Speaker 1: Going to be an American idiot.
Speaker 2: Kick it off the holiday season this week seven hundred
Speaker 2: W Scott's Loan Show, And of course with that is
Speaker 2: seeing friends and associates, coworkers, family, and others, and that
Speaker 2: means to come in close contact. And it is also
Speaker 2: the start of the Hey, I'm going to get six seasons,
Speaker 2: and some of us already had a had start on
Speaker 2: this one. Hamlin County is seeing a rise in pediatric
Speaker 2: RSV hospitalizations and usually early in the season. The other
Speaker 2: thing you need to know is that for the second
Speaker 2: consecutive year, it looks like this flu season is going
Speaker 2: to be pretty bad. That's because of a new mutation.
Speaker 2: On the show on seven hundred WW is the medical
Speaker 2: director of Hamlin County Public Health, doctor Stephen Vegans. Good morning,
Speaker 2: how are you?
Speaker 1: Thanks got good morning? How are you?
Speaker 2: I'm well today tomorrow? Yeah, I'm well today tomorrow.
Speaker 3: I don't know.
Speaker 2: We'll find out here. Good to have you back, and
Speaker 2: I know you're really busy. Thanks for taking time out.
Speaker 2: So first of all, let's start with the RSV thing.
Speaker 2: We're seeing a rise number of hospitalizations unusually early this year.
Speaker 1: What's driving that, well, RC is one of the Big
Speaker 1: three restaurants and social bars, COVID and influenza. Uh, and
Speaker 1: it just proportionately impacts kids, basically very young. And so
Speaker 1: you know, we've last year we saw a pretty significant
Speaker 1: RC season in children. This year we actually start a
Speaker 1: little bit earlier. So typically all this season starts, you know,
Speaker 1: after October one towards Thanksgiving. We started seeing cases in September.
Speaker 1: Why is that. It's probably just a combination of a
Speaker 1: bunch of stuff. Kids being out and about as well
Speaker 1: as adults. So and there's a there's some now now
Speaker 1: some vaccines for mothers so that the kid doesn't get
Speaker 1: r C as well as older adults. But yeah, it's
Speaker 1: just a part of the respiratory season, and we're saying
Speaker 1: it and especially especially as we go into the holidays.
Speaker 2: Okay, it hits our elderly people just as likely to
Speaker 2: get r SCV as a child.
Speaker 1: Yeah, And so in fact it impacts the very young
Speaker 1: in the very old. And that's why these are these
Speaker 1: vaccines are now out for you know, eight seventy five
Speaker 1: and upright, it's fifty enough and so all the stuff
Speaker 1: that you find yourself in the hospital for, even to
Speaker 1: some extent fluence restorts and citial virus, and so you've
Speaker 1: got the young that may be impacted by the old
Speaker 1: and the old that may be impacted by the young.
Speaker 1: And so the important thing is to wash your hands,
Speaker 1: do all that stuff. You're gonna let have told you.
Speaker 1: But also if you are eligible, there's some vaccinations now
Speaker 1: in the last two years.
Speaker 3: Yeah, how does that present?
Speaker 2: By the way, it's art because you know, I don't
Speaker 2: know what we called it back in the day, but
Speaker 2: it seems like a it's another one of those no
Speaker 2: illnesses you guys in Hamlin County Health made up.
Speaker 1: No, we didn't make it up. You know the key,
Speaker 1: it's all about markets.
Speaker 3: It's all about marketing.
Speaker 1: Yeah, well we just report the data. But it's it's
Speaker 1: like a lower respiratory track, so you know the cold. Uh,
Speaker 1: the typical coronavirus is upper restory cogs that.
Speaker 2: We're losing your cell. You're there, doctor Stephen Fagin's into
Speaker 2: the lungs. Yes, Oh, we're losing your We'll lost you
Speaker 2: there for a minute.
Speaker 1: Oh try about that. Yeah, So barses that can kind
Speaker 1: of get down in the lungs are the ones you
Speaker 1: got to kind of worry about. And so that's when
Speaker 1: you you know, the.
Speaker 2: Kind of cutting. Now you're cutting your cat. I'll pause
Speaker 2: for a second. Maybe you can get another bar on
Speaker 2: your phone.
