Rotary Club: Dr. Beverly Jordan discusses COVID-19 vaccines

Dr. Beverly Jordan discussed COVID-19 and the vaccine with the Enterprise Rotary Club on Jan. 26.

Jordan – who is a physician at Professional Medical Associates in Enterprise – went over many of the risk factors involved with COVID-19 and went into great detail about the COVID-19 vaccines and issues surrounding the distribution.

Jordan started by pointing out one solid fact involving Coffee County and COVID-19 being that the county has had a 1.3 percent fatality rate in regards to COVID-19, which is slightly below the national rate and virtually the same as the state rate.

“That means we’re holding the state and national averages, which is a really good thing,” Jordan emphasized. “The hospitals are crowded and full but we are doing the best we can, which is exactly why it is important you have excellent local medical care.”

Jordan said that Alabama has begun to look like doctors feared it could look last spring with the fear of hospitals becoming overcrowded like they had in other parts of the country.

“We have not been able to transfer patients in a timely manner to outside hospitals since Thanksgiving,” Jordan said. “Last week one of my partners transferred a patient to Indiana because that was the closest open bed we could find.

“We look like what New York looked like in March. We don’t have beds and we’re doing the very best we can. Luckily we have good medical staff that can deal with very sick patients because we’ve been doing that for a very long time here.”

Another benefit for Jordan and other local doctors is that Alabama has two major resources in the state in regards to infectious disease.

“We talk routinely with the experts in Montgomery and Birmingham. There is a pulmonologist in Montgomery and an infectious disease expert in Birmingham who are major (World Health Organization) and (Centers for Disease Control and Prevention) players in infectious disease,” Jordan emphasized. “They have really kept us on top of current treatments.

“We are doing the exact same things here as they are doing in Birmingham or any other major hospital facility and that is a very good thing. We can’t always say that.”

When it comes to treatments, Jordan said there are really three treatment categories. The first would be patients that have COVID-19 but are not having severe symptoms and that treatment involves simply administering vitamins and monitoring the patient’s progress.

The second category includes patients that are sick enough to be treated but not sick enough to be hospitalized. Jordan said those patients can receive a monoclonal antibody shot called Bamlanivimab, which Jordan and her associates refer to as the Bama Slam Shot. This shot includes man-made COVID-19 antibodies that are similar to the antibodies found in patients that have recovered from COVID-19.

“There is plenty of it and it greatly reduces the need to go into the hospital and speeds up the recovery,” Jordan said of the Bama Slam Shot. “There is a very strict protocol of who can get it and who can’t. We don’t want to use it on people that don’t need it and if your patient is too sick it makes them sicker.”

The third category includes patients that are required to be hospitalized. The treatment for those patients involves a drug used in the treatment of HIV that is given in five doses over the course of five days.

Jordan also said that a big question that continues to arise is people questioning whether many of the deaths attributed to COVID-19 are as a result of the virus rather than an illness many patients already had. While Jordan says that stats aren’t perfect, it is clear that these deaths are a result of the virus.

“The way COVID kills you is the body mounts too good of an immune response and turns on itself and kilts its own organs,” Jordan explained. “When that happens you go into what we call the Cytokine Storm.

“It attacks all your organs and you go into multisystem organ failure. If your organs were already at risk you don’t have the reserve a healthy 20 year old has, so that attacking itself will send you over the edge much quicker.”

Jordan briefly discussed mask wearing and said that while the topic may have become political, the science is not in question.

“A mask is part of the methodology to diminish the risk (of spreading the virus,” she said. “It isn’t perfect by any means and perfection is really unachievable.

“The best protection from the mask is if both people are wearing the mask but if one person is wearing it, then the other person is protected from you.

“Wearing your mask diminishes the particles you are spreading around. It is not 100 percent effect but it is clearly effective and there is tons of data that shows that. It has become a very political and controversial thing, but the science is very clear and has just been politicized.”

While the rollout of the COVID-19 vaccine in Alabama has been frustrating, Jordan pointed out that each state receives a number of vaccines based on the state’s population. Alabama has 1.4 percent of the country’s population, so Alabama receives 1.4 percent of the doses distributed each week.

Jordan also pointed out that the phases the state has gone with for who can receive the vaccines first is based on science and is broken down into two categories.

“It is a very scientific process and is based on balancing prevention of morbidity and fatality and keeping the country open and society functioning,” Jordan said.

People over the age of 75 are 30 times more likely to die from COVID-19 than if those in the 35-55 age group. Those in the 65-75 range are eight times more likely than those in the 35-55 age group.

