Kimberly Griffin, Dr. Thomas Dobbs, and Donna Ladd participate in a virtual discussion of the state of the current COVID-19 outbreak in Mississippi.
As delta surges across Mississippi, State Health Officer Thomas Dobbs joined the Mississippi Free Press for a long conversation about the continuing pandemic. Dr. Dobbs photo by AP/Rogelio V. Solis

Dr. Dobbs Explains Why the Delta Variant Is Exploding in Mississippi, What To Do (Transcript)

On the Monday that Mississippi saw a report of almost 5,000 new COVID-19 cases, most of them due to the delta variant, State Health Officer Dr. Thomas Dobbs joined Mississippi Free Press Publisher Kimberly Griffin and Editor Donna Ladd on a special edition of MFP Live. During the afternoon of Aug. 2, 2021, Dr. Dobbs gave unblinking safety advice; talked about his fears about flying now (it’s not about the plane itself); why masks are essential in schools, and what activities shouldn’t happen there; praised Black leaders for vaccine efforts while the virus shifted into “predominantly a white disease in Mississippi,” and much more.

Below is the full transcript of Dr. Dobbs’ interview. You can watch the show on YouTube here and Facebook here. It is also one of the first two new MFP Live Podcasts that producer Kourtney Moncure launched today on Spotify, Apple and Simplecast, where you can listen to the conversation now.

We urge everyone to plug into Dr. Dobbs’ words during this interview—from his advice, to his weariness over those who do not follow safety precautions, to what gives him hope. He also talks a bit about facing threats of violence.

MFP Live: So could you talk about what’s going on with children in specific?

Dr. Dobbs: We learned a lot last year. We had a pretty normal school year last year compared to a lot of states in our nation. It was different, there’s no doubt about it, but we were able to maintain a large percentage of our kids in the classroom in a personal learning environment.

And we learned that in controlled settings in a structured environment. We had a pretty normal school year last year, compared to a lot of states in our nation. When you have kids separated by a minimum of three feet, and they’re wearing a mask, and you’re being conscientious about who’s infected, you do pretty well, and we see very little transmission in the classroom. 

Now we did have a lot of challenges in sporting events and kids on buses going to the games, or band. And the parent-sponsored social activities, actually, were the biggest challenge, because we had a few pool parties that would take down the whole school—as far as being able to operate.

But right now what we’re having is a combination of a variant that’s three times more contagious than what we were dealing with last year, and a public that’s increasingly reticent to take on the preventive measures. 

I can’t make reality any different than it is, but you can’t have that combination of factors and throw in the fact that probably only a third of our kids are immune, either through previous infection or vaccination. It’s an explosive recipe for disease transmission. I think it’s going to be very challenging. 

I think if we look at what happened in Lamar County schools, I think it’s very demonstrative of what we’re going to see.

Dr. Dobbs listens intently during a press conference.
State Health Officer Dr. Thomas Dobbs has warned of substantial growth of the Delta variant of COVID-19, which emerged from India during that country’s deadly viral peak. The virus presents severely increased rates of transmission and potentially a deadlier disease, but vaccines are still extremely effective against it. Photo courtesy UMMC News

It’s just really a nature of the biology of the Delta variant. It’s just so very contagious, unless we are absolutely fastidious. We’re just really focused on every safety measure to make sure our kids can have a good in-person learning environment. We’re going to have to have kids out of school all the time, and and it’s just going to be that way for a while.

The MSDH website that showed the numbers of new cases that are young people. If you could, share a couple of numbers with this to just kind of set the table on that.

Most of the cases we’re seeing right now are in younger age groups. One of the things you may have seen was the hospitalizations, and you can see that the fastest-growing number of hospitalizations are in people under 50. We’ve got a lot of people in the ICU in their 20s, 30s and 40s. It’s a very disturbing trend. That’s one thing, but we are starting to see increasing transmission in young adults. Not quite so much in children. It’s been pretty steadily increasing, and we do anticipate when kids are going to get back into school, that we’re going to see a lot more of that.

And we’ll be monitoring that very closely, similarly, like we’ve seen with young adults. It’s pretty inevitable that we’re going to see a lot more cases in young kids and one final data point. 

Delta Variant: Much More Infectious and Faster-Spreading

You had also tweeted that the Delta variant is just so much more infectious. Each case can affect eight or nine people, you’ve said, and that’s different than before. Can you address that a little bit?

That’s the R₀ thing that people talk about, which is the infectiousness of the virus. And that was within CDC-released information last week where it looks at how a person who has COVID, on average, can spread it to eight or nine additional people. And you can run that through several different cycles. One goes to eight, goes to 64, ad infinitum.

It’ll spread really, really quickly. The other challenge is that without a doubt the delta variant people go from being exposed to contagious within about two days, compared to four days with other ones. So you don’t really have as much time to intervene. It kind of gets away from you more quickly.