Speaker 1: There.
Speaker 2: It's doctor Stephen Fagan's medical director Hamlet County Public Health.
Speaker 2: With the cold weather now here, the wet weather and
Speaker 2: of course being around family and friends and big crowds
Speaker 2: as we like to do during the holidays, and then
Speaker 2: being inside of course as an element of this thing
Speaker 2: too or see an RSV cases hospitalizations spiking already. We
Speaker 2: know that it is deadly and children, especially if it's
Speaker 2: left untreated. And uh, we're talking about the warning signs.
Speaker 2: So are you saying, is it is it cough? Is
Speaker 2: it fever? Is both of those?
Speaker 1: Yeah, it's most a favor as well as cough. And
Speaker 1: so you know, if you're very young, and they always
Speaker 1: tell you if you have a feed you need to
Speaker 1: go to hospital, especially if you're in that first month
Speaker 1: of life, and so those first six months are very
Speaker 1: susceptible and that that's the kind of problem that you'll see.
Speaker 1: And you also that's why you have those bulbs to
Speaker 1: clear out the nose from all the congestion as well,
Speaker 1: so you can kind of reade that. Yeah, fever and
Speaker 1: cought is what the first start can be.
Speaker 2: Gotcha. Yeah, I'm a big fan of the upper respiratory.
Speaker 2: Having one of those nasal rinses, the netty pot things
Speaker 2: work pretty much kind of gross, but especially in an
Speaker 2: allergy season. I use it not often, but pretty much
Speaker 2: you're around if I'm a little bit stuffy, just to
Speaker 2: kind of clean the pipes out a little bit. So
Speaker 2: we have RSV, but we also have the flu too,
Speaker 2: so let's talk about that. I think that's the one
Speaker 2: that's going to affect a lot more people. It's a
Speaker 2: so explain how the flu vaccine works. People go, well,
Speaker 2: let's why I don't get the vaccines because it doesn't work.
Speaker 2: It's not worked last year, it's not going to work
Speaker 2: this year. Why can't they get this right? It'd be
Speaker 2: the typical question that gets asked, how do you answer that?
Speaker 1: Yeah, so the flu vaccine for then from having bad flu,
Speaker 1: finding yourself in the hospital or find yourself in the
Speaker 1: emergency department. The reason employers like you to get the
Speaker 1: flu vaccine. It also keeps you able to work, and
Speaker 1: so it doesn't decrease transmission, although it can some, but
Speaker 1: it does it really decreases just how bad the flu
Speaker 1: is when you get it.
Speaker 2: Yeah, And also we look at what is happening in
Speaker 2: half the world away right whereas now summer, you know,
Speaker 2: on the other half Australia, for example, we look and
Speaker 2: see what diseases they get in the winter and go, okay,
Speaker 2: that's going to be part of our annual vaccine here
Speaker 2: in America. And sometimes now two years in a row
Speaker 2: we missed the mutation. In this case, it's called the
Speaker 2: H three N two What is that?
Speaker 1: Yeah, So we characterized by H or ema gluten or
Speaker 1: in neuromenidase, and so it's the hema gluten that helps
Speaker 1: the virus get into the cell, and that's what you
Speaker 1: vaccinate against. The neuromenidase is what the canna flu and
Speaker 1: the anti viarls work against. And so we're always looking
Speaker 1: to see if the H part changes and arch of
Speaker 1: the typical year when they have to decide what's the
Speaker 1: vaccine is going to have in it because it takes
Speaker 1: six months to produce, you look at the southern hemisphere
Speaker 1: like Australia to see what it's going to be like
Speaker 1: for up here, and so between summer and going into fall,
Speaker 1: it looks like yes, there was not just a small
Speaker 1: but a pretty significant change actually changing from one subclaim
Speaker 1: to another. As you mentioned previously, United Kingdom is seeing
Speaker 1: a significant flu season. Japan of the places saw a
Speaker 1: significant flu season, and we did have a big ah
Speaker 1: three in two flu season last year, one of the
Speaker 1: biggest months they had in five years here, both locally
Speaker 1: and nationally. So who knows what's coming up?
