Kentucky will continue to see coronavirus surges from time to time, and because Covid-19 still has the potential to overwhelm the health-care system, it's too early to start treating it as just another infection to live with, state Health Commissioner Steven Stack told Kentucky Health News in an interview.
"Covid is here to stay," Stack said. "I think the sooner people acknowledge that, the better off we'll be, but it's still premature to just try to mainstream it as if it were like any other condition, because it still has the very real potential to swamp hospitals." That is "a threat not only to people who become infected with Covid, but also to every other person in society" who needs a hospital.
"It's not yet time to say that it is just a regular part of our daily lives because it isn't," he added. "It will cause problems that the common cold and influenza don't typically cause, but we have to accept the fact that our behaviors will matter and the choices we make will determine how quickly we can normalize this and not have it be so exceptional."
One of those behaviors is getting a Covid-19 vaccine, but a substantial number of people say in polls that they will never get one, no matter what.
Stack said that ultimately, society will need to "normalize the expectation" that getting the Covid-19 vaccine is "something all of us have to do," just like we have to follow the rules of the road when we drive an automobile.
"The adverse consequences of the pandemic are being extended because there are still too many people vulnerable to its worst impact," and those aren't just the unvaccinated, he said. "When those consequences compromise the safety and well being of whole communities and larger populations, it is still a very much a societal need to work on this."
Right now, Stack said, the messaging to get hold-outs vaccinated must come from people that they personally trust and respect, like local leaders. He came to the interview just after a conference call with Gov. Andy Beshear and 121 county judge-executives and mayors. They have such a call every two weeks or so, according to the Cabinet for Health and Family Services.
Stack said he didn't have specific numbers for how many unvaccinated Kentuckians are firmly resistant to all messages, even from people they trust, but he said Kentucky is a conservative state and its vaccination rates are lower than many other states, so such resistance is probably strong.
"We have work to do, and we have to continue to try, because giving up is just not an option," he said. "The consequences are too substantial. I mean, literally, people's health, wellness and lives are potentially in the balance if we don't find a way to get through this."
In October, 27% of U.S. adults in the Kaiser Family Foundation Covid-19 Vaccine Monitor poll said they had not gotten a Covid-19 vaccine, and 60% of those identified themselves as Republican or Republican-leaning and 17% called themselves Democrats or Democratic-leaning.
Only 5% of those polled said they will "wait and see" before getting vaccinated, a share that has steadily declined since the survey was first taken in December 2020, when 39% said so. Four percent said they would only get a shot if it is required, and 16% said they would "definitely not," a share that has held steady throughout the polling.
According to the Centers for Disease Control and Prevention, 60.5% of Kentucky's eligible population is fully vaccinated; and less than half of the total population in 67 Kentucky counties have received at least one dose of a vaccine. Becker's Hospital Review ranks Kentucky 36th among the states and Washington, D.C., for the number of people fully vaccinated.
Stack agreed with President Joe Biden and others who have said the pandemic is now driven by people who are unvaccinated, but said, "It doesn't really serve us well to castigate and scold and lecture people and tell them that they are wrong. That's not the way to persuade people."
And as he's said before, we have mastered the science of why such vaccines are necessary, but we haven't mastered human behavior, or the sociology of it.
"And that's a tale as old as time," he said. Drawing on his love of classical literature, he said reading Greek poet Homer's The Iliad and The Odyssey to find "that behavior has been alive and well in the human population for a very long time."
One of the many challenges public-health officials face is behavior influenced by the plethora of Covid-19 vaccine misinformation on social media. To that end, Stack's advice is to "unplug" from all of it regularly.
"I think we would find we would still know all of the stuff that's really important and we would be less revved up and less polarized to see each other as enemies, instead of fellow members of our community," he said.
One key recommendation for getting Kentuckians vaccinated is easy access, a challenge for families of some youth, since most of the state's pediatric offices don't offer the vaccine at this time.
Stack acknowledged that's a challenge in a convenience-driven society, he said more than 1,600 registered vaccination sites across the state give plenty of access, and that he expects more pediatricians to start offering vaccines, especially with them now approved for children five and older.
At the end of the interview, Stack was asked what has surprised, disappointed and frustrated him most in the pandemic.
He said he's been surprised that despite all of the negative comments about the state's efforts, "Hands down, 99% of what I've received has been positive." He said when he runs into folks in public, "They always have said, 'Thank you.' They've always had a smile on their face."
"As far as disappointed, it's just that we haven't found, despite all of our efforts, a way to take what unites and focus on that, instead of what divides us. I mean, we are waging a war with ourselves, where we have taken a very simple tool that works -- the vaccination -- and made it into an identity statement, whether or not I'm going to accept it. So I'm disappointed that humanity still hasn't found a way to rise above Homer or Shakespeare, or any of these others who have described it so well."