 Aloha and welcome to Lillian's Beacon World. I'm your host, Lillian Cumick. Today's show is COVID Booster Shots and Delta Virus, COVID-19 101 and Vaccine Update, brought to you by Think Tech Hawaii. I'd like to introduce my regular guest on the show, Dr. Grace Chen O'Neill. Aloha, Dr. O'Neill. Hi, everyone. Hi, Lillian. Thank you. Hi, welcome to the show. And first of all, I must say thank you for all that you do. I know this is a challenging time to be in the medical profession, but I appreciate your time in coming on the show. I appreciate your show. Dr. O'Neill, we are just going to dive in. This is a vaccine update that you're going to help us with. Tell us, first of all, what are the COVID costs for patients who are hospitalized? Well, so, you know, right now what's happening is that because COVID has cost so much for insurance companies, there's this shift where they're trying to shift the cost, more of the cost to the patient. But even right now, it's really expensive. So if you look at, can you bring up the slide with the COVID costs? I think it's slide 23. Yeah, so I mean, some people, they'll spend like $30,000 in the hospital just for COVID. Now, if you need the extracorporeal membrane oxygenation, which is basically the machine they put you on for, you know, kind of like a heart, you know, all heart surgeries that patients get put on this machine. But they're also using it for really sick COVID patients. And so that therapy in itself is $5,000 a day. And that's, you know, maybe even on top of your other costs, like being in an intensive care unit, which you would need to be to even have that kind of therapy. Not all hospitals are doing it, but, you know, I was reading that one person who got really, really sick from COVID, his wife called all around and finally found, like she called 30 different hospitals, finally found a hospital where he could be essentially helicoptered out to or, you know, flown to that would do this therapy on him. And, you know, he's survived, but, you know, not everybody can afford to pay for this kind of thing. So, you know, if you are just hospitalized for COVID, suppose you have no insurance, then it's very, very costly. You will spend like more than $200,000 on an ICU stay, you know, on the vent, or if you're in the hospital, it could be like $50,000. You know, with insurance, it's a little bit more reasonable, but it's still, you know, $20,000 for a hospital stay, depending on how long you stay. And, you know, more than $100,000 if you have an ICU stay. So, I mean, these costs people aren't really realizing. And now the insurance companies, they're starting to try to pass on more of these costs to the patient because, you know, it's been very costly and the insurance companies are in it to make money. So, that's the unfortunate way things are. So. So, are these patients who have been hospitalized and run up bills like that for a couple of $100,000 or, you know, around $20,000, are they actually paying off their bills out of curiosity? I think a lot of them can. I mean, I think that, you know, that's another major problem that people are having, they're unable to pay these bills. So, I mean, and, you know, you could be able to pay it, but you might use all your life savings. So, I mean, that's another issue that people are having right now. So, I mean, it's something to consider, you know, maybe getting the vaccine for, because if you have a vaccine, you would be more protected, at least against severe illness. So, you probably would not have to be hospitalized. I mean, it's not a hundred percent, but you would have much less risk of hospitalization. Dr. Anil, does the Delta variant cause more infections or spread faster than coronavirus? The Delta variant is much more transmissible than the other variant that was here before, that Alpha variant right now in Hawaii and in the United States. The Delta variant is the most common variant. And so, it's probably about two times or more transmissible than the Alpha, and people are getting more sick from Delta as well. So... So then, what are some of the symptoms that people are suffering from in regards to the Delta virus? Can you go through some of them with us? And are they different from coronavirus symptoms? Well, I mean, so the coronavirus itself, the coronavirus is like a big group of viruses under which SARS-CoV-2 is under that. The Delta variant is a variant of the SARS-CoV-2. So, I mean, you have essentially the same symptoms, but people are suffering from more severe illness. I mean, I know a few people who had Alpha and then they thought they were pretty protected because they already had Alpha and they thought, well, I have antibodies, but your immunity does wane after a while, right? But then they felt pretty confident and even people who were vaccinated and then they got Delta and Delta really hit them very hard. There was an article that was in the paper a little bit ago and she was a vegan, a young vegan girl, very healthy and she did not get vaccinated and she was really surprised. She was in bed very sick for 10 days. I mean, she didn't have to be hospitalized because she's completely healthy, but I mean, now she regrets not having the vaccine and a lot of other people too because no Delta tends to be more severe and people are having more symptoms. People who even had Alpha before are having more symptoms than