Speaker 2: We'll see right right are you what's the scoreboard saying
Speaker 2: right now? I know you have the tracker the gateway
Speaker 2: on your website, but does it look like it's going
Speaker 2: to be a particularly bad flu season again?
Speaker 1: Well, and actually what we're showing is a lower hostilization
Speaker 1: rate for influenza than the five year average would show.
Speaker 1: But the reason for that is that the High Department
Speaker 1: of Health change their data to something called Clinton Sinc
Speaker 1: October one, and so we're not sure. We think it's
Speaker 1: reporting lower than actual because if you go to actual hospital,
Speaker 1: we're higher than what we typically were over the five
Speaker 1: year average. So we have a little bit of data
Speaker 1: reporting issue. Subjectively, it looks like we're higher, but we
Speaker 1: are reporting slightly lower. Right now.
Speaker 3: The vaccine better for kids or adults.
Speaker 1: It's best for both six months and up. Go get one.
Speaker 1: It's about fifty percent effective, which doesn't sound like much,
Speaker 1: but it does a lot. If you're feeling bad against
Speaker 1: hospitalization and er visits and having bad flu, well.
Speaker 2: We see at some point a combined combined vaccination. Doctor
Speaker 2: Stephen Fagin's you get the flu and an RSV in
Speaker 2: the same one.
Speaker 1: Now, probably not that there's a potential combined COVID and
Speaker 1: flu vaccine, but I will tell you if you're an
Speaker 1: adult and you qualify, you can get RSC vaccine, influenza vaccine,
Speaker 1: and COVID vaccine all at the same time. It'd be
Speaker 1: a good thing to do before the holiday.
Speaker 2: How we do it on covid By the way, we've
Speaker 2: talked about RSV and the flu. I mean, obviously COVID
Speaker 2: was major headlines five years ago, but diminishing ever since.
Speaker 2: Is that like a false sense of security?
Speaker 1: Well still here still puts feature in the hospital, not
Speaker 1: as much as as it did. It's almost something that
Speaker 1: we kind of we kind of deal with. We do
Speaker 1: have some antivirals, just like flu. If you do have
Speaker 1: a positive COVID test, it's good to start the anti
Speaker 1: viral within two days of the first symptoms. But it's
Speaker 1: it's still here. It's one of the big three that
Speaker 1: we that we monitor.
Speaker 2: Uh, but it's not we're not seeing the fatality rights
Speaker 2: because we've done a lot they heard immunity.
Speaker 4: We got some kind of community less combination combination vaccine
Speaker 4: and prior prior vaccine and stuff, and it's mutating less
Speaker 4: fast than it used to, and so that's also well.
Speaker 1: And so we do have the experience and it's just
Speaker 1: one of the virus is now. We definitely definitely don't
Speaker 1: see the fatalities that we saw with this when it
Speaker 1: first started.
Speaker 2: Which we kind of do, but five years ago much different.
Speaker 2: We're in a much different spot at that time. How
Speaker 2: much of that immunity has to do with the vaccine
Speaker 2: versus natural resistance and the heard immunities I.
Speaker 1: Mentioned, Yeah, probably a combination of both. You know, the
Speaker 1: vaccine probably has its effectiveness like flu for the first
Speaker 1: three to six months and then it gradually comes off.
Speaker 1: And so it's probably more previous affection immunity right now
Speaker 1: than vaccine immunity. But there is a good combination of both,
Speaker 1: and if you're a certain age or have a lot
Speaker 1: of comorbidities. You know, it's a good idea to go
Speaker 1: ahead and get that COVID vaccine to boost that.
Speaker 2: Is it like RSV in a way that the young
Speaker 2: and very old are the ones that really need to
Speaker 2: get vaccine.
Speaker 1: Innocence. Yeah, you probably can drop that age range around
Speaker 1: fifty or so for COVID, But nonetheless that's exactly right.
Speaker 3: Yeah, I get a lot American.
Speaker 1: Tem pediatrics will say that from six months to two
Speaker 1: years they're recommending the COVID vaccine for kids.
Speaker 2: I know that Texas is dealing with a very severe
Speaker 2: whooping cough upbrates its like I think four times higher
Speaker 2: than the national average or something like that. Why Texas,
Speaker 2: And are you seeing any of those upticks and protesters
Speaker 2: here in the Tri State?
