What will our ‘new normal’ be after COVID-19? Experts predict what Idahoans can expect

Is it too soon to be talking about life after the pandemic?

Nearly 1 million vaccine doses have been administered in Idaho. More than 415,000 people in Idaho are fully vaccinated. Idaho is also slowly making progress on tackling inequities in vaccine access and uptake, especially among racial and ethnic minorities. Increasing numbers of Latinos, the state’s largest minority group and a community that bore a disproportionate share of the state’s cases for most of the pandemic’s course in Idaho, are getting the vaccine.

Our state and country still have quite a few hurdles left. More-contagious variants are spreading and seem to be transmitted more easily by younger people and children. Idahoans are still losing their lives every week to COVID-19, as the state recently surpassed 2,000 COVID-19 deaths.

The Idaho Statesman hosted a live Q&A on April 8 with two people who have been closely involved in health care during the pandemic.

Dr. David Pate spent a decade leading St. Luke’s Health System, the state’s largest health care provider. He now helps advise Gov. Brad Little on Idaho’s pandemic response. He blogs at drpatesblog.com — and you can find him on Twitter at @drpatesblog

Dr. Tommy Ahlquist is a former ER doctor, the CEO of BVA development and the co-founder of Crush The Curve Idaho, a nonprofit that got its start with COVID-19 testing but now helps arrange vaccine clinics. You can find him on Twitter at @TommyAhlquist

Here are a few highlights from the conversation with Pate and Ahlquist.

Q: Is it too soon to be talking about life after vaccination? Will we have another wave?

Dr. Tommy Ahlquist: Yes, we’re too soon. I think every time David and I talk, there’s so much good. I think the vaccine rollout has accelerated and we’ve been pleasantly surprised by so much good. There’s some problems, too … but we’re doing a really good job of getting that out there, but it’s just too soon. I think people are just so tired … and wanting to get back together so soon.

We’ve been saying all along, if we could have just waited … you know, there’s still people losing their lives. The percentage of people not vaccinated is still really high. Even if we can save another hundred lives in the next few months in Boise or our area, let’s just hold on a little longer. Now, the thing I would say that really frustrates me — and I said this this morning in my business meeting — is how has wearing a mask harmed me this last year? How is it really harming me if I’m asked by public health officials to hold on a little longer to social distance a little longer, to just be a little careful for my fellow man? So I think that’s what I would say, is we’re not there yet. I wish it wasn’t like it is. Vaccinations are going well, but we’re not there yet. Dave will talk a little bit more about these variants, I’m sure, but I wish we could hold on a little longer to save a few more lives.

Dr. David Pate: Yeah, I think Dr. Ahlquist has hit it on the head. We are close, we are getting to where we can see light at the end of the tunnel, but we’re still in the tunnel, and we shouldn’t get complacent. In fact, the very behavior that Dr. Ahlquist described, where people are just throwing up their hands saying, ‘I’m done with it,’ is what will actually make it more likely that we have another surge.

I’ve been predicting that we would have a fourth surge since February. Not because I have any magic ball to look into. But I’ve been looking at what’s happening across the rest of the world. I’m looking at what’s happening in Europe and they often precede us by several weeks or a month or so, and I’m seeing what’s happening there.

I think that we need to take this seriously. It’s just a couple more months. It’s this race of getting people vaccinated ahead of the growth in the variants. I was just concerned variants are going to beat us. So far, it looks like they’re going to beat us. But like everything in this pandemic, it’s always been in our control. It’s just whether we decide to exercise that control. We know how to stop this virus in its tracks, it’s are we willing? And that’s the big problem.

Ahlquist: The other reason to hold on a little longer is even though, if you come from a middle- or upper-middle-class family, you have friends and family that know how to navigate systems … you can navigate that wait list and how to sign up and you’re not nervous about signing up, you’re fine.