they did with the Alpha. I'm interested to know because you did mention a young, this young woman who recently was dealing with the variant, are people who are hospitalized? What's the major age group? Are we talking younger people, more younger people? Are there still a lot of people are, there's many more younger people being hospitalized now than there were before and that's because right now, a lot of the more old people are getting vaccinated because they realize they're at high risk but a lot of the younger people because originally with Alpha and the primary variants from earlier, people who were young weren't really getting sick because they didn't have a lot of medical problems but now what's happening is because they're unvaccinated and they didn't think they would need to get vaccinated because they didn't think they would get sick, they're actually at higher risk because they don't have the antibodies there to protect themselves against Delta. So they're actually, the shift, there's been a shift in the predominant age group and so we're seeing people, I mean, there are children, but still not a lot of kids but there have been a lot of kids that are sick, like 30% of the kids who get COVID are really, really sick and they need intensive care unit care. So, I mean, it's, and a lot of these kids, yeah, they do have preexisting illnesses, but some of them don't. I mean, some people who are 20 have died. And I've read this article about how there was this, these twins from India, they were in their 20s, they were healthy and they died. So, for whatever reason, I mean, you don't know, you're kind of playing the lottery when you say, I'm healthy, I'm not going to get this. So, I'm not gonna get vaccinated because you don't know, even though you're healthy, there could be something, we don't know everything about COVID yet and we don't know everything about the Delta variant. So, for whatever reason, you might still get sick even though you're healthy. Now it is more common to get sick if you do have medical problems. So, yes, there are people who are younger getting sick now but a lot of them, they do have the same preexisting conditions that were risk factors before, like high blood pressure, obesity, and I would say probably a third of the population we have is even overweight and even being overweight is a risk factor, having high cholesterol, a lot of things that people just, they don't even consider as medical problems, those are risk factors for COVID. I think we, yes, I think we do have a slide that lists some of the risk factors, a slide that you prepped for us. Yes. Here it is. So, if you can just go through that, again, Dr. Anil. Yeah, let me, sorry, I just got a school. So, yeah, so I mean, the main risk factors are all these chronic conditions that people have a lot of people in the United States. And I do wanna highlight, besides diabetes, heart disease, having cancer, something that you might not think is a risk factor but actually being pregnant is a risk factor too. So I know a lot of pregnant people are hesitant to get the vaccine because they don't know what kind of effects it has or they just don't wanna deal with the unknown but actually being pregnant and getting COVID could be a lot worse. I mean, it is a lot worse. So, I mean, that is a risk factor for severe COVID. So anybody with lung disease, like I was saying, overweight people, if you're born with something like a genetic defect, like sickle cell disease, cystic fibrosis, any kind of immunodeficiency because your immune system can't mount a good response initially to fight COVID, these are all major risk factors. Dr. Anil, I do wanna go get back to something that you just mentioned about pregnancy. Is it safe to get the vaccination while you're doing a pregnancy? Yes, and they do recommend it for pregnant women. And actually if you get the vaccine when you're pregnant, the great thing is that you can confer those antibodies to your child because right now it's not yet approved for children to get the vaccine and especially not newborns. So if you get the vaccine, then you can confer those antibodies to your newborn child. So that would be something that would protect your child because I mean, a lot of people don't think about it but I mean, I was reading these articles about how somebody got COVID and they were vaccinated and their child was not vaccinated because she wasn't in the age category that she could get a vaccine anyway, but her child got COVID and got really sick from it. And so it's just something to think about that you could be the one helping protect your child. I mean, it's rare that a child would have severe symptoms of COVID but they do get other side effects. They could have long COVID, they could have Ms. C, we call it Ms. C is it's kind of like Kawasaki disease where people have these cardiac problems in the long run which can be problematic for the rest of their life. So these are all things that people have to consider. I mean, even though a child doesn't get really sick from COVID, which is not a guarantee like I said, it's like playing the lottery but even if they don't really get sick you can still have this other, Ms. C happens about six weeks after the child gets COVID you'll see them present with this syndrome. That's so many interesting points you bring up. I mean, when you think about it people