Speaker 1: Yeah, we are and we continue to see that. And
Speaker 1: protests is a bacteria and it's a vaccination. That's what
Speaker 1: Ted app tetness dipteria, a cellular protesters is vaccinated for.
Speaker 1: But the vaccine kind of wanes over time, and you
Speaker 1: do treat it with zpac exist from end and if
Speaker 1: it's a reportable condition. So if we see a kid
Speaker 1: with protessis, we will actually treat other members of the family,
Speaker 1: their home.
Speaker 2: Yeah, because as a child you might get this if
Speaker 2: you're not vaccinated or not on the schedule yet. But
Speaker 2: of course as you get older, you don't get vaccinated
Speaker 2: this often, and so that makes older people where the
Speaker 2: vaccine has worn off, it affects them.
Speaker 1: Yeah, it does. And you won't get the big whoop
Speaker 1: of a cough that you do when you're older. You know,
Speaker 1: you characteristically know that barking cost if you've ever heard it.
Speaker 1: But you do get pretty, you know, pretty sort of
Speaker 1: breath if you got enthazem or asthma or something that
Speaker 1: can it can pass it even more. And so it's
Speaker 1: not about idea. Sometimes you get the t DOW. It
Speaker 1: is recommended if you go travel. That's a travel vaccine.
Speaker 3: Okay.
Speaker 2: Yeah, there's a lot of things I get. I mean
Speaker 2: nice for when I travel abroad, that's for sure, because
Speaker 2: a lot of nafty things out the world. Doctor Stephen
Speaker 2: Fagin's medical director Hamilt County Public Health. We're seeing spike
Speaker 2: and RSV cases here among the young and older people,
Speaker 2: but it's going to be a rough season for that
Speaker 2: as well as the flu because we have a mutuated
Speaker 2: strain that came out since the vaccine was developed six
Speaker 2: months ago. It's it's causing hospitalization rates to spike in
Speaker 2: the UK, Canada, Japan, Australia and the other half of
Speaker 2: the world. And so expect a bad flu season, not
Speaker 2: too late to get that flu vax or the RSV.
Speaker 1: By the way, right, absolutely get it now. You can
Speaker 1: get them together and you know, the shared decision making,
Speaker 1: it's discussed about talking with your pharmacists. While five the
Speaker 1: attestation of a you know, comorbidity to get one or
Speaker 1: more of the vaccines is a self attestation. And so
Speaker 1: if you feel like you really would benefit from that,
Speaker 1: go to your local pharmacy and talk with them.
Speaker 2: Yeah, and that makes make sense, and it really you know,
Speaker 2: you can get right in these days too, because are
Speaker 2: we seeing a decrease in number of people people getting vaccinations?
Speaker 3: What do you attribute that to?
Speaker 1: Well, all kinds of stuff and that the various hesitancy
Speaker 1: and things like that. But we still feel a fair
Speaker 1: bit of confidence in the vaccine. And you talk to
Speaker 1: people and like do you want to get this vaccine?
Speaker 1: They may not want to, but they think other people should.
Speaker 1: And so you know, there's still a high confidence and
Speaker 1: there are lower rates for a lot of reasons, and
Speaker 1: you've probably talked about most of them.
Speaker 2: Yeah, And it seems to me, like all vacs. It's
Speaker 2: weird because we had COVID, and granted it was controversial.
Speaker 2: We developed a fast tressed and thing and people went
Speaker 2: and I get it. You know, I'm not going to
Speaker 2: put that in my body. You know, I read, I
Speaker 2: read what was about and how you developed and said, Okay,
Speaker 2: I'm gonna I'd rather take my risk with the vaccine
Speaker 2: than take up my risk with COVID because I knew
Speaker 2: people actually got sick and died from COVID who were
Speaker 2: normally healthy people. You just don't know how your body
Speaker 2: is going to react. I had it a couple of
Speaker 2: times and I'm fine, but someone else may get us
Speaker 2: perfectly healthy and wind up passing. And this was in
Speaker 2: you know, twenty twenty, twenty twenty one. Since then, we've
Speaker 2: learned a lot about this. But it seems like because
Speaker 2: of that vaccine hesitating with COVID that's now spread to
Speaker 2: other vaccines. Is that what you're saying?