There are still a lot of people in this state that are disadvantaged. I mean, we spend a lot of our time at Crush The Curve meeting with those communities, trying to send out mobile units to them, to make it a little easier at their place of work to get vaccinated. But they’re not vaccinated yet, and they’re elderly, they’re at risk, and some of the places where they work are in confined spaces. They’re not there yet.

Q: Idaho Gov. Brad Little signed an executive order banning state agencies from requiring “vaccine passports.” What do you think about this order, and the concept of vaccine passports in general?

Ahlquist: I thought it was a political stunt. I think he’s rallying to his base because everyone’s freaking out. It’s the same people in our party saying I don’t want to comply with anything, “I don’t want to mask, I want my freedom, don’t tell me what to do.” Well, now we have vaccines available and logically lots of people are going to say, “Hey, if you are vaccinated, you’re going to have the ability to do things that people that aren’t vaccinated, aren’t.” That’s a medical thing, that’s a science thing. That’s not a political thing.

Pate: This is going to be driven by two things, particularly: Foreign countries and private businesses. If you have to have 80-90% of your restaurant filled to break even or make money and you depend on 90% of those people being seniors, and you don’t give them assurance, it’s going to hurt your business.

If it turns out that because Americans don’t take this seriously and we don’t control it and eventually, most of the rest of the world has, we’re going to face what we found before. There were a lot of countries that said, “We’re not taking people from the U.S.” or, “You’re going to have to have evidence of immunization to come.”

Q: Is it really so unprecedented to require certain vaccinations or immunizations?

Pate: No, it’s not. First of all, at a lot of schools, you have to show your vaccination record, or you have to give them an appropriate exemption. I can tell you in every health care organization I’ve worked for, I have to show evidence that I’ve had measles or if I can show that I’ve been vaccinated for it. If you want to travel, a lot of destinations require vaccines. There are a lot of countries that require yellow fever vaccine or other things so no, this is not unprecedented at all.

Do you have any advice for talking to friends and family who have concerns about getting a COVID-19 vaccine?

Ahlquist: Ask, first, this simple question: “What are your concerns, and why do you have them?” God gave us two ears, one mouth for a reason, and I think if you listen first, then you’ll understand where you’re starting from.

I found a lot of times where I’m starting is just really bad misinformation. The second I’m able to listen to where their concerns are coming from, I validate that concern and say, “Gosh, if that’s what you’re hearing, I can understand why you would be so nervous and upset.” Then, I kind of walk them through the science and with the real information.

Pate: There’s some people, you know you can spend the next two weeks talking to them and you’re not going to get anywhere. You need to know when to kind of cut your line and move on. I have that in my family. I have one person who was hesitant, and I was able to talk to her and alleviate her concerns. I’ve got other members of my family where I’m not going to waste my time, it is not going to happen. But I do think with those people, we still want to say: “Look, I understand, you’re not going to get it now. If later, what you’re seeing changes, if you’re starting to have thoughts about it, if you want to talk again, you just reach out to me and I’ll be happy to talk you through it, when you’re ready.”

Q: What will the new normal look like? Will the public ever be able to safely gather in large crowds unmasked again?

Ahlquist: If we can really vaccinate our population in Idaho and in the United States, if we do a really good job of getting as many people who will be vaccinated, vaccinated, you’re going to get back to a sense of normal — pending what the variants do, what they are like, and how sick they make us.

I’m very hopeful that by fall, if we really stick to this, we’re going to be able to gather in large groups and have some sense of normal and we’re watching football. But we’re in April and that’s a long ways away and a lot of it depends on our behavior.

Is it safe to get the vaccine if you are planning to get pregnant?

Pate: If you are planning or intending to get pregnant in the near future, go ahead and get vaccinated now. We know that’s perfectly safe.