are all about trying to prevent illness in their lives, during their lifespan. So it makes me wonder like what do you say to people who just are so against getting vaccinated but still live relatively healthy lives? Yes, I do think that is, I mean, I think this, that's the reason I brought up that young girl who was vegan and healthy and she got COVID. People don't realize, I mean, yes, you are young and healthy and you can nine times out of 10 your body systems gonna be able to fight COVID but you can have these long-term side effects. Like when we talked about, I think a while ago we did a COVID update episode and we talked about how people get long COVID and they have these symptoms of shortness of breath for a long time, which might not be that they're actually having a low oxygen saturation that we require a hospital admission but they have these symptoms that are bothersome for them. They feel like that they can't do the level of activity they are used to doing. I mean, there's some young athletes that get COVID and they're not able to, after months, months after they got COVID, which they should be cleared, they're not able to return to their original activity which is terrible. And I mean, how about losing your sense of taste and smell? I mean, that kind of stinks and it's not just losing it, you might gain it back but then when it comes back, I was listening to the radio and someone said they had COVID and then at first when it came back it was kind of like a metallic taste so it was kind of like a bad taste. So that's a problem too because I love eating and I'm sure you do too as your chef. So I can't imagine losing my sense of taste or smell although losing the sense of smell might be helpful working in the emergency room, but. Well, yes, but I don't want to lose my taste. Absolutely not, that's such a great point. I mean, I have actually people I know who have just recovered from it and they have said that it's been like over eight months and they still haven't got their sense of taste back and are very, very worried about whether it's actually gonna come back and back to its normal sense. It's scary, gosh, all of these and the thing is all of this can be prevented with vaccination shot, which brings me into what some of the long COVID risks are that I do wanna talk about after the break, Dr. O'Neill but for now we are gonna take a short break for some messages, please do stay tuned for this very important show and we'll be back shortly after these messages. Good afternoon, this is Howard Wigg, the proud host of Hold Green, a Think Tech Hawaii program. We air every other Monday from noon to 12.30 and my guests are subject matter experts in bringing Hawaii to 100% clean energy by 2045 and we're aiming not just at the electricity but also at ground transportation. Exciting stuff, please join me. Aloha and welcome back to Lillian's Vegan World. I'm your host, Lillian Kubik with Think Tech Hawaii. I am very excited to have on the show Dr. Grace Chen O'Neill and she and I are talking about the COVID update, the vaccines and the risks involved. Before then I would like to briefly mention that I am a vegan chef and recipe developer, also cooking instructor and my new newly released cookbook is Hawaii, a Vegan Paradise with over 120 plant-based recipes from the islands. My next book is going to be released hopefully this November next month of 2021 and it is called Tasting Hawaii Vegan Style, do look out for it. I would love to welcome back my regular guest on the show, Dr. O'Neill. Welcome back, Dr. Thank you, Lillian, it's nice to be here. I appreciate your time. Let's just get right back into it and I wanna ask you about the long COVID risks. We do have a slide, it's slide number six. Please tell us about this. So a lot of people, even though they get mild symptoms from COVID, they could have these lingering symptoms for months and a lot of the symptoms have to do with like I was talking about before, difficulty breathing, they could have a cough that lingers on, headaches. Then there's this thing called brain fog where they're not, they don't feel like they're thinking clearly. They could have lingering chest pains, sleeping problems, dizziness and they could have this, ongoing loss of sense of taste or smell. I had somebody, one of the residents I know had COVID and he's essentially a year after having it still couldn't smell. So these are all things. Another thing is that COVID can change the menstrual cycle and I know there's a lot of concern over if the COVID vaccine causes, fertility to be affected, decreasing your fertility or whatever, but the COVID vaccine has not been shown to affect your fertility. If it did then all the people who had COVID, their fertility would be affected as well. So we're not seeing that in people who have COVID, but it can like the COVID vaccine just like long COVID can change your menstrual cycle a bit just because the immune system is involved in your menstrual cycle. So that's just something to note. That's actually a very scary thing. Yeah, I mean, but I mean, I guess the immune system is involved in a lot of things that people don't realize the immune system is all over your gut because whenever you take in food, your immune system, it's like this foreign thing entering your body even though it's post-nursary, but there's some things that maybe you shouldn't be eating