanish translation is forthcoming for the online vaccine portal.
How are 211 and LIFE Senior Services trying to help?
Call center staff at 211 can help Oklahomans connect to resources they may need to physically access the vaccine distribution sites, but they cannot schedule appointments. OSDH helped add to 211 staff, who can collect patients' contact info to pass on to local health departments for phone scheduling.
LIFE Senior Services is helping callers get scheduled by signing them up on the portal and receiving emails for the patient. Pictured: LIFE Senior Services activities director Amberly Villegas and Geneva Boling.
Who else is trying to help people book appointments?
Josh Wright, software developer from Norman, developed a text-alert system for Oklahomans as a companion site for the state's COVID-19 vaccine portal.
The vaccine-alerts.com site has 41,000 users, who have received 1.25 million text alerts, as of Feb. 5.
Can I show up at a vaccination site without an appointment to wait for someone to miss their scheduled time?
No, Tulsa Health Department and other sites say those without appointments are not welcome at known vaccination sites. THD says if someone does miss their appointment, those shots may be offered to first-responders in the area who have not been able to get vaccinated yet.
What happens if I am unable to make my scheduled appointment? Can it be changed?
Asking that residents strive to keep their bookings as time slots are in high demand, the state has said that those who miss their scheduled time will need to make a new appointment. Cancellations or scheduling changes can be made through the portal. “There’s been some difficulty with that,” Spohn said. “Sometimes you have to wait 24 hours to be able to get back in and redirect your appointment because it locks up. … That’s among fixes we’re working on on our end.”
At what point do I schedule my second dose or "booster shot"?
The answer seems to change depending on which site a patient received their first dose.
Second-dose appointments may be scheduled at the time of the first shot. It is not required to schedule booster doses through the portal. “Follow the instructions given when you got your first shot,” OSDH Deputy Commissioner Keith Reed said.
Second-dose appointments may also be made via the state portal, and users will be asked whether they need the Pfizer or Moderna shot. Some clinics have had scheduling issues for second doses, Spohn said, so officials are working to ensure those sites aren’t filling up with only first-dose appointments.
Tulsa Health Department says: “You are able to walk in for your second dose without an appt, provided you come at the same time as your first dose. Must bring your vaccination card with you.” Director Bruce Dart said those who got a Pfizer vaccine through Tulsa Health Department should try to come back to the same site 21 days after the prime dose; those who got Moderna should walk back into the same site 28 days after.
In Wagoner County, second-dose appointments cannot be made until one week before the patient is due for the booster shot.
I can't get an appointment for my booster dose when I am supposed to — is it OK to take it any later?
Those concerned about getting appointments exactly 21 or 28 days after their first dose don’t need to worry; if you’re a little late, it doesn’t cause you to have to restart the shots. You may just take a few more days to reach 95% immunity.
The state says it may take longer for second-dose appointments to show up in the system as those cannot be entered into the system weeks in advance. Because the timing of booster doses means a three- or four-week delay, those scheduling their booster dose via the online portal are told not expect to set the schedule right after the prime dose.
Can I choose whether I receive a Moderna or Pfizer shot?
Some clinics have both Pfizer and Moderna available, but basically it’s whatever is available at the time of the appointment at the site.
Will I be able to drive-through to get my vaccination or will I have to go inside a facility?
Mindy Spohn said the state is trying at each location to help patients with accessibility issues to be able to drive-through. “The problem with drive-throughs … it does limit our throughput because you have a 15-minute observation period.” She said some sites may have found ways to offer drive-through with observation, "but their ability to reach large numbers is limited because of that."
If I have already had COVID-19, do I still need to consider getting the vaccine?
The short answer is yes. Dr. Jennifer Clark, who leads Project ECHO’s COVID-19 data sessions, said the human body’s natural immunity isn’t fully reliable and can be erratic. She said the response a person’s body will have from the vaccine will be more reliable and robust relative to the body’s natural immune response. Monks recommends waiting 90 days after recovering, especially if those who received monoclonal antibodies or convalescent plasma.
Do I still need to practice the three W’s after getting my vaccination?
Yes, it is vital for Oklahomans to continue to wear masks, wash their hands and watch their distance even after being vaccinated. The vaccine effectively protects recipients, but recipients may still be able to spread the virus to others. The CDC has not yet determined if or when it will stop recommending that people wear masks and avoid close contact with others to help prevent community spread.
Can you be a carrier of the virus after receiving a vaccination?
"We have to assume the answer is yes, you can. In other infectious diseases, this happens pretty commonly, though in others it does not. It won’t be known for another few months as we’ve gotten lots of people vaccinated and then tested with viral swabs," Oklahoma Medical Research Foundation President Dr. Stephen Prescott said.
Why do I have to wait 15 minutes before being able to leave after my vaccination, and what side effects are common?
Any adverse reaction that could endanger the patient's health should be evident within 15 minutes, so those receiving the vaccine must agree to observation during that time. Dr. George Monks, president of the Oklahoma State Medical Association, said possible side effects include mild pain or swelling at the injection site, true of any medicine injected into skin. Other possible side effects include mild fever, chills, tiredness and headache. Monks said side effects are almost always mild and are more common in younger people or when receiving the boost dose. Monks said one can think of the symptoms as a sign that the vaccine is working.
How many vaccine doses have gone to waste in Oklahoma?
State officials say there is no problem with expiring vaccines; doses arriving each week are already scheduled to be distributed the following week. “We don’t have any vaccine that’s sitting on the shelf,” says deputy OSDH commissioner Keith Reed. On Feb. 9, he said only 247 cumulative doses had been wasted due to broken or leading needles and vials.
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Corey Jones
Staff Writer
I am a general assignment reporter who predominately writes about public health, public safety and justice reform. I'm in journalism to help make this community, state, country and, ultimately, world a better place.
