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