“That’s huge. That is a huge increased risk of fatality,” Jordan said.

That is the reason that the first group to receive the vaccines were those over the age of 75 – because of the high risk of fatality – and healthcare workers, to keep society moving forward.

Another frustrating thing for residents has been the fact that many people not in either of the categories that are supposed to be receiving the vaccine have managed to get vaccines early on.

Both the Moderna and Pfizer vaccines must be administered within six hours of a vial being pierced, so if a healthcare provider runs out of individuals to give the vaccine to they begin searching for anyone willing to take it so as to not waste a precious resource.

“Once you pierce the vial you have those six hours to get rid of it. This is how people that aren’t in the right category are getting the vaccine,” Jordan said. “Say I have 10 people lined up once I pierced my vial and Little Johnny doesn’t show up and I have one shot left. I have to figure out what I’m doing doing with it.

“Any living participant gets it then. This is how people are getting extra vaccine.”

The Pfizer vaccine is required to be purchased by 975-dose orders, while Moderna can be purchased by 100 doses. Also, Pfizer is required to be stored at -15 degrees Celsius – only 15 sites in the entire state can store it at that temperature – and Moderna’s vaccine can be stored at just 2-8 degrees Celsius.

In recent weeks the way that neighboring states have been delivering vaccines has become a big talking point as both Georgia and Florida have been administering it to anyone that wants the drug rather than following CDC guidelines.

“(Florida Governor Ron) DeSantis has the politics and the national clout to say, ‘Screw you,’ and do whatever he wants to do with the vaccines and that is exactly what he did and no one is going to do anything about it,” Jordan said. “Everyone in Florida can get the vaccine but not a lot has been said about the fact that a lot of 80-year-old people have been waiting in hot cars or waiting in line for hours to get a vaccine. It hasn’t been as pretty as the media has polished it up to be.”

Another issue has involved those in Alabama that have traveled to Florida to receive their first dose of the vaccine but now Florida has changed its policy requiring a Florida driver’s license to receive it.

“So, all of our people that were driving to the Panhandle to get their vaccine now will need to get their second dose in Alabama,” Jordan said. “So, that may prolong things here to get all of those people their second doses, too.”

Jordan said that Coffee County has four locations that have received the vaccine, which includes the Coffee County Health Department, Medical Center Enterprise, the SARHA Clinic in Enterprise and Professional Medical Associates in Enterprise. While MCE is only giving the vaccine to medical workers, the other three are going strictly by the Alabama Department of Public Health and CDC guidelines, but said that is important that those wanting the vaccine let it be known that they want to be on the list to receive in case they have extras to give out.

“We are going by the guidelines but most of us also have a running list of people to call if we have excess vaccine,” Jordan said. “Talk to your doctor’s office about getting on the list if you don’t meet the current criteria (to receive the vaccine).”

While Jordan and other healthcare workers have acknowledged that many more people appear to be willing to take the vaccine than was originally expected, there are still a number of people apprehensive about taking a vaccine that is thought to have been “rushed through” the process of being approved.

Jordan points out that the Pfizer and Moderna vaccines are MRNA vaccines, which have been in development for years to treat various viruses.

“They have been in development for two decades but the problem is that (MRNA vaccines) are so expensive that we never use them in vaccine production due to cost,” she said. “We threw every bit of money we could at (a vaccine) because we realized the fatality rate was so high. So, we quickly moved on (finding a vaccine).

“The science has been there for two decades, so it isn’t that new or scary.”

Jordan said that the narrative that the trial phase was bypassed or skipped simply isn’t true either.

“There was a lot of talk about skipping through the trial phases but that isn’t really what they did,” she said. “We went through the processes but each process typically has gaps in between each phase for really no reason. What we did was skip those gaps.

“The final phase is where we try it on mass groups and the government came in and agreed to buy it whether it worked or not. So, what that did was allow production to begin during that final phase to speed up the process so once it was approved it was ready to begin to be distributed. From a safety aspect there really is nothing risky about the speed (that it was approved).”

A potential game changer for COVID-19 vaccines is the upcoming Johnson and Johnson COVID-19 vaccine that will require just one dose.

“It will be a completely different vaccine. It is one dose and is similarly made to the current flu vaccine,” Jordan said. “The rumor is that they are set to go to the FDA for emergency approval sometime in February.

“The other two were approved in under two weeks, so Johnson and Johnson says that if they are approved by the end of February we will have a significant amount of vaccine by April.”