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Capitol Insider: With Coronavirus Cases Spiking, Expectations Grow for "Dark Winter"

President-Elect, Oklahoma State Medical Association
Stillwater Medical
Mary S. Clarke, M.D.

New figures from the Oklahoma State Department of Health show the rapid rise of coronavirus cases is pushing the state into new territory. Over the last five days, the state has registered 11,100 new cases, including 2,667 on Friday, November 13th. The state's trend line in November is going practically straight up and the White House Coronavirus Task Force has issued a stern warning about the direction the state is heading with winter approaching. 

The President-Elect of the Oklahoma State Medical Association, Dr. Mary S. Clarke of Stillwater, discussed the increasingly troubling situation in Oklahoma, from a physician's perspective, with Dick Pryor and Shawn Ashley in this week's Capitol Insider.


Dick Pryor: This is Capitol Insider. I'm Dick Pryor with eCapitol news director Shawn Ashley. Coronavirus infections are sharply rising across Oklahoma with the holidays upcoming. Our guest is the president-elect of the Oklahoma State Medical Association, Dr. Mary Clarke. Thanks for taking time to visit with us.

Mary Clarke, M.D.: Thank you for having me on.

Shawn Ashley: Dr. Clarke, the two-week coronavirus case count has increased 76 percent. Friday saw 2,667 more cases, making more than 11,000 new cases in a week's time. What's happening in Oklahoma that's driving this big spike?

Mary Clarke, M.D.: There are a few things that have been all predicted that would happen. One is a little bit of mask fatigue. And I understand that. We have a lot of student and younger person's infections that are, that have gone up since we've decided to go back to in-person instruction in a lot of our cities. We have a lot of adults who are not currently following the recommended guidelines of masking up when they're in public, social distancing, etc.. And the thought that the younger population has the impression, “Well, if I get it, I won't have a serious illness, so it's really just not a big deal for me.” So multiple things are coming together to aggravate an already touchy situation at this point.

Dick Pryor: How would you characterize what's going on now compared to earlier this year?

Mary Clarke, M.D.: Well, back in the spring, we didn't have a lot of information, first of all, so because we knew there was a new virus that we could not really put our handle on, of how severe this was going to be, but we knew this was going to be extreme, with the basically shutting down of everything that limited exposure. And when you limit transmission, of course, the numbers drop. When we opened back up, when businesses were able to open up again, we had a mask ordinance – mask mandates were still in place to still decrease transmission because that was some information that we had early on that we were aware of that masking decreases the transmission rates.

When the mask ordinance began to expire that's when you started to see a little uptick in cases. And then the students went back to university and school, and then you really started seeing a significant uptick in cases from that point. That's also worsened the cases of death, because not necessarily the students are dying, but they're taking it back home to their parents and their grandparents and putting them at risk and that's where the transmission is really coming. So, we just shut everything down. That's pretty simple to limit transmission. Now we have better information. We don't need to do that. We just need to mask up and, you know, follow some simple social rules. But we're having a hard time doing that right now.

Shawn Ashley: Dr. Clark, how would you rate Oklahoma's response so far to the pandemic?

Mary Clarke, M.D.: Disappointing. From our standpoint, as far as physicians and the Oklahoma State Medical Association we’re quite disappointed at not just the people that are around us because we all have people who don't believe this is real, think it's just going to go away. It’s not as serious as people are saying. They don't believe the researchers. And we're disappointed a little bit in our elected officials.

We have some good things in place for surge plans initially, you know, in case we have problems with hospitalizations after the fact. But we're disappointed that we're not trying to prevent more. We're making sure there's enough hospital space after every woman gets sick instead of trying to prevent people getting sick. So that's been our biggest disappointment, I think, in some of our elected officials that the understanding is let's treat instead of prevent.

