COVID-19: The definition of fully vaccinated ‘needs to be changed,’ doctor says

Dr. Owais Durrani, Emergency Medicine Physician, joins Yahoo Finance Live to discuss including the booster shot in definitions of being fully vaccinated, monitoring and testing for potential COVID symptoms, transmissibility in hospitals for non-COVID patients, and the outlook on variant case numbers.

Video Transcript

- Let's bring in our next guest now for more on this topic. Dr. Owais Durrani is an emergency medicine physician based in Texas. Dr. Durrani, thank you so much for your time. You heard Anjalee talking about these latest booster shot data coming out from the CDC. Are these findings that booster shots have been highly effective against hospitalizations related to Omicron consistent with what you've been seeing in terms of who, as patients, are coming in with COVID, and whether they've been vaccinated or boosted or not?

OWAIS DURRANI: Absolutely. I could probably count on one hand the number of patients I've admitted to the hospital that were boosted over the last two months or so. None of them needed to be intubated. They were all in the hospital for a few days and then discharged. The vast majority of patients that I'm admitting that need intubation or high levels of oxygen are all patients that are either unvaccinated, or they got two shots and they're months out-- seven, eight months out from those two shots.

And so right now, it is more clear than ever that three shots is what we need. The FDA and CDC have data that supports that. We have data from across the globe that supports that. And the definition of fully vaccinated needs to be changed to that.

Right now, when patients come in and I ask them, are you fully vaccinated? They'll say, yes, but they, as I mentioned, may have done that second shot eight months ago. And so they're not really protected at the levels that we need them to be protected with. If the CDC and FDA change those guidances, it's going to help me convince those patients to get a booster, and help them think of a booster something that's going to be a sequence in that vaccination schedule, rather than something that's a bonus, which is what we've kind of made it out to be over the last few months.

ADAM SHAPIRO: Doctor, I want to ask you a question that I think lots of Americans over the age of 40 deal with every day at 6:00 AM. It sound like we're possessed by our grandparents, with the coughing and hacking and the morning noises that gross everyone out. But you might think to yourself, I got a sniffle. I got the cough. Am I ill?

And then a decision has to be made at that moment. Do I proceed, you know? Do I go to work today? Because a lot of people there are hybrid office settings.

In the old world, you'd go. But today, that doesn't necessarily mean you have COVID. So is there a number of questions we should ask ourselves before we make that final decision?

OWAIS DURRANI: Yeah. That kind of sounds like me some mornings, too, even though I'm not over 40. The short answer is you need to stay at home until you have a negative COVID test. With how much COVID transmission there is and Omicron transmission there is in our communities, it's safe to assume that it's COVID until proven otherwise. Now, unfortunately, all of us don't have readily available testing. And so that's going to require some legwork in terms of calling your primary care doctor's office, seeing if there's community testing sites around you, seeing if a friend has an extra test that you could borrow, whatever the case may be.

But right now, I tell my patients and anyone who asks me this question-- safe to say that you have COVID until proven otherwise. Maybe in a month or two months when that transmission level drops to under 10%, the answer to that will be different. But right now, assume you have it.

EMILY MCCORMICK: Dr. Durrani, the CDC also reported that there are steep declines being seen right now in COVID cases in New York and in the Northeast at large. What are you seeing right now in Texas and in the South? And do you feel that cases are getting to the point of plateauing, or are you past that peak?

OWAIS DURRANI: Yeah, so we're seeing some initial data here in Texas where we have a decrease in the number of cases. Now, there have been some delays in reporting case numbers. So we'll need to follow those trends. But when I go into the emergency department, it still feels like we're in the thick of it. And that's because anything hospital-related is going to be lagging from case numbers. So I'm still seeing patients that are admitted to the ICU still boarding in the emergency department.

We're still having issues transferring patients into our hospitals from rural areas that need the specialist care available in places like Houston. We are still seeing waiting room times that are 8, 12, 15 hours. And so right now, I still urge everyone to be cautious. You don't want to get COVID. You don't want to break an ankle, because that's going to be a 15-hour ER visit. You want to stay away from hospitals as much as possible and be as cautious as possible, because right now is not the time to be sick.

ADAM SHAPIRO: The vast majority of those beds-- you're telling us are those who are not vaccinated with COVID?

OWAIS DURRANI: So yeah. The COVID patients that are waiting for beds, yes. A majority of them are either unvaccinated with COVID, they're either severely immunocompromised with things like cancer or transplant patients that unfortunately are not going to get that robust immune response, or they're kids.

EMILY MCCORMICK: You mentioned those 8, 12, 15-hour waits for ER visits. What has the staffing situation been like where you're practicing at, and at hospitals in your region?

OWAIS DURRANI: Yeah. We've really been strained for staffing. We have a skeleton nursing staff. Many doctors are out sick, and so we're all having to pick up extra shifts to fill in those areas. You can come to the ER for, say, an upset stomach. That's no big deal.

But then, you know, I'm examining patients in the waiting room. I'm ordering tests, and they're getting their blood work drawn in the waiting room. They are sitting in the waiting room for hours, and even if they don't have COVID, they may be sitting next to someone who does. And they may be positive a few days after that visit. And so the staffing shortages and the surge in patients that we're seeing are coming at the worst time possible, and leading to these situations.

ADAM SHAPIRO: Doctor, looking ahead, because we realize how much work people like you and the other medics and staffs at hospitals are doing-- a year or two years from now, is it going to be hard to get hospital staffs back up to where they need to be? Are people going to be so burned out that they might not even want to consider a future in medical care?

OWAIS DURRANI: You know, I hope not. I went into medicine, and so many nurses, respiratory technicians, others went into medicine because it's a fulfilling field. This pandemic is a once-in-a-generation kind of thing. There are already flaws when it came to health care workers not getting care for mental health and things like burnout. And it's been magnified by this pandemic.

And so I hope that once we're out of this crisis mode, hospital systems and medical schools and all levels of the health care system will address a lot of these issues and put into place mechanisms that allow us to get a break when needed, allow us to get mental health for those that need it, allow us to have in place paid sick leave for those who don't. And I think putting those things into place-- if we do those, we'll bring people back into the healthcare workforce. Because it is such a fulfilling field when done right.

EMILY MCCORMICK: There have been some early reports emerging that Omicron may mark a turning point in the pandemic in that once we get past this point, we may see this become something more endemic rather than as a pandemic. What's your view on that, as someone working in this field and who has been working in this field over the course of the entirety of this pandemic?

OWAIS DURRANI: Yeah. If there's one thing that I've learned throughout this pandemic is to not make bold predictions. And I've been humbled time after time. And so I hope that's the case, but I'm really cautious about that. Now, when you look at just simple biology, viruses mutate. That's normal. And they mutate down the path of least resistance.

Omicron is so transmissible that it becoming potentially more transmissible wouldn't really benefit it, because it is the dominant variant. So when you look at it from kind of that simple biology, evolutionary 101 point of view, that makes sense. That being said, we've had so many curveballs throughout this pandemic that I don't want to hang my hang my head on that and just assume that's going to happen. I really hope that once we get through this kind of crisis phase of Omicron, we don't simply go back to, you know, this is over and things are going to be fine. We really need to focus on ensuring we get the globe vaccinated, that we decrease transmission, and so that we don't get another variant that may be more transmissible, or more severe, or both.

EMILY MCCORMICK: All right, we'll leave it there. Dr. Owais Durrani is an emergency medicine physician in Texas, and we thank you so much for your time this afternoon.

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