Speaker 1: You know, it adds and we're actually last year we
Speaker 1: dropped a low fifty percent for pediatric influenza vaccination forty
Speaker 1: nine percent pediatric kids got vaccine against influenza. In addition
Speaker 1: to the biggest influenza season we had last year, there
Speaker 1: were two hundred and eighty seven pediatric deaths two hundred
Speaker 1: and eighty seven, that's the highest in two thousand and four,
Speaker 1: and half of those kids were totally healthy, had nothing
Speaker 1: else going on. I ended up dying from the flu.
Speaker 1: So it's still it's still there and it's still important
Speaker 1: to get the vaccine.
Speaker 3: Yeah, gotcha.
Speaker 2: When you guys mind, do you put all this stuff
Speaker 2: on your dashboard or the Hamlet County Public Health website?
Speaker 2: What the data is? It's interesting how you collect that.
Speaker 2: Could you take us through where those numbers come from
Speaker 2: and how you get your accuracy.
Speaker 1: With Yeah, so for rest of ours is it's hospitalization.
Speaker 1: So that's the one thing you clearly know if you're
Speaker 1: in the hospital and you have a positive test, you
Speaker 1: definitely know you have it. And so it's the one
Speaker 1: So it's for rc COVID influenza that data Hall hospitals
Speaker 1: are required to report. They report up electronically through the
Speaker 1: old High Department of Health and we get that data
Speaker 1: from the High Department of Health and that's how we
Speaker 1: get that. We report it locally, report Hamleton County, southest
Speaker 1: Ohio as you see on the website, but it does
Speaker 1: come through ODH, which is anytime there's a glitch or
Speaker 1: anything in that reporting, there's a delay or possibly an
Speaker 1: underreporting of the numbers. We think that's happening now for
Speaker 1: this month, and we're working to reconcile that.
Speaker 3: Yeah, I got you.
Speaker 2: The other thing too is you guys look at wastewater
Speaker 2: treatment plans.
Speaker 1: Right, yeah, you did, and so here locally there's three
Speaker 1: wayte water plants that are monitoring mostly for COVID nationally
Speaker 1: to monitor flu polio as well as RSV. The thing
Speaker 1: about RSV he's got is, for the most part, it's
Speaker 1: the kids that shed who are putting it in a diaper,
Speaker 1: who doesn't go to the wastewater. A little bit of underreporting,
Speaker 1: but you could, you know, get some trend from adult RSC.
Speaker 1: We don't measure RSC locally though.
Speaker 2: That's incredible how granular you can get in to the
Speaker 2: details what's in our wastewater right.
Speaker 1: Well, and there is one case of polio not here
Speaker 1: but in New York and it picks it up in
Speaker 1: the wastewater. It is absolutely amazing technology.
Speaker 3: How do you know it's uh, how do you pick
Speaker 3: out one case out of some water?
Speaker 1: Well, there had to be more than one case, and
Speaker 1: so you pick up the little figment of DNA. Not
Speaker 1: only did they know it was polio, they know it
Speaker 1: was wild type meaning not vaccine associated polio, which is amazing.
Speaker 2: That is incredible. How much there's just got to be
Speaker 2: so much information out there that's noise. On top of
Speaker 2: if you're getting down the world a couple of cases
Speaker 2: of polio and a sample of wastewater, there's gonna be
Speaker 2: a ton of other interesting data you pull out of there.
Speaker 1: Well yeah, I mean, but all those very unique DNA
Speaker 1: and it's like CSI, you know, in terms of DNA testing,
Speaker 1: And it's amazing. The guys that do this are super
Speaker 1: geeks and they really can go on and on about it.
Speaker 3: I bet. Yeah.
Speaker 2: It's always a fascinating dinner discussion when the when the
Speaker 2: guys who look through wastewater and the cowboy, it makes
Speaker 2: me want to order a second round.
Speaker 3: Uh.
Speaker 2: Doctor Stephen Fagin's is here. He is a medical director
Speaker 2: Hamlin County Public Health. Expect a bigger RSV season, a
Speaker 2: bigger flu season, as well. COVID numbers should be about
Speaker 2: the same. We expect her more.