A map of the United States, with Mississippi highlighted. The state's counties are outlined and all but one are either light or dark red, indicating rapid spread of the virus.
Centers for Disease Control data show Mississippi in a state of unmitigated spread of COVID-19, with virtually every county in the state in a place of mass community transmission. Source: MSDH

It’s just a natural factor of this delta variant: it’s just so contagious. You’ve just really got to be that much more cautious in your approach to it.

For my generation, and I guess everyone’s generation on this call, when we hear that the variant spreads like chicken pox,  we know what that feels like, what that looks like. Can you clarify the quarantine isolation protocols for vaccinating people who’ve been diagnosed with COVID; it sounds like the viral loads are about the same.

The terminology we use is a little bit different. And so I think sometimes that’s confusing. If someone is actively infected, we call that isolation. And so if you’re actively infected, we say isolation for any infected person should be for 10 days. 

At least ,that’s assuming they’re recovered at that 10-day period. Whether you’re vaccinated or not, because you can be contagious. What we have seen is that people who are vaccinated and get COVID, there’s a couple of different scenarios.

A common one is they may become contagious and—you know, vaccines mostly protect you from getting sick. It doesn’t always prevent you from having some viral replication in your nose until your body can get rid of it. Because your immune system has to be woken up to say, ‘Hey, it’s back, let’s get rid of it.’

And that’s kind of what’s happening. The current vaccines are two-thirds effective at keeping you from developing any viral production and about 93% from getting severely ill. So that’s going to be a little bit of a difference, but I think that it’s very important to see that … you know, are some vaccinated people going to become ill? Yes. Are they going to be less ill? Absolutely. 

Without a doubt, the vast majority of transmission that is being perpetuated in Mississippi is from unvaccinated folks. We’re also seeing a good number of infections (in people) with prior cases. People who had COVID before are getting the Delta variant and then spreading it, too.

So, but since you brought this up, I do want to reiterate that the COVID vaccine is still pretty darn good against the Delta variant. It’s just not quite as good as it was before, with estimates of 88% effectiveness at preventing any symptomatic illness.

But what we’ve seen is the illness that people do have by and large is much less severe with the Delta variant than otherwise.

‘Outdoor Transmission Is Very Uncommon’

Should vaccinated people avoid crowded spaces, even if they’re wearing masks? What about outdoors? What are best practices in those cases? 

Yeah, so I think we can think about what we can do that’s reasonable to prevent COVID transmission. And what’s reasonable to do that’s not overly restrictive is doing things outdoors. Outdoor transmission is very uncommon.

It can happen, but you know, having super-spreader events outdoors is going to be very, very rare. So do it outdoors. Certainly, we recommend indoor masking for you if you’re in the public. 

Everyone needs to wear a mask. Mostly it’s going to be beneficial for people who are unvaccinated, but there’s an additional benefit for people who have been vaccinated because they might fall into that less common sort of slice of folks.

We, and me personally, recommend avoiding any mass indoor social gathering. If we look at what happened in Massachusetts, that’s a whole different sort of story. That’s very interesting. Because if you look at what happened there, it was thousands of people who were crowded into bars and restaurants unmasked, and, you know, a lot of people did get it, who were vaccinated, but it was estimated that 90% of people who were there were vaccinated.

So the per capita risk was actually a lot higher for the unvaccinated, but because the majority 90% or so of folks in that area were vaccinated, of course, you know, you’re going to have a pretty big slice of those folks who are going to have it, although their infection is going to be is going to be milder. 

You can see this from the Kaiser Family Foundation analysis, and it’s a good article for people who want to read about what it means for you if you’ve been vaccinated. It’s pretty demonstrative. It’s still (clear that) vaccination is our best way to slow down the pandemic to be done with it, but also to save lives and keep people from being hospitalized.

To kind of build off of that, you’re talking about outdoor spaces, and I know it’s safer, but then we think about these huge events like Lollapalooza this weekend and the Neshoba County fair. I understand Trace Atkins was there and 10,000 people elbow to elbow. We’ve heard reports of an outbreak at the Neshoba County Fair, what about events like that that are outdoors, but they’re also indoors, and it’s just this really kind of crowded cauldron of stuff?

I mean, the people (should) be wearing masks in those cases. Really, people really just don’t need to be putting themselves in that situation, honestly. What we see that worries me more about Neshoba (County Fair) is not the concert as much as it is 30 people sleeping in a cabin overnight, right? I mean, this is the challenge about masks.

And I think this is one of the reasons why if I had to choose between masks and social gatherings, I would say avoid social gatherings. I think a mask is useful, don’t get me wrong, but people catch COVID in situations where they wouldn’t wear it. People catch COVID when they’re at a wedding and they’re dancing. They catch COVID when they’re at a funeral and they’re hugging somebody. You might wear a mask at a funeral, but if you’re hugging somebody and you’re crying over each other, that’s a high-transmission risk.

