Black touts vaccination effort while urging residents to remain cautious

Health Officer Dr. Brad Black expressed optimism about the steadily decreasing COVID-19 case numbers locally, but warned residents to stay vigilant in the face of new variants of the coronavirus.

“You just don’t know what will happen in Montana going forward, but we’re seeing a definite drop in the number of cases of coronavirus,” Black said during a Feb. 9 meeting of the Lincoln County Health Board. “I guess the real concern is the variants, the mutations moving our way.”

Active cases of COVID-19 have fallen to 35 as of Feb. 15 down from highs in November. Cases also have dropped statewide in the same period. That left Black feeling pretty good about the county’s situation, though he recommended residents stay the course on mitigation efforts, like donning face masks and socially distancing.

“I feel like we’re headed in a good direction,” he told the health board. “I want to see the light there [at the end of the tunnel] and I think I do, and we’ll keep moving on this.”

Montana has thus far remained free from the new coronavirus strains circulating in the U.S., according to the Centers for Disease Control and Prevention. That leaves health workers in a race to vaccinate as many people as possible before the variants begin circulating in the population, Black said.

Of particular concern to Black is the B.1.1.7 strain, first detected in the U.K. According to The New York Times, the mutations in that strain have changed the spike on the coronavirus that it uses to attach to human cells. The mutation leaves the virus better suited to grab hold of a cell and infect it.

The strain is much more contagious than the type of coronavirus already in circulation and researchers worry it could prove deadlier, though that remains under study. Its emergence in the U.K. led to a new round of shutdowns and other pandemic restrictions in the European nation.

Another variant, first seen in South Africa, has been shown to limit the effectiveness of vaccines. Researchers also found evidence that individuals who already weathered one bout of COVID-19 became reinfected with this strain, known as B.1.351, according to the Washington Post.

But for Black, the concern rests with B.1.1.7 strain, which led to a surge in hospitalizations in the U.K. According to the CDC, the strain has racked up 981 cases in 37 states, including nearby Washington state and Wyoming.

“It will be a race against B.1.1.7 and how fast it transmits in our country,” Black told the health board. “The potential is it could create another big surge. The vaccine is very effective against it.”

Black’s push for vaccinations, though, drew criticism from member Debra Armstrong, who represents Eureka on the health board. Armstrong has in the past raised concerns with the FDA-authorized coronavirus vaccines and pushed back on Black’s efforts to promote the measure.

“I think in this situation we’re getting a little bit ahead of the science,” said Armstrong, who asked that a letter from a cardiothoracic surgeon warning about potential side-effects be added to the meeting minutes.

“I just wanted to reiterate for everybody that the vaccines that are out are under emergency use authorization,” she said. “They’re not FDA approved and they’re not approved because they haven’t met the stringent FDA guidelines.”

Officials at all levels of government, from Black to national experts like Dr. Anthony Fauci, have praised vaccination as both safe and effective. Writing recently in the Harvard Health Blog, Dr. Robert H. Shmerling touted the vaccines as boasting effectiveness above that of the annual flu shot, for example. Shmerling previously worked as clinical chief at Beth Israel Deaconess Medical Center in Boston.

The most common side effects from the vaccine include pain at the site of injection, swollen lymph nodes, tiredness, fever, headache, muscle or joint aches, chills, and nausea or vomiting. Severe allergic reactions can occur, but Shmerling deemed it rare. Based on CDC data, there are about 11 cases per million doses for the Pfizer vaccine, for example, he wrote.

“The signs are trouble breathing, swelling of the face and throat, rash and low blood pressure,” Shmerling wrote. “It usually occurs soon after vaccination, and can be treated with epinephrine (as in an EpiPen). That’s why people are observed for at least 15 minutes after receiving the vaccine with epinephrine at the ready.”

As for deaths attributed to the vaccine, Shmerling said they need further investigation. As with other conditions that emerge after vaccination, it may be unrelated.

“A fatal blood disorder suffered by a Florida physician two weeks after receiving a COVID-19 vaccine raised concerns that it was triggered by the vaccine,” he wrote. “Authorities are investigating this and similar cases. This condition did not occur among the tens of thousands of clinical trial subjects, so it might be a complete coincidence.”

Back at the health board, Chair Jan Ivers thanked Armstrong for her message and said that officials would buttress any recommendations for vaccinations by urging residents to check with their primary care providers.

That elicited a bit of frustration from County Commissioner Josh Letcher (D-3), that group’s representative to the board. He agreed that residents should check with their providers first, but questioned the board’s focus on the vaccines.

“I completely agree it’s a personal choice that people should take up with a health care provider,” he said. “Why are we not having these same conversations about supplements and vitamins? They’ve been shut down. We don’t talk about those things.”

Residents attending the meeting urged health board members to drop the vaccine talk. During the public comment portion, which preceded Black’s report, Trego resident Catherine Kahle described the vaccines as a health risk.

Fellow north Lincoln County resident Diane Watson called for the board to ensure people were warned about potential side effects, including death, prior to getting vaccinated.

“There is quite a growing number of people who are experiencing adverse effects and quite a few elderly who are dying after receiving this biological, experimental device,” she said. “It would be good to have a response from the board on how informed consent is being conducted.”

Both Kahle and Watson have previously lobbied the health board and other county officials to reject the vaccine. Kahle, a leader of a group of residents who pushed commissioners to disband the health board last year, has long falsely claimed the vaccine will alter the DNA of those who receive it.

Black said his focus would continue to be on vaccinations.

“I think we’ve got to realize we’re probably still a ways away from where we want to be with vaccines,” he said. “It’ll be a few months anyway. I hope in Lincoln County it will be better than that. We’re working hard to get the vaccine.”