Speaker 1: Yeah, so far, so good, Probably a little uptick you know,
Speaker 1: around Christmas or so. That's why we started basically looking
Speaker 1: at the big three altogether respiratory virus season and what
Speaker 1: is the impact, mostly around hospitalizations and mostly so we
Speaker 1: can know how many beds do we need for how
Speaker 1: much capacity do we need? As a regent?
Speaker 2: Gotcha, what what's going to keep you awake at night
Speaker 2: here for the next few months?
Speaker 3: This uh, this season?
Speaker 1: You know everything? God, but I do. I am concerned
Speaker 1: about this shift in subclade for a three into for
Speaker 1: influenza and just what that might mean because you know
Speaker 1: that's they call it vaccine evasion, which means that our
Speaker 1: immune invasion, so previous immunity or vaccine immunity, you know,
Speaker 1: is it doesn't work nearly as well. When that human
Speaker 1: glutin thing really changes, that could make a big difference,
Speaker 1: and we could see an even more significant flu season
Speaker 1: this year than than we did last year. And the
Speaker 1: vaccine still works. Vaccine still helps. It may not be
Speaker 1: you know, as much as as it typically might, but
Speaker 1: it definitely does still help as well as covery calls
Speaker 1: wash your hands and do what your grandmother told you
Speaker 1: to do.
Speaker 2: And advice is stilter. Wash your damn hands and cover
Speaker 2: your mouth when you see it. Yeah, it's it's I
Speaker 2: mentioned before you came on and I got the flew
Speaker 2: last year. I have to get the vaccine every season.
Speaker 2: And I hit me and somebody said, hey, you know'slon,
Speaker 2: why are you getting the vaccine?
Speaker 3: It doesn't work. I'm like, I'm thinking, but if.
Speaker 2: I was, if I've got that crappy for three days
Speaker 2: I could have, I'd probably be in the hospital if
Speaker 2: I didn't have the vaccine to at least help my
Speaker 2: body deal with us. So you even get you do
Speaker 2: get some protection and some of those proteins in your body.
Speaker 2: Even if you they wind up misguessing and we have
Speaker 2: some sort of mutation like we have this year, right.
Speaker 1: Oh my gosh. Yeah. And then you know, the flu
Speaker 1: vaccine really kind of only works for about five to
Speaker 1: six months. That's why you get one every year. That's
Speaker 1: why you kind of time it so that you sort
Speaker 1: of you know, certainly two weeks before the holiday. He's
Speaker 1: got two weeks to have the impact and it definitely works,
Speaker 1: and get one every year. There's a medicine called tamusues
Speaker 1: that also work, but you have to take it within
Speaker 1: forty hours of the start of symptoms. But you always
Speaker 1: know when flu starts. It is a sudden fever, feeling bad.
Speaker 1: You know, time that that occurred. So it's a little
Speaker 1: bit easier to time the medication.
Speaker 3: Gotcha.
Speaker 2: Yeah, you know people go, oh, yeah, the stomach flu
Speaker 2: for a day. Well, that's not the flu. That's something
Speaker 2: entirely gasting to rise, something entirely different. You have the flu,
Speaker 2: you know you had the flu. It's a good, solid
Speaker 2: week of being a feeling like you've been over by
Speaker 2: a school bus.
Speaker 1: Well, there is a VARs called neuro barsin vomiting signing,
Speaker 1: and so that's another bars you see in the in
Speaker 1: the winter, and we had a pretty significant neuro bars
Speaker 1: season last year as well. But that's upper gi just
Speaker 1: like up rest ory upper GIF. You're vomiting, you know
Speaker 1: it's irritating the stomach. You haven diary, you know it's
Speaker 1: irritating the colon.
Speaker 2: Right right, all right, useful information. And this is why
Speaker 2: we do it at a ten ten thirty because it's
Speaker 2: far enough between breakfast and lunch just to not nausey.
Speaker 2: Your further doctor Stephen Vegan's medical director, Hamlin County Public Health.
Speaker 2: Always appreciate you coming on. Thanks for the time.
Speaker 1: Thank you, Scott tak care Right.
Speaker 3: Well, there you go.
Speaker 2: You got your information for Warner's Forarmed Scott's Loan Show
Speaker 2: with News and three on seven hundred WW