It’s when you’re having a big family dinner with people. These indoor (gatherings) are really going to be the main thing. I mean, I wouldn’t go to a … well, I guess I’m too old for that sort of thing. I did go to the first Lollapalooza: that might tell you how old I am. But you know, I don’t think it’s a good idea. (Still,) it’s really the indoor stuff that’s driving it.

I think even for Neshoba, there’ll definitely be transmission events linked back to that. It’s the indoor stuff. We mostly give COVID to the people that we know and the people that we love, that’s where COVID goes. And if we think about the vaccine and COVID, I think it sounds like a hard reality, but it’s reality.

One of the reasons it’s important to get the vaccine is obviously you want to protect yourself from getting sick. And we see a lot of younger folks who are in ICU right now, who are not going to make it from COVID, who needed to get the vaccine. But it’s not just you, if you get COVID it’s that maybe eight or nine people you’re gonna give it to.

Eight 5mL vials of COVID-19 vaccine arranged on a white surface.
National trends showing a slowdown in new vaccinations preceded Mississippi’s decline in new shots through April. Photo by Braňo on Unsplash

And those people you’re going to give to are your family and your friends that you don’t want to give COVID to. And so this is one of the most important reasons for me to be vaccinated, just because I want to protect my family from getting it from me. My dad, who has a weakened immune system you know, that sort of thing.

It’s very important to see how the effect of the vaccine is preventing death, and you can see almost all of our deaths in the past seven months are in unvaccinated folks. And we haven’t had any deaths in vaccinated folks under 50, and very few in the 50 to 64 range.

So, we know that. The vaccines are hugely effective, especially for teenagers. We know that teenagers respond robustly. For the previous strains, it was about a hundred percent effective, and it’s going to be even better—for Delta, it’s gonna be a lot better for teenagers than it would be for older folks.

What about flying at this moment? You know, I just came back from my first flight since the pandemic started. That was nerve wracking to me, you know, but it was OK. I got through it. But then, should we be flying right now while everything seems to be exploding in this fourth wave. Is it safe? 

You know, everything’s risk reduction and, you know, if it’s not something that’s absolutely necessary, it’s probably good to put (flying) off. But you know, there’s something you might have to do. It may well be that your aunt broke her hip or something, you know, and you just have to do that.

But I tell you, I’m more worried about being in the airport than being in the airplane. The airplanes actually have pretty phenomenal circulation and we see this with other scenarios like measles or tuberculosis. We see very little transmission within the airplane because of the way the circulation is.

I’m not saying it doesn’t happen, but it’s pretty good, especially if you’re wearing a mask and you have that good circulation. I certainly would wear a good quality mask, probably a medical grade mask if I’m flying, but it’s, it’s the Chili’s and the TGI Fridays in the airport that scares me to death.

What About Booster Shots? When Available?

A reader asks: For those of us with compromised immune systems, immuno and auto, would there be an implementation of boosters of the COVID vaccine for those who need them? Currently, this appears to be state by state.

So this is a real challenge, because we’ve been having a lot of conversations with our federal colleagues, especially at the CDC. It has an EUA for the vaccine and there is no…There’s potential limitations on using it outside of that EUA. I know this is kind of technical, but we can’t get clearance to use it from a health department perspective and a routine basis.

But what we have done is we tried to make sure, and we’ve released information that certain subgroups of folks who are immunocompromised, especially cancer patients, transplant patients, people on medicines that make their immune system weak, are very likely to benefit from an additional dose. And we’ve seen this in studies; we know that Israel is doing this.

And so, we encourage docs to sit down with their patients and have a one-on-one risk benefit conversation like we do with so many other medical issues. And we’ve seen quite a few physicians provide these booster vaccines for their patients. And that’s really where the conversation needs to happen right now.

We’re supportive of that physician-patient conversation to try to make the best decision for them. And when we do get clearance to do it from the CDC, we were going to make it available in every single county health department across the state. 

This is also from a reader. We are masked and vaxxed. Hubby still works with an unmatched soon-to-be caretaker of a newborn grandchild. How do I keep hubby safe? 

Dr. Dobbs, wearing a mask, is injected with the COVID-19 vaccine by a healthcare professional wearing blue gloves.
Mississippi State Health Officer Dr. Thomas Dobbs, seen here receiving his second dose of the COVID-19 vaccine in early January 2021, is warning that the pandemic’s seriousness is not abating anytime soon. Courtesy MSDH

I mean, it helps, when you have vaccinated people around each other, there’s always going to be some risk. Anything you can do, it’s always risk mitigation. There’s never a risk elimination. And if you can layer your risk-reduction strategies, you’re going to be in better shape.

Wearing your own mask…You know, I’m very confident that people who want to protect themselves, if you wear a medical-grade mask that has the properties that are used in hospitals, to prevent transmission, it is protective for you as a person. And so that’s what is worth doing for sure.

