Aug. 24, 2021
Dear Members of the Baylor College of Medicine Community,
As we all deserve a little good news, let us start there. This week the COVID-19 vaccine produced by Pfizer-BioNTech received its full, unqualified FDA approval, like every other medication routinely prescribed by your doctor. Starting now, it is no longer "the Pfizer vaccine," but will be known by a name that will tax many of our pronunciation skills: Comirnaty.
Apparently, this is intended to be some sort of combination of "COVID-19, mRNA, community, and immunity." (The generic name is tozinameran). Love or hate the name, full approval is a big deal. While many remain unvaccinated for a variety of reasons, a substantial percentage say they want to "wait and see." They can be influenced. Several have cited the Emergency Use Authorization (EUA) as their reason not to be immunized. With that concern off the table, let us hope this is the impetus for many of them to become fully vaccinated.
A second major benefit to full vaccination will be an increase in employer vaccination requirements. Even under EUA the courts and regulatory bodies have made it clear that employers can legally require vaccination of employees, but to date these requirements have largely been limited to healthcare organizations.
Over the next few weeks, we will see a broader array of businesses, schools, and human services organizations require vaccination of employees. In a tight labor market, organizations will need to be mindful of the impact this might have on their ability to recruit and retain staff. Others will make a judgment – sometimes based on civic duty, sometimes out of concern for employee welfare, sometimes based on a perceived competitive advantage – to vaccinate their people.
Ask yourself the question: Are you more likely to patronize a daycare center, coffee shop, restaurant, or department store if you know the staff is fully vaccinated? For me, the answer is clear. I will actively work to reward organizations with a strong and public commitment to viral control practices with my business.
An additional benefit I do not hear discussed is advertising. Now that Comirnaty is off EUA, I believe Pfizer is free to actively market the vaccine. Can a prime-time commercial with a catchy jingle set to the tune of an iconic 1970s soft rock classic be far behind? As annoying as I find most drug company advertising, in this case, I welcome the marketing dollars that will help drive a well-crafted vaccination message to the country.
Comirnaty (tozinameran) approval is very good news.
Bad news. We are still on the wrong side of the worst wave of the pandemic to date. By the end of last week in the Greater Houston Area, we were experiencing an average of almost 5,000 confirmed cases per day, the highest level of community disease burden we have seen in the entire pandemic. Texas Medical Center facilities are admitting an average of 390 COVID-19 patients per day, also the highest rate of admissions seen since the pandemic's start. Hospitals and the medical teams caring for these patients have done an impressive job flexing up to meet the demand. Staffing – particularly nurse staffing – remains the single biggest problem. We are a year and a half into this crisis. Healthcare workers aren't running on adrenaline; they are running on fumes. The strain is taking its toll on nurses, physicians, and other staff.
Although still rising, there is some suggestion the rate of rise is starting to slow. Projections from the Institute for Health Metrics and Evaluation (IHME) predict a peak in hospital resource use this week, which we all hope is true. Keep in mind, once we peak, we are still at least 4-6 weeks from returning to some semblance of normal operations.
This brings me to the topic of serious concern: Return to school.
This week, Dr. Klotman and the CEOs of many of the major health systems of the Texas Medical Center wrote an open letter to Houston and the surrounding communities. The letter summarizes critical back-to-school recommendations from health care leaders who are advised by leading epidemiologists, virologists, vaccinololgists, infectious disease specialists, other specialists, and scientists. The letter contains serious recommendations based on the current state of our knowledge. The recommendations are solid and practical.
I strongly encourage you to download the document. Read it, copy it, share it, discuss it. I will not repeat the contents here, but in summary it states we can open schools safely if parents, schools, and communities actively collaborate around proven viral control practices. Absent safe practices, we are inviting viral spread, and a prolongation of the current wave. I am encouraged to see more and more school systems adopt best practices.
Things will likely get worse before they get better, but we still have the tools to get us through this crisis. Hang in there, take care of yourself, and take care of each other.
James T McDeavitt, M.D.
Executive Vice President and Dean of Clinical Affairs
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