AN INTERVIEW WITH DR. DREW COLFAX
Local physician says ‘We have almost made it’
Dr. Drew Colfax, a member of the team of the Pacific Redwood Medical Group, has had his finger on the pulse of the COVID-19 pandemic from the beginning.
As an emergency room physician at Adventist Health Ukiah Valley, he has been treating SARS-COV-2 patients since the virus came to the county and, being concerned, informed and articulate, has kept county residents up to date with ongoing developments with his Local Coronavirus Update on KZYX at 3 p.m. on Monday, Wednesday and Friday, presenting new information and answering phone-in questions with host Alicia Bales.
Intro to Coronavirus Vaccine 101
(In order for viruses, such as the SARSCOV-2 virus, to survive, they must get inside cells in order to replicate, where they use the cell’s own biochemical machinery to build new virus particles and spread to other cells.
In order to ward off such intrusions, the cell has an outer coating composed of a
fatty layer that holds in all its enzymes, proteins and DNA and the virus has to get across this barrier to get into the cell.
Spike proteins—stuck on the surface of the viral particle and embedded within its envelope, sticking out into space—are also surrounded by a fatty membrane and allow the virus to fuse to the membrane of the human cell and enter it.
The vaccines produced by Pfizer and Moderna contain synthetic MRNA or messenger RNA (a genetic material that contains instructions for making proteins) that give instructions to the immune system to make its own version of the spike protein that occurs shortly following immunization.
The body recognizes the spike protein as an invader and starts producing antibodies against it. Soon after, the cell breaks down the MRNA into harmless pieces. If the antibodies later encounter the actual virus, they are ready to recognize and destroy it before it causes illness.)
Side effects from the vaccine, or as Colfax says, effects, not side effects, can vary from none to a couple of days of feeling
flu-like with symptoms that might include fatigue, headache, some significant chills and a low-grade fever.
“It’s much better than getting COVID, for sure,” he says.
It is your body’s response to the vaccine and if you are feeling under the weather 12 to 18 hours after getting the vaccine, it is likely you will experience some or all of these symptoms for about 24 hours, most likely after the second shot.
The vaccine triggers an immune response and the booster shot triggers a stronger immune response; that is what you are feeling when you experience this discomfort.
The second dose is the same dose, same potency, same vaccine; however, the body is already primed by the first shot to recognize what the vaccine induces so you tend to have a stronger reaction to the second dose.
“That’s why some of the clinics are staggering the second shot, so not everybody feels terrible at once, for a day, and can’t come to work.”
He says it is perfectly safe to take either aspirin, Tylenol or Ibuprofen to help dampen the body’s response.
The new strain of COVID-19, B-117, appears to be 50 percent more contagious or infectious than the current strain presently dominating the country which means it is going to spread more readily in situations where the current dominant strain may not.
“You might see more people infected during an indoor gathering that’s only 10-15 minutes long, more people infected from what we had thought of as fairly casual contact during, for example, grocery shopping.”
The new strain, causing significant concern, is adapting so well that it is estimated to be the single dominant strain in this country by the end of March.
Although it is more infectious, it is not more dangerous; people are not getting sicker from it and the vaccines are equally effective toward it.
With minimal federal guidance, there is poor genomic surveillance in the country right now and with inadequate data, it is difficult to determine the prevalence of the new strain.
“We’re still flying pretty much blind.”
There is more hope around the corner with Johnson and Johnson moving toward completion of their Phase 3 trial by the end of the month, initially projecting to produce 1 billion doses by late summer.
Presently behind, a more realistic expectation will be hundreds of millions by March or April—still a very significant influx of vaccine on the market.
Due to an unfortunate series of mishaps during the Astrazenica clinical trials, the FDA is taking a very cautious approach here and is waiting for more data before they grant approval.
“Ultimately, I think it will be approved,” he says. Do you trust the FDA? “The FDA has a very rigorous vaccine approval process and there are multiple bodies that review the data. This is certainly the most scrutinized vaccination roll-out in the history of this country and yes, I think their approval means a lot.”
“We’re not seeing any significant adverse events from the tens of millions of people who have been vaccinated so far and that speaks to the fact that they are very safe vaccines.”
And as an emergency room physician at the hospital?
“We’ve developed protocols at this point; we’re used to seeing COVID patients and we’re very good at it. Everybody in Adventist Health in this county is doing an excellent job of supporting health care workers—from front line workers to ER doctors and those working in the ICU.
“The teams that are seeing these patients, taking care of them, day to day, have developed an incredibly robust skill set in managing this.”
He says that he and others working on the front lines experienced a tremendous sense of relief after receiving their first and second doses of the vaccine.
“One thing in the back of our minds concerning COVID-19 from the beginning was being an asymptomatic carrier and bringing it from patient to patient as we went through the day’s work at the hospital and also possibly bringing it back to our families.”
Doctors are presently advising people that they will reach full immunity about two weeks after receiving their second dose but it is important to understand that maximum immunity does not mean complete immunity.
“You can still get it; there will still be people who get it after they are fully vaccinated and fully immune; the data, however, suggest that those who do get it will not get very sick from it.”
While COVID-19 remains, the fully vaccinated will have to do everything that everyone has been advised to do during the pandemic—maintain social distancing, wash your hands, wear a face mask, avoid congregant settings, stay outside and stay home.
These are all critical behaviors for both the unvaccinated and the vaccinated to maintain until numbers fall significantly—probably the late spring or early summer, especially considering the impact of the new strain.
He says the county and health organizations have mounted a very good program in spite of the lack of coherent guidelines from the federal government and the state’s inability to provide an adequate supply of the vaccine.
“We don’t know how much vaccine we will be getting from day to day, from week to week, so it’s really hard to develop plans or vaccine events or to notify eligible people when we don’t know what our supply looks like, truly frustrating at many levels.
“I urge people to be patient; Public Health is doing a great job with limited information in getting the vaccines out of the freezers and into people as fast as it comes in. We may not be able to control how much vaccine comes into the county but we can control how fast we administer it to the neediest. Every responsible party is currently doing a very good job with that.
“Health care workers who are administering these vaccines can really feel a sense of what an awesome advance this is; we have a medication that’s going to substantially stop this pandemic once it gets administered to enough people.
“We don’t have enough but we’re so close to the end. It’s incumbent on each of us to stay safe, double down on being safe; we have almost made it; we’re months from getting through this.
“Don’t die now. We’re almost there.”