But also good air circulation: making sure you have good air flow outdoors, open windows, though it’s pretty darn hot right now, and then space, in physical distancing. All those things are gonna make it safer for you, but everything you can do to make sure that your cohort is vaccinated is good. I mean, I’m vaccinated. My nuclear family is vaccinated. All of our nuclear families are vaccinated. These layers of protection make us all that much safer. 

Does the Delta variant have different characteristics of airborne or droplet transmission than previous strains? Is it enough to have a good mask? Or should you keep it on when they cleared the room?

So I think without a doubt, we have seen that COVID (our traditional COVID that we saw last year) under the right circumstances, is airborne, meaning it spreads and fills the room. And so it’s not an either or. With the delta variant being much more prolific in its reproductive mechanism. The viral levels in somebody with delta are a thousand times higher than what we’ve seen previously. (With) the transfer being airborne, transmission is much higher.

And so I do absolutely think that that’s happening with greater frequency. Is there a potential for it being in a room for a period of time after someone leaves? I think it’s definitely, just like other viruses. So airflow, air clearance, is so critically important and, yes, probably we would wear a mask for a period of time.

You know, that’s gonna depend on how many air turnovers you have in the room, but for that sort of situation, airflow is critical. 

Long-term Effects: Reproductive and Sexual Outcomes

I have been seeing pediatricians that I trust talk about seeing some long-term effects with kids after they’ve had COVID. Pediatricians are reminding people that parents should be aware of certain symptoms they see after COVID. What are you hearing and seeing?

Yeah, so COVID is bad for you. It’s not like getting a cold and getting over it. There are going to be a lot of long-term complications that we’re going to see from this. You know, there are some studies that show like maybe 20% of kids have long COVID-type symptoms.

We know it causes brain inflammation and can have some cognitive impact, especially in a long COVID. A lot of it’s like forgetfulness, memory issues, fogginess, that sort of thing. But there are other things too. There is a growing body of evidence that shows what can happen to your reproductive system from COVID infection. 

We’re seeing evidence of potential destructive changes in male testicles and reproductive health, in that regard, from the infection, right? And for women increased risk of preeclampsia, and that threatens the pregnancy and the health of the mom.

Even if you’ve had COVID before, not recently, it increases your risk of preeclampsia. So COVID is bad for you. Please don’t buy into some of the information out there that, “Well, most people don’t die from it.” Amen. That’s wonderful. But a lot of people who survive are going to have some long-term sequelae (ongoing effects) from it.

So, don’t get COVID. I don’t want it. I don’t want anybody in my family to get COVID. I’m scared of COVID and I’m worried about it. I’m really worried about the effects that play in my family. So yeah, it’s bad for you.

A male healthcare professional prepares a hospital room for a COVID-19 patient.
As of Aug. 10, 2021, state medical officials and doctors were warning that they are out of intensive-care beds for any kind of emergency treatment due to the fourth wave of the pandemic here. University of Mississippi Medical Medical Center ICU nurse Mike Henrickson here prepared a room for a COVID-19 patient during the 2020 summer surge. Photo courtesy UMMC

Safety in Colleges and Schools

A reader wants to know if MDHS is going to make recommendations for higher ed, like you have done for K-12. Plus: Will you specifically recommend that college and universities require masks?

Yes. Yes, absolutely. And we have a draft guidance for higher education that will be out probably by the morning, we’re just going through some of it with different leaders to make sure there’s no concerns. 

We’re going to recommend universal masking in colleges and universities, just like we do for any other indoor gathering. We’re also going to have some guidance about how to do isolation and quarantine and how to respond to outbreaks. 

It’s going to be a challenging school year for colleges and universities again, and I do want to reiterate that just like our high schoolers, the majority of kids who are going to college are not vaccinated. And they’re going to be susceptible to delta, and delta is way more contagious than what we had last year.

So, I’ll say that the colleges and universities that we’ve been working with have been incredibly responsive and really engaging in trying to make sure that their students have a productive year, understanding that they’re college kids, and they need to have a little bit of fun, too, but we’re going to try to help them do (it) well.

Another reader says colleges say they were working closely with IHL and MSDH, but still haven’t even gone back to indoor masking yet. Are they not getting guidance on this, or is this a failure at the level of the schools themselves or IHL? (Note: Many Mississippi universities later announced masking mandates)

Well, I mean, CDC already said universal masking. So I think that that’s kind of a slam dunk. There’s federal guidance, and then we’ve been waiting on CDC specific IHL guidance that has not come to fruition, yet. So we’re going to go ahead and release ours. We’re kind of hoping to align it with theirs. I think it would be aligned anyway based on the principles, but yeah, we’ll, we’ll make sure that they have our full complement of guidelines. And I would say by the morning, if not this evening, they’ll have that final product. 

Is the recommendation for universal masking in K-12 meant for the entire school year, or is it short term? Would a plan for universal masking make more sense. And is it possible to mandate masking in schools until Labor Day, and then maybe we’ll have some optional masking afterward.