that are not nourishing your, so your immune system has to react to it. So just like anything, it affects everything. Well, then Dr. O'Neill, let's talk about slide 13 and the COVID-19 vaccine side effects. So you've given us a little rundown on what happens if you do actually get the virus, but let's compare it to the side effects from the vaccine. Most of the time the side effects are pretty minor. The most common side effect is just having pain and redness and swelling at the site of the injection. A lot of times people feel tired, have a headache, some body aches, maybe a little bit nausea, but those are the main side effects. Now, people can have a life-threatening reaction called anaphylaxis. It's exceedingly rare. Apparently this is at a rate of like 0.0005% for the vaccine. So just, I mean, it's two to five people per one million people. It's just exceedingly rare that people get it. And if you do have anaphylaxis, it'll usually happen within 30 minutes of you getting the vaccine. So if you've had a problem with having another medication, getting anaphylaxis before on your hesitant, I would suggest that when you get the vaccine, get it at a hospital and make sure to stay there 30 minutes if anything happens to you. But it is treatable and it's pretty rare that something like this would happen. So another side effect that they've been seeing with the mRNA vaccines is myocarditis or I spelled myocarditis when I'm sorry about that and pericarditis, which is happening in mostly young males, less than 30 and kind of like teenagers. I've seen one case, these cases they usually resolve spontaneously with, you know, don't really need much treatment really. But you know, like if you do get COVID, people can suffer from myocarditis and pericarditis of COVID. So, you know, I mean, that's probably gonna be much worse than you having the vaccine and getting myocarditis from that, honestly. And then another thing people can have is Guillain-Barre syndrome, which is kind of like an ascending paralysis usually, but this again is exceedingly rare. Happens within two weeks of the vaccine. It's also a possible side effect of the flu vaccine, a possible side effect of getting, you know, some kind of gastroenteritis or diarrheal illness. People can get this as a problem too. So this is another thing that's rare it's seen in the J and J. So that's, you know, one thing to note but very, very rare as well. There's been 195 cases out of 14.5 million doses. And then I know a lot of people are, they've heard of the thrombosis and thrombocytopenia syndrome. This is mostly in women 18 to 49 years old. There's been 46 cases and they're not really sure if it's increased from the population yet. But, you know, it's probably it's, I think it's something like 0.0007% of people who've had J and J vaccine who are getting this. But if you are hospitalized for COVID, apparently the risk of you being like bed bound, hospitalized for COVID, of you getting a clot in your leg or whatever would be much higher, like 20%. So you're thinking like 0.0007% versus 20% and then I would choose 0.007% probably. Yeah, I must say I would too. I urge anyone watching the show to really take all of this information into consideration because I am not a medical professional but I am looking at the symptoms and side effects and it looks to me quite clearly that getting vaccinated, the symptoms are far less and severe but, you know, it's all about choices and it really is your choice whether you want to get vaccinated or not. Dr. O'Neill, is some of the data that's coming out true that the unvaccinated face 11 times more the risk of dying from COVID? Yes, yes, yeah, it is true. I mean, there's unfortunately, like I was saying before, you know, it used to be older people mostly who were dying of COVID but now it's shifted to younger people unvaccinated and they have a much higher risk because they don't yet have antibodies to the, you know, the COVID so they don't mount an immune response in time and the virus is able to kind of multiply and replicate really fast and then they haven't yet begun their immune response whereas if you've been vaccinated your immune system can already recognize the COVID and then it can go after it quickly and extinguish it before it becomes a real problem and that's why vaccinated people also are not as transmissible. I mean, they can still transmit COVID but they're not as transmissible as people who are unvaccinated. I mean, I will say I've seen in families actually, I've had families come in, be tested, everybody like, you know, the whole family comes in they all have COVID-like symptoms but somehow the parents are negative and the children who can't get the vaccine yet because they're too young are positive. I've had that happen a lot of times. So, I mean, I think that's because the parents they're just mounting immune response really quick because they've already had the vaccine and so they're extinguishing it, you know, whereas, you know, you have to wait for, you know, your body to develop immune response if you haven't seen it yet. You haven't recognized the foreign substance. In the state of Hawaii, what is the age at which a child can get vaccinated? Well, it's just like anywhere in the United States. Right now, I think it's 12 and up but they're working on like five to 12 right now. I think they've put in like a request or