Dick Pryor: Governor Kevin Stitt and Commissioner of Health Dr. Lance Frye continue to assure people that if they get sick, there will be a hospital bed available. That's what you're talking about, that the methodology for handling the pandemic has been focusing on treatment and bed capacity more than prevention and mitigation. So, what would you like to see the state of Oklahoma do and shift its approach?

Mary Clarke, M.D.: We would like to see a combination of both. It does make perfect sense to have bed capacity surge plans in place, and, that is, that's reasonable and realistic. And the hospital associations are working hard to do that. However, you can't treat yourself a way out of a pandemic. You do have to have prevention measures in place just like any other significant pandemic. You need both.

Shawn Ashley: How much worse do health care professionals expect this situation to get with the holidays coming up?

Mary Clarke, M.D.: Terrible. A lot worse. It's hard to predict because no one's gone through a full winter season and holiday season yet and we're still looking at some of the other countries and what their numbers are, too. So, you know, everyone's looking at everybody else to a certain extent to see what those numbers are.

But if you want to take any example, I'm going to use flu. Flu does not really tick up until after Thanksgiving for most of the cases, most of the time, there are some exceptions to that rule, but most of the time, the vast majority of cases really start to pick up after the holidays, after your first big holiday, which is Thanksgiving. People go, they bring it back to different communities and it starts to spread like wildfire. So we fully expect to see large increases in numbers. Should we see large numbers of travel like we normally do in the holidays.

Dick Pryor: The White House Coronavirus Task Force's most recent state report says, and I quote, “the unyielding coronavirus spread across Oklahoma needs immediate action, including mask requirements, to decrease severity in morbidity and mortality among Oklahomans.” What is OSMA's position on mask mandates, shutdown orders or other government directives to control the spread of the virus?

Mary Clarke, M.D.: The OSMA position has always been mask mandate. Always. We have very staunchly recommended mask mandates from the beginning, knowing full well that as soon as once we saw the numbers start to creep up when the mask ordinance expired in June, we knew that the longer people were not wearing masks, the higher the numbers would be. So, from that point on, we have been very aggressive with the governor and his administration to require a mask ordinance, a statewide mask ordinance, and that he and his office have been very reluctant for that. And I understand that it's hard to make those decisions. We fully understand that we know how people can be. Modeling behavior and modeling computer programs don't probably need to make huge closures if everyone wears a mask. It's very simple. Doctors do it for 15 hours every single day, all day long. It is very safe and we know it works. So, wear a mask, try and get people in the hospital for those beds when we can.

Dick Pryor: What is your short and direct advice to people that want to think that a vaccine will be here soon and that it will handle the coronavirus?

Mary Clarke, M.D.:  Soon is relative. You know, how they're going to roll this out is going to be highest risk first because you can't vaccinate everybody all at one time. So, you have to do the highest risk first and that will be probably medical personnel, first responders, and then down the line. That may be a few months. Best case scenario, next group, maybe another few months beyond that. Next group, another few months beyond that. My general rule of thumb is probably six to 12 months for really general population, give or take. That that may be a little shorter, maybe a little longer. And I think that a vaccine and most of us, that's the only way we're going to get ahead of this.

Dick Pryor: Do you see a dark winter ahead?

Mary Clarke, M.D.: I try and be a pretty optimistic person for the most part, but right now, the numbers don't look very good. I have a lot of people who ask me, “Well, my family wants to get together, we always have a big Thanksgiving. What do you think? Should I go? I'm a little concerned.” My general opinion is if you are questioning whether you should go or not this season, the answer is no.

Dick Pryor: Dr. Mary Clarke, president-elect of the Oklahoma State Medical Association, thank you for sharing your insights with us.

Mary Clarke, M.D.: Thank you so much for the opportunity.

Dick Pryor: And that's Capitol Insider. If you have questions, e-mail us at news@kgou.org or contact us on Twitter @kgounews and @eCapitol. You can also find us online at kgou.org and eCapitol.net. Until next time with Shawn Ashley, I'm Dick Pryor.

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