Reframing COVID-19 Prevention: Practical Approaches to Reduce Risk

Announcer:
You’re listening to VacciNation on ReachMD, and this episode is sponsored by Pfizer. Here’s your host, Dr. Jennifer Caudle.

Dr. Caudle:
This is VacciNation on ReachMD, and I'm your host, Dr. Jennifer Caudle. And here with me today to discuss the importance of preventative strategies for COVID-19 is Dr. Teena Chopra. She serves as Interim Chair and Professor of Medicine at Wayne State University's Center for Emerging and Infectious Diseases in Detroit, Michigan. Dr. Chopra, welcome to the program.

Dr. Chopra:
Thank you, Dr. Caudle. Thank you for having me.

Dr. Caudle: 
Well, we're excited that you're here. And so beginning with some background, Dr. Chopra, CDC surveillance data from late 2023 found that hospitalization rates for COVID-19 among older adults remain elevated, with ICU admissions making up around 15 percent of hospital cases. So given the significant burden that COVID-19 still has, what role do preventative strategies play?

Dr. Chopra: 
Absolutely, that's a great question. Like you pointed out, hospitalizations remain a big concern, especially in our older population—our very vulnerable population—and we do have the tools. And the biggest tool that we have is the booster vaccinations, right? So we have vaccines that can prevent and have shown, time and again, to decrease the number of hospitalizations, severe disease, and mortality from COVID-19. So I think that this decrease is up to 80 percent in our older population. So I think that is one of the biggest preventative strategies that we have. In addition to that, we have masking. We have masks available, especially during the respiratory season. We have other antivirals that are available that can be taken. And so we really need to make use of these strategies that we have out there.

Dr. Caudle: 
Those are really excellent points. And in terms of mortality, COVID-19 still accounts for tens of thousands of deaths annually in the United States, largely among the unvaccinated, immunocompromised, and even elderly population. So, with this being said, how can we help support the long-term health and survival of these vulnerable groups?

Dr. Chopra: 
Absolutely. Again, we have to be more proactive. We have to work in collaboration, not only with healthcare systems, but also with local, state, and regional organizations and with the CDC, and we need to increase access to vaccination. I think that's the biggest rate-limiting step right now, to create this trust in vaccinations, including access to it. For example, I work in Detroit, where transportation can be the biggest rate-limiting factor, and so we have to go to patients and talk about vaccinations, listen to their concerns in a non-judgmental manner, provide education around myths that exist around vaccinations, and again, integrate care. All of these factors can help mitigate future deterioration and improve access.

Dr. Caudle:
Those are really excellent points, and I'm really glad you also brought up things such as access, in terms of transportation—some of the things that we may not always think about. So I appreciate that.

If we shift gears and talk briefly about long COVID, what are some of the hidden or delayed complications clinicians need to keep on their radar?

Dr. Chopra: 
Sure. Long COVID is a complex syndrome that can affect pretty much any organ in the body. And the major symptoms include fatigue, which is very common. And long COVID can affect up to 15 percent of infected individuals, with a higher impact on minorities, women, and also immunocompromised patients. It can cause shortness of breath and fatigue. It can affect the brain and cause cognitive decline, which is very common, and I've seen a lot of patients—young patients—with memory loss, which can impact their quality of life. It can also affect the vascular system, including clots and heart disease—in the young, old, and the vulnerable. So it can have long-term impacts on our highly vulnerable populations, including people with pre-existing conditions like diabetes, COPD, and hypertension, and have a multitude of complex issues in our patients and affect their clinical, financial, and social life. So all of this has to be kept in mind when we are trying to manage long COVID.

Dr. Caudle: 
And for those of you who are just tuning in, this is VacciNation on ReachMD. I'm your host, Dr. Jennifer Caudle, and I'm speaking with Dr. Teena Chopra about how we can mitigate the burden of COVID-19 through preventative strategies.

So Dr. Chopra, moving beyond the clinical setting for a moment, how is COVID-19 affecting our economy? And where does prevention fit into that picture?

Dr. Chopra: 
Sure. Long COVID alone is costing the US economy an estimated 170 billion dollars annually. It includes lost productivity, early retirements, and multitude of other factors. So again, the answer lies in vaccination: access to vaccination, early treatment options, and getting your boosters in a timely fashion. So all of these can significantly mitigate these costs.

Dr. Caudle: 
And when it comes to dealing with public fatigue, how can we reframe prevention not as a restriction, but as a way to normalize smart behaviors?

Dr. Chopra: 
Just like we did in the past, right? Making vaccinations routine care and talking about vaccines every opportunity we get with our patients, whether they have come for their prenatal care, they have come to their primary care physician, or they have gone for screening mammogram. So talking to them routinely and listening to them, hearing their concerns, promoting other preventative strategies like masks during the respiratory viral season, talking to all kinds of care providers for the patients—whether the patient has gone to their wound care specialist or they have gone to their rehab—and embedding these preventative strategies in their routine care, I think would normalize it. Talking about hand hygiene—why is it important? Talking about other preventative strategies like masks, and also, most importantly, hearing out their concerns. What are their barriers? What are the barriers that our patients are facing towards these preventative strategies? I think that can really help.

Dr. Caudle: 
Thank you. And before we come to the end of our program, Dr. Chopra, do you have any key takeaways you'd like to leave with our audience about COVID-19 prevention?

Dr. Chopra: 
Sure. I think at this point, now that we are five years out into the pandemic and we are continuing to see newer variants of COVID-19, including the most recent variant, I think it's very, very important to have strong care models, policy, and education so that we can reduce the future strain and protect both our patients and our systems.

Dr. Caudle: 
Well, that's a great comment for us to think on as we wrap up our discussion. I'd like to thank my guest, Dr. Teena Chopra, for joining me to discuss strategies for reducing the impact of COVID-19. Dr. Chopra, it was great having you on the program.

Dr. Chopra:
Thank you, Dr. Caudle. Thank you for having me.

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This episode of VacciNation was sponsored by Pfizer. To access this and other episodes in our series, visit VacciNation on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!