whatever. So, maybe by the end of this year, I think they said. I'm wondering, do you know if any of the schools are offering vaccine programs or trying to get some kind of support in schools for parents who are thinking about getting their children vaccinated? That's a good question. I'm not quite sure, but I feel like a lot of places there's a lot of free vaccine clinics and I think a lot of the drug stores are offering it too. So, I think that it shouldn't be an issue. I mean, the primary care doctors aren't offering it but, you know, say like you go to Longs or, you know, Walgreens, whatever, they're all offering it and all the hospitals are still offering it as well. We were talking about, I don't know about at other hospitals, we were talking about trying to give people who come to the ER for other complaints, you know, who don't have COVID, obviously, but for other complaints, we were talking about trying to get them the vaccine in the emergency room. And I know like maybe Queens and some of the other hospitals might be able to do that but we weren't able to institute that at Tripler. But at Tripler, people can just go in and then have the vaccine done. You know, they just need to make an appointment. So, it's really, I feel like they're, it's relatively easy, you know. And you could sign up. I mean, I did the vaccination, I signed up my husband for it. So, all you have to do is you go online and you can just Google search it and then you fill out all the information and make an appointment for yourself when you show up. I don't know. The access is there. I mean, I just walked into a Longs drug store very randomly and asked if I could get it. I had ID with me and 10 minutes later I was vaccinated. I did exactly the same thing for my second shot. So, definitely it's an easy sale as far as getting vaccinated. Dr. Anil, let's talk about the booster shot. Some people wanna know if we need a booster shot does that mean that the vaccine isn't working? Well, no, the vaccine is working. It is very protective against severe disease. They are offering it to over 65 because people who are over 65 as you age your immunity is not as strong as it was when you were young for multiple reasons. Like, you develop more, people can have malnutrition because they don't have access to food. They may not be as ambulatory as they used to be. So, multiple reasons, your immune system kind of declined. So, your immune system isn't able to mount as strong of a response. So, they're concerned about those people not, they don't want those people to get sick. And then, as time goes on, your immunity does wane a little bit. So, that's why they are offering it at the eight month mark right now. I don't know if it's gonna be like that forever that we'll need a booster, but for right now they are going to offer it to healthcare workers, residents of long-term care facilities, nursing home residents, that kind of thing. And people who are immunocompromised who can't mount a sufficient immune response are getting people getting cancer treatments or who are on immunosuppressive medications. So, I mean, it doesn't mean that it's not working. I mean, I think that obviously it would work a lot better if more people had the vaccine because then we would have good herd immunity and the vaccine would kind of control the virus. So, there wouldn't be as much of the virus circulating around and it wouldn't be able to mutate and have new variants like Delta and there's Lambda, there's Mu and there's all these other variants coming up. So, if you have less of that being able to mutate in people then that kind of controls it because a lot of people have chosen not to get vaccinated and it makes it difficult to get to herd immunity. So, yeah. Yes, I mean, there's a lot to take in when you consider getting vaccinated, getting the booster shot. There's also the social responsibility of whether you wanna be part of trying to move forward with this, but I do agree that we all have choices. That's the beauty of living in a country like the United States, but the access is there. So, Dr. Anil, in your medical opinion, your professional opinion, do you advise the unvaccinated to get vaccinated for the COVID-19 and do you advise people who have been vaccinated to get the booster shots? Well, yeah, I definitely advise that people who are unvaccinated go get the vaccine. Now, there was hesitancy about recommending the booster shot just because the WHO, the World Health Organization, was saying we should try to get everybody vaccinated before we offer the booster. So, that's why there was that backlash against that, but I do think if the booster is available for you, I think, yes, you should get it. You may protect yourself, especially if you're over 65. You're immunocompromised, absolutely. If you're a healthcare worker, you're constantly exposed. I don't want to give it. I don't want to get COVID. I don't want to give it to my patients who are immunocompromised, who have medical problems. So, that's why I'm getting the vaccine. And I'll get the booster shot. Yes, I can offer it to me. Again, thank you so much for everything that you do. Please do stay safe. Thank you so much for joining us today on Lillian's Beacon World. To the viewers, stay safe also. Stay healthy and do please consider getting vaccinated if you haven't already. Aloha, until next time. Thank you.