The second thing is, we do know that when you’re pregnant you are at higher risk of worse outcomes for you and your baby, so it is important for you to get vaccinated. The growing evidence that we’re seeing is that this looks perfectly safe (to be vaccinated) during your pregnancy. Check with your obstetrician and see if you have any special circumstances, but my guess is your obstetrician will actually recommend for you to be vaccinated. We’re seeing additional benefits, like when women are vaccinated, it looks like — like with many other immune conditions — that the mother transfers antibodies to that newborn at least for the first several months.

Q: What do you think school will look like in the fall?

Ahlquist: The (Biden) administration has allocated large amounts of money to try to help people stay open and stay safe. I think you’ll see more testing early on, to try to do surveillance testing to make sure that when you do have an outbreak in a school that it’s tested and we shut it down. It’s kind of what we should have done last year, but we weren’t ready for it.

Pate: People don’t realize that we could have all the kids in school all this year. We could have, if we had planned last summer. I think we need to make some smart investments.

The other key thing is that I do think vaccines are going to come available for younger kids. We need those parents to take their kids and get them vaccinated, because that’s a great way to get us back in full-time school. We’ve got to get kids vaccinated to get ready for next year.

Is it safe to travel after getting the vaccine?

Pate: For the next couple of months, I wouldn’t be traveling just to travel. Now, the CDC says it’s OK to travel if you’re vaccinated. Yes, if you’re vaccinated, you’re gonna have a whole lot of protection. But, police officers that are wearing a bulletproof vest still try not to get shot at. So the same thing is, if you’re vaccinated, that’s wonderful. It’s going to give you a tremendous protection, but you still don’t want to put yourself in really high risk situations. I certainly don’t think this is a time for international travel.

Other highlights from the COVID-19 vaccine conversation:

Pate on whether Idaho and the country learned anything from battling COVID-19: I’ve been pandemic planning for 20 years or so … and I thought this national strategic stockpile was going to have everything we need. Dr. Ahlquist and I could sit here for the rest of the time of the show and name off viruses that could easily become pandemic, and have higher mortality rates. In a way, as horrific as this has been, we got off easy. There are viruses that have 10 times the mortality, 30 times the mortality, that COVID has. So the question is, while the Legislature is taking all these steps to make sure that we are not capable of taking a state response, or even a local response to the next pandemic, what if it is one of these really bad ones? I think the Legislature is incredibly foolish because they’re not serving the people. This is not putting us in a better spot.

Ahlquist on one of his biggest frustrations during the pandemic: I think we needed better clarity on messaging, because … it became a political battle that was really frustrating anyone in health care. We’re used to not being second-guessed on our intentions. For the first time in my lifetime, (people were saying) health care workers and doctors are falsifying records, or hospitals just want to get money. For people that were in the trenches, like a lot of my friends on the front line even in Blaine County at the start, they’re like, “I don’t understand this because I’ve never had my intentions questioned.” I blame that straight to the top. I think you look back now at tweets from then-President Trump and from his administration, they thrived on misinformation early and we never caught up from it.

Pate on how unvaccinated kids can impact others: It’s different with the variants and we have to understand that it’s almost like we have a new pandemic. We have a different virus now that we’re dealing with.

You get a lot more infections in kids with the UK variant than before, when the kids didn’t tend to transmit the virus so much. Until we can get kids vaccinated, they are going to continue to be part of spreading this. Kids are the big driver of influenza epidemics that we have every year through schools. So, if we can be really good in schools, if until we can get the kids vaccinated, if we can make sure they’re wearing masks, if we can make sure they’re distancing … If we can make sure there’s good hand washing, then we can control this.

Pate on lifestyle changes that he thinks he’ll retain after the pandemic: I now carry around sanitizer with me, that I didn’t do before. I’ve wondered if I will ever get back to shaking hands. I think there will probably be some circumstances where I probably will still mask on occasion, for particularly high-risk situations in the future, that I didn’t before. I may wear masks on airplanes from now on. We’ve seen what this does to decrease flu, so maybe I’ll wear a mask during flu season in the future, even after COVID-19 is not a concern.