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St. Louis Pandemic Doctor: COVID-19 Now Almost 'Universally Preventable' With Vaccines

Dr. Alex Garza is the head of the St. Louis Metropolitan Pandemic Task Force, which comprises the region's four largest health systems.
Sarah Fentem
St. Louis Public Radio
Dr. Alex Garza is the head of the St. Louis Metropolitan Pandemic Task Force, which includes representatives from the region's four largest health systems.

For more than 14 months, Dr. Alex Garza has been the face of the region’s COVID-19 response as the head of the St. Louis Metropolitan Pandemic Task Force, a group of leaders from the region’s hospitals.

The task forcehas shut down its weekly livestreamed conferences as coronavirus cases and hospitalizations in the area’s hospitals have remained relatively flat.

St. Louis Public Radio’s Sarah Fentem asked Garza about his work, the continuing challenge of the coronavirus pandemic and how health care workers are dealing with the psychological toll of the past year.

Sarah Fentem: One of the most interesting aspects of the briefings for me was seeing doctors and health workers show a lot of emotion and show the human side of the health care industry, which I don’t think a lot of patients see. How are workers doing now? Are they still carrying a psychological toll from this?

Alex Garza: I would be surprised if they weren’t still carrying it. I think as you know and many people know, I’m also in the military, and one of the things that has a long tail after conflicts is the post-conflict issues with PTSD and the mental tolls that last for a long time. And this is really not that much different. There are physical manifestations that are going to last for a long time.

Also from a societal point of view I do believe that we need to go back and take a look at what just happened over the past year and a half. How did we react as a society? What things worked, what didn’t work, why didn’t some things work the way we wanted to? And ask those serious questions.

A lot of the issues aren’t necessarily scientific and medical issues. I think they’re more cultural and more social than they are anything to do with ‘How do we make vaccines?’ or ‘What are the protective things we need to do?” The scientific discoveries already occurred with that it’s mostly the cultural and social things that have the questions that need to be answered.

Fentem: The obvious follow-up question is: What questions are those that we need to be looking at culturally? I’m sure you’re thinking about vaccines, right?

Garza: Throughout the pandemic, there were always challenges with the counternarrative, whether that was “this is nothing more than the flu” or “these classes of drugs are going to work,” even though they’re definitively scientifically proven not to work. The whole issue of mask wearing, which put on a whole new political and social dynamic, even though without a doubt science had shown them to be effective. And the same thing with vaccines.

Fentem: Do you think that doctors and the health care industry as a whole underestimated that at the beginning?

Garza: I think we did, I really do. Fortunately, we don’t have a whole lot of experience with raging pandemics and how it’s going to be interpreted and how it’s going to affect societies and countries.

The advent of social media and things like that created a much greater challenge to try and protect the communities and encourage people to do the right things to protect and prevent spread. I think that’s what was underestimated.

Fentem: Let’s talk about what's going on in the hospitals right now. Who are you seeing coming into the hospitals right now, and is it a manageable caseload at the moment?

The last time we sort of snapped the line on this, it was something like 97% of people that were admitted to the hospital were unvaccinated. And it’s also a younger cohort of patients, which goes along with the narrative of vaccinations. I think it’s very frustrating and somewhat disappointing for health care workers to still be taking care of patients from this disease that by and large is almost universally preventable.

Fentem: The last question is related. We’re looking at vaccine hesitancy, and I’m hearing a lot about the variants approaching. Is it possible the two of those factors combined could take us back to last year? Is that something you’re worried about?

Garza: I do worry about that. I think it’s possible we’ll see an increase in younger patients, but probably not to the level we saw in the fall and winter. The challenge is when you look at what drives the pandemic, there’s a couple of things. One is the virus, how transmissible is the virus? If you throw in a new virus that’s more transmissible that causes more disease, that’s going to naturally cause more cases and hospitalizations. The second is: What sort of mitigation strategies do I have? Virtually all the mitigation strategies are gone now.

That’s why you’re seeing such a large proliferation of cases in places that are unvaccinated and have no public mitigation strategies. And you throw these variants in there ... it’s just science and math, there’s no magic to it. You’re introducing a virus that is highly virulent in a naïve population, it’s going to spread unless you take measures to prevent it from spreading.

Follow Sarah on Twitter:Petit_Smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.