Yeah, no, that’s an extremely good question. I would say that this is a “for now” sort of thing. We definitely recommend universal masking in the K-12 environment for now. Delta’s going to rip through (schools) pretty aggressively. I’m just going to be honest about it. But hopefully it’ll be done … within a couple months, I’m not saying a couple of weeks, couple of months, right.

We’ve got a lot of headwinds ahead of us and, you know, my fear is that we’re going to achieve herd immunity the hard way. We’re going to have a lot of people get the Delta variant, and then they’re going to be immune to it. But because they had to go through it the hard way, it’s much better to get it through the really safe and effective vaccine.

But I would hope that mask guidances of this measure would be short-term. 

Follow up from a reader: Should high schools consider holding off on large athletic events and practice for a few weeks to allow for kids to get into the classroom and things to settle down, or have sports been going on? Maybe schools got through the whole summer without outbreaks or concerns. 

No, we had a lot of outbreaks, without a doubt. Yeah. Over the summer again, you know, it’s a matter of indoor, outdoor and being conscientious with excluding infected folks. We have run into considerable pushback on anything that would delay high school athletics. We have clearly recognized that that is a priority for many Mississippi schools and parents and kids. So really just to do it as safely as possible, but if you’re a parent … and you’re worried about your kid, don’t let him participate. I mean, COVID is not forever. The Delta wave is not forever. It’s just better outdoors, and be careful inside and in buses. 

Dealing with Peer Pressure Against Covid Safety

We all know about the crazy division out there right now over Covid safety. One reader asks what you would say to a student or teacher, or I would add anyone, who feels peer pressure not to mask?

That’s pretty tough. That’s one of the reasons I think why universal masking is such a good idea, if you sort of, it’s kind of like that’s why we have school uniforms sometimes, right? I mean, we have standards, and that makes a lot of sense. But sometimes doing the right thing is the hard thing.

A graph showing the 7-day moving average of confirmed COVID-19 cases and hospital admissions from May 5 to August 1.
Courtesy Mississippi State Department of Health

And if you don’t want to take COVID back to your mom and your grandma, and you know, maybe your grandma has an immunocompromised condition, or maybe she didn’t respond to the vaccine, and you don’t wanna take COVID back to her, it’s the right thing to do. It’s the loving thing to do, to protect yourself, to protect others.

It’s also motivated self-interest to protect yourself because COVID is bad for you. 

You’re in that hot seat where I would guess that it can be hard to sleep sometimes thinking about what can happen. What have you seen work, and what are some of the victories on reaching people that you have seen, or are aware of, that made them go, “oh, wow, I need to think about doing this a different way.”

So you know, it’s different for different folks. And in different parts of our population, I want to give a just a really, just a remarkable shout-out to our black faith leaders who have done a phenomenal job. I think that, by and large, across the state of Mississippi, African American communities recognize the threat of COVID.

Now, we still don’t have enough folks protected with the vaccine, but if we look at the transmission that’s going on, since the early part of the pandemic, this has switched to a disproportionately, predominantly white disease in Mississippi.

Now, still a lot of Black folks are getting affected, don’t get me wrong, and we’ve got a lot more work to do. But I think a lot of it has to do with people in the Black community standing up and saying,”OK, This is not OK. We need to make sure (that) first people are masked and separated.”

Still a lot of the Black churches are still doing virtual (services). And I think (many churches are) going back to virtual. I have had a lot of good conversations with the National Baptist Convention, and they’re very attuned to it, but also speak to Black physicians. A lot of the political leaders and just community leaders, mayors, have done an absolutely phenomenal job communicating with their constituents.

I think that’s been a real success. The other successes we’ve seen have been with physicians who are willing to sit down and talk to their patients and answer questions. Social media has just scared the mess out of people. It’s a lot easier to introduce a fear than to replace it with the truth.

And you know, this sort of noxious social media environment has poisoned our minds to some degree. And some of the cable news stuff is mind poison as well. … I think having those questions and concerns and sitting down with a thoughtful, caring physician who’s worked with you and your family for years makes all the difference.

I’ll tell you, last week I was visiting a hospital, and they had a woman who had to deliver a baby in her early 30s. I think the baby’s OK, but the woman died from COVID. We know that pregnant women do much worse with COVID, and we know that the preeclampsia rate is looking really bad for women with COVID.

So COVID is bad for you. Talking to your docs is one of the most important conversations you can have. 

Dr. Dobbs, wearing a white lab coat and mask, sits in front of a bar graph.
Mississippi State Health Officer Dr. Thomas Dobbs, seen here during a summer press conference at UMMC, said he expects 1,000 more Mississippians to die this month as COVID-19 cases surge post-Thanksgiving. Photo courtesy UMMC

We had a question on Facebook about indoor worship, which is good for mental health. I know my church went back, but I haven’t been back since we went back. I went one time. And we have a responsible faith community that is asking everyone to mask. But how do you do that balance of, especially, the disconnection for so many people?  

