Q&A: Dr. Anil Vaidian

Dr. Anil Vaidian, the Dutchess County health commissioner, spoke with Senior Editor Leonard Sparks on Wednesday (Nov. 18). His responses have been condensed.

Dr. Vaidian

Dr. Anil Vaidian

We’ve seen an uptick in cases in Dutchess and the Mid-Hudson Valley counties. Are you concerned?
Yes, but it was not unexpected. When the pandemic arrived on our shores, there were a lot of things that we didn’t understand about its dynamics, such as how infectious it was. But those of us in public health understand from history how pandemics behave. They tend to be multi-modal, meaning they have multiple peaks. When you look at other pandemics, the second wave tends to have a greater magnitude and scope. In the spring, people in public health were warning: The fall is coming, winter is coming, we have to be prepared.

What is happening now is that people are congregating indoors, and there are more opportunities to run into people who may be infectious. When a cluster of infections is identified, we’re fairly quick in our response, so we’re not seeing them spilling over into the community. We’re also seeing people getting fatigued [with the restrictions] and becoming lax. This is what I’ve heard from my contact investigators. People are getting together for parties, to watch football and so on.

We’ve talked so much about bubbles, but people are starting to broaden their social circles. You can have a small core, but if one person in that cohort has another network… If you introduce a pathogen into the network, over time it’s going to filter through pretty much everybody. People can restrict the number of people they come into contact with, but how well is that network insulated?

What, if anything, can be