HJAR Mar/Apr 2022

44 MAR / APR 2022 I  HEALTHCARE JOURNAL OF ARKANSAS SECRETARY’S CORNER or deciding not to return to the healthcare field. The state’s healthcare workers — from physicians and nurses to those who work behind the scenes to clean rooms and pre- pare meals — have done an extraordinary job to meet the demand of the pandemic. With bravery and sacrifice, they have stood suc- cessfully to face each successive wave of the pandemic and deliver the healthcare our citi- zens have required. In less than a year from the first confirmed case inArkansas, safe and effective COVID-19 vaccines became available. This has been a monumental achievement. Since vaccines became available, the ADH has worked to ensure equitable distribution and access to them as well as to increase vaccination rates in the state. Two vaccines, Pfizer-Bi- oNTech and Moderna, have been FDA ap- proved for use, while a third, Johnson and Johnson (Janssen), has emergency authori- zation for use. Since their development and release, these vaccines have demonstrated themselves to be safe and extremely effec- tive in preventing severe COVID-19 illness and death. Throughout their availability, the public has looked to ADH and healthcare workers for guidance as to vaccine use and as role models for their acceptance. TheADH has actively worked to educate Arkansans about COVID-19 vaccines, their safety, and their benefits. Additionally, it has provided up-to-date and timely recommendations for their use. COVID-19 vaccination has been a chal- lenge within the state since the initiation of the vaccination effort in December 2020. Initially, the prioritization of limited vac- cine supply was guided by the recommen- dations of the Centers for Disease Control and Prevention with state-specific modifica- tions as appropriate. TheADH has developed networks to distribute vaccines throughout the state and has created repositories in each of the public health regions of the state to store and distribute COVID-19 vaccines more efficiently. Today, COVID-19 vaccines are available in all corners of the state. Unfortunately, vaccine uptake has been a challenge with Arkansas lagging behind the national average of fully vaccinated individuals. Approximately 54% of Arkansans aged 5 years and older have been fully vaccinated as of late January. Only about 11% of children aged 5-11 have been fully vaccinated. An examination of the re- ported hospitalization and deaths since De- cember 2021 shows that greater than 95% of these have either not been vaccinated or not received the recommended booster dose for their age. As experience with the available COVID-19 vaccines has grown, it has been learned that a “booster”dose is required to provide the high- est degree of protection. This does not mean that the vaccines aren’t working — they are. This only means multiple doses are needed to get the maximum benefit. Finally, even if an individual has had a COVID-19 infection, it is important for them to get vaccinated. It is not known how long “natural immunity” lasts, or if it will provide adequate protec- tion against different strains of SARS-CoV-2. Aside from the immediate clinical effects of COVID-19 infection, there are longer-term complications that can affect patients and impact the state’s health system into the fu- ture. Some individuals who have had severe COVID-19 illness experience multiorgan ef- fects or autoimmune conditions with symp- toms that last for weeks or months following infection. The lungs, heart, kidneys, skin, and brain can be affected. Even adults and chil- dren who have had mild COVID-19 infection can suffer from “long COVID,” a syndrome that can persist for weeks tomonths after the acute infection has resolved. Myocarditis is 15 times more common in individuals hospital- ized with COVID-19 infection compared to those hospitalized for other reasons. The se- quela frommyocarditis may persist for a life- time. Recent reports have demonstrated an association between SARS-CoV-2 infection and diabetes in adults and children. Diabetes is a lifelong problem with many complica- tions. Data also suggest that COVID-19 may cause postinfectious encephalitis or inflam- mation in the brain. While there are challenges to be faced, it is important to remember that the pandemic has also brought favorable changes inArkan- sas. Programs such as COVID COMM and Pulsara have improved the response to pa- tient needs. The COVID-19ADHPHL’s testing capabilities have been expanded. Our elec- tronic data collection, information technol- ogy, and infrastructure has been updated. The ADH’s updated IT capabilities will allow staff to analyze data more efficiently than before. All these improvements will serve the citizens of Arkansas years into the future. There is no way to predict what is going to happen with the COVID-19 pandemic or when the next public health emergency will occur. However, the changes brought about so far during the COVID-19 pandemic will help improve public health and how the state’s healthcare systems respond to future health crises. The state’s healthcare system and citizens will need to be nimble and flex- ible to adapt and respond as needed. It is important for everyone to remember that Arkansans can rise to meet a challenge like this, but we can only do that if we all work together. n