I think it’s absolutely critical to have an online version. For people to have that as an option. Right? And a lot of people really enjoy it. 

My aunt actually loves it. She can stay in our pajamas and pull up her Bible, and she can sit in her recliner, and she loves it. But it’s always risk reduction. Right? And the safest thing is going to be at home. I get that. But for people who just need to be back in person there are safer ways to do it.

I can’t say it’s perfectly safe, but safer in the sense that, you know, if people are masked and they’re separated, and they’re not congregating in tight groups after the service is over, have good airflow, you know, gotta be careful about the choirs singing on folks, because that’s a real good way to spread it.

You know, it can be done pretty safely. So. I think it’s a matter of taking those steps, but I will say that, right now, we are especially advising people who are older or have significant underlying medical issues to probably stay home for now. It’s just too high risk because it’s one thing to get COVID, it’s another thing to die from COVID, and we don’t want our most vulnerable folks catching (it).

Fact vs. Myth: Actual Dangers of Covid Vaccine

Our reporter Nick Judin asks: I see a lot of people spreading a lot of misinformation and fear over the experimental vaccines, but the virus is far more experimental, isn’t it? Viral resurgence can often harm individuals years later, correct?  

You know, it really might. There’s a lot that we don’t know about what it’s going to be. You know, like the Ebola virus. We thought that that was an acute thing. And now we’re seeing people who had (problems) years later. And I’m not saying that’s going to happen, but we do see evidence of sort of persistent viral viability in testicular tissue in a recent neurological journal. So, yeah, COVID is really bad for you.

There’s really been no vaccine more studied than these COVID vaccines, and we have found some rare, bad things that have happened. With the Johnson and Johnson vaccine, specifically, with  the cerebral blood clots and the Guillain-Barre syndrome, it’s fortunately very rare, but it’s also reassuring that even these very rare things that happen maybe a few per million sort of frequency—that we’re able to tease that out.

I think clearly we know that the MRNA vaccines are more effective and don’t have those rare but serious side effects, which is reassuring. But I think it’s easy for some really bad misinformation to get out there and, and scare people terribly.

Yeah. You know, they haven’t really killed anybody, the vaccines, except for these rare sorts of things. And of the over 1.2 million people have gotten the COVID vaccine in Mississippi, we’re not aware of a one who’s died from the vaccine. 

We get these reports here and there, and of course, if you vaccinate half the population. And you know, a lot of them are older, somebody is going to have a heart attack or a stroke a week or two later. And when we’ve investigated them, they’ve had nothing to do with the vaccine. It was just a random sort of co-occurrence within some temporal proximity of vaccines.

It’s interesting, because we hear about these things associated with a vaccine, but there are these one-in-a-million things that are listed in the very small print of the insert of the medicine bottle that you get that no one reads.

There are some common side effects. I mean, it does make people feel a little bit sore and maybe a little bit achy for a day or two. I mean, we know all that and, and we’ve seen it. … People can be allergic to anything, just about. Right? And so we’re going to see some of that (vaccine side effects and allergies).

But one of the docs said he had a really good way (to address it). He talked to his patients about it, and he said,” look, we know you can have allergies to anything, but if you have an allergic reaction, we know how to treat that, and we’ll take care of it. And that’s what we’re here for. We’re here to take care of you, but you know, if you get COVID and you get seriously ill, there’s not that much we can do about it, except to try to help you get through it.”

Four healthcare professionals in full PPE surround a hospital bed as they work on a COVID-19 patient.
Gov. Tate Reeves used his state of the state speech in part to honor the work of the health-care professionals on the front line of the virus. Back in April 2021, he vowed that he would not require masks in Mississippi schools in the fall no matter what happened. He has held to that promise, putting the decision on individual schools and districts. Photo courtesy UMMC

There are some treatments, there’s no doubt. But if we look at the data, we know that about 7% to 8% of COVID patients end up in the hospital of the ones that were diagnosed, and of that number that go to the hospital about 14% to 15% will die. That’s a huge mortality rate.

And if you make it to the ICU, over a third are going to die. That’s horrible. We want to prevent people from getting to that stage. It’s not uncommon. 

Anti-Masking Parents Try to Prevent School Mandates

Over the weekend, we heard about prominent people doing these parental rights petitions to keep their school or the district from requiring masks. I wonder what you have to say about that, as it’s presented as a parental rights issue.

We always have to behave in a way that protects others in public. You know, you can’t drink and drive. You have to wear a seatbelt. You can’t shoot firearms in the city limits. There are things that you have to be cautious of when what you perceive as your individual rights are harmful to (the rest of) us.

You know, the mask thing is, has, has become more symbolic, I think, than real, because it’s just not that much of an impediment for someone to have a piece of cloth over their face. It seems like that it’s the parents that mind more than the kids. 

If we want to keep our kids in school and learning, then we need to do things that are going to keep them safe from something bad happening. You know, we’re not going to let our kids, you know, do something reckless in school. We want to protect them. And one of the best ways we can to protect them is to do these simple things that we know work.

I think it’s a little bit misguided (to lobby against mask mandates). We’re missing our priorities. The priority should be to educate our kids and educate them safely. And this is a very simple, simple step that adds a layer of protection to that. But you know, this is sort of like the debate of our century.

We had a couple of reader questions that show parents are confused and worried and need advice. First, is it a good idea or bad idea for the first quarter of the new school year to have full lunch rooms; school assemblies; pep rallies and dances, the band and choir.  

You know, one can be a bad idea, really, to space folks out to a very bad idea. Three, you know, can be done safely under certain circumstances, you know, band outdoors, you know, that’s probably pretty safe, but a packed choir is, is a really bad idea.

If I think about my school assemblies when I was a kid, that’s not a good idea.

Right. And then their second one is useful or not useful for the coming school year: face shields, temp checks-temperature checks, I guess-neurotic surface cleaning, which, you know, we’ve all done, and excessive hand washing.

You know, desk and face shields are probably somewhat useful. Less than a mask, but you’re going to kind of contain it within the local sort of area. Although it’s not like it’s hermetically sealed, right? Temperature checks are probably not that useful. Honestly, I don’t think we exclude that many folks, symptom checks are probably more important.

A lot of these kids are not febrile when they’re contagious. Surface cleaning and hand-washing, you know, that’s become a little bit … what drives me crazy is when people make up for not wearing masks by doing more hand-washing: most of it is going to be from breathing people’s air. 

So do we want good hand hygiene? Yeah, we do. I think a little bit of hand sanitizer in there makes a lot of sense. But it’s mostly breathing other people’s air where we’re transmitting.

State of Hospitals, Medical Care As Delta Surges

Our next section from readers is about hospitals in general, medical staffing-related issues. From a reader: The governor used to emphasize the importance of keeping the hospitals from getting overwhelmed, but it’s happening again, and we’re not hearing as much about it. How are you working with the governor to take action, to increase vaccination and reduce the spread?

I know the governor is supportive of vaccinations, and I know he’s made some statements about it, and certainly, we’re glad to have his support. We need pretty much every Mississippian immune, and the vaccination is going to be the best way to get there, without a doubt.

As far as the hospital situation, it’s pretty dire. I have to confess it’s as bad as it’s ever been, right this very moment, and it’s getting worse quickly. Our challenge is that it’s already bad, but our staffing is more challenged. We have a lot less nurses.

Dr. Dobbs, wearing a mask, looks at Governor Tate Reeves as Reeves speaks in a press conference.
Mississippi State Health Officer Dr. Thomas Dobbs, seen here listening to Gov. Tate Reeves respond to a question about the distribution of COVID-19 vaccine during his briefing for reporters in Jackson on Jan. 4, 2021, is now warning that COVID-19 cases and hospitalizations are rising after the Delta variant became the predominant strain of the novel coronavirus in the least vaccinated state. AP Photo/Rogelio V. Solis

The only good thing is we have adequate PPE, which we didn’t have in the first wave. And certainly that’s a big relief, but it’s really bad, y’all. And so, I just really encourage everybody to be safe. I mean, not just from COVID, but from other stuff. Don’t get in a car wreck, you know, don’t fall off a ladder, because I just don’t know that you’re going to get the care that you think you’re entitled to.

If you go in the hospital, have people help you get stuff done because we … really have high and very concerning nurse-to-patient ratios. … I mean, we can overtax the system. And we have. And it’s almost like it’s a self fulfilling prophecy, because we’re burning out these nurses and they’re saying, I’ve had enough of this. I’m leaving. I can’t believe you’re putting me through this again. 

I’ve heard that over and over again. We knew this was going to happen. It’s actually worse than I thought it would be. This fast. … I really thought we’d be at about 1,000 cases a day, and we’re getting closer to 2,000.

Remember that for every thousand cases that we have another 80 patients who are going to the hospital every day on top of an already full system. And once you get a sick COVID patient in ICU, they’re going to be there for a month or two, often. If they don’t die. So, it’s a slow recovery. It just stacks up fast.

You said recently that Mississippi has 2,000 fewer nurses over the past seven months, and we are a place that turns out good nurses at a pretty good clip. What are you hearing? And what, are they removing themselves from the workplace and going home? What can we do to reverse it? You’ve talked about the impact. 

Obviously, I think there are different factors involved. I think for a lot of nurses, nursing has always been sort of like an expandable career sometimes.

People come and go from the employment pool, and I think that’s part of it. Part of it is moving out of state. Part of it’s retiring. Part of it is people moving from inpatient to outpatient. It’s exhausting taking care of dying patients all day long in an overburdened hospital. 

A blonde female respiratory therapist crouches down to prepare an oxygen tank for use by a hospitalized COVID-19 patient.
Kelly Jones, a supervisor and registered respiratory therapist at the University of Mississippi Medical Center, prepares oxygen for a COVID-19 patient in the medical intensive care unit this past July. Photo courtesy UMMC

And you may want to go work in an urgent care clinic or surgery center. And so we’re seeing that sort of transition … we are talking with the board of nursing and the nursing association and other groups trying to see what we can do to support the nursing workforce.

This is a problem that transcends COVID. We are understaffed in nurses, and have been for a long time. It’s just that much worse right now, and the timing is bad. 

So Dr. Dobbs, here’s another reader question. To what degree can the health department launch a public information campaign to ensure that people know vaccines are free, where to get them et cetera, via PSA’s, text messages, billboards, and any other means. And is there a plan to launch such a campaign? 

You know, we have been doing stuff, and a lot of it’s been sort of social media and other sort of direct communications. A lot of our stuff has been going through partners too, that you might not realize that we’re part of that conversation.

I do think that access can be an issue for some people, but you can hardly walk through Kroger without them saying “please come get vaccinated,” or Walgreens, or wherever. We’ll bring it to your house. We have pop-up clinics.

We go to communities and are asking people if they want to get vaccinated, and they say no. I don’t think it’s an access issue. And I think it’s a different issue of trust that, unfortunately, has been undermined for so many in our population. And that’s really where a lot of our focus has been, is trying to make sure that people have trust or they have mechanisms to reach that.

Access is really broad. We have been doing a lot of stuff, and there’s more stuff on the way. 

I’m curious what your advice would be to, to the media? And I don’t necessarily mean the crazy media, but the rest of us. What else can we do? 

Make sure that the stories are there that people will understand. That if you have a heart attack, you might not get taken care of in a hospital, or there might not be an ambulance for you there. That your local community hospital is not there for you now, because we have overwhelmed the system with COVID.

(Report on) the pregnant woman who dies because she didn’t get vaccinated. You know, I do see these stories from around the country. (Stories) of young folks who didn’t get vaccinated now that wish they had; I think it’d be good to see more of that from Mississippi.

You know, getting those people to folks to speak out because this COVID surge that we’re living through was not inevitable, and it was not necessary. Were we going to see a rise in COVID from delta variants? Of course we were; it’s a more contagious variant. But it wouldn’t look like it looks here.

I’m talking to my son on a regular basis about what’s going on, and he lives in Washington, D.C. He’s like, I can’t believe that y’all are having to go through this (unlike in D.C. now). He’s a med student, and he knows what’s going on in the hospitals.

It’s just a different environment. We have allowed lies and disinformation to fool us. We have allowed the loud voices of disinformation to sow the seeds of distrust. You know, I’m going to tell you the health part. We’re not going to mandate any universal vaccinations.

We’re not going to mandate (where we) go to your house and give you a (forced) vaccine. The things that people say are phenomenal! Our scope of control is really primarily over things where we have regulatory, statutory authority, and we’re not going to be doing anything wild. This is something we need to do collectively.

But that’s something that we’ve lost. We’ve lost a collective spirit to do things for one another. And it’s really disheartening to see that. You know, the greatest generation stormed Normandy, and was willing to sacrifice themselves for that. And we’ve lost more people from COVID than we have from World War II.

And we’re not even willing to wear a mask or get a shot or stay away from a crowded bar. You know, it’s a pretty simple ask. It is discouraging, I just think we’re having policy debates based on mistruths, unfortunately. 

How do you cope with being in this kind of hot seat? And then what gives you hope?

I’ll have to say that for every sort of nasty comment and, and even threats of physical violence, there are 20, maybe 30 positive reinforcing comments. And so I think that’s really helpful for us to know that people get it. …

A young, Black female healthcare professional wearing PPE administers a COVID-19 vaccine injection to a middle-aged white male through his vehicle's window.
Most adults who suffer from serious mental illnesses also have chronic health conditions, such as cardiovascular disease, diabetes and obesity, making them more susceptible to contracting COVID-19. Photo by Alex Mecl on Unsplash

It’s the more extreme folks. Like I said, I, people sent me (messages): If I come to their house, they’re gonna shoot me. I’m not going to go to your house. If we’re not invited, why am I going to go to your house? I mean, just think of the logic of that. You know, if you asked me to help you, I will try to help you.

That’s what our job is, but it’s kind of bizarre … if it weren’t so sad, it’d be kind of funny. I’m just doing my job. What really bothers me is the extra 1,000 or 2,000 people who are going to die from the delta wave because we weren’t where we needed to be.

And just ask ourselves what more we could have done. But as far as people being harsh or critical or unfair, that’s such a small price to pay for what we can do to help other folks. 

Watch this Aug. 2, 2021, episode of MFP Live here on YouTube here and Facebook here. It is also one of the first two new MFP Live Podcasts that producer Kourtney Moncure launched today on Spotify, Apple and Simplecast, where you can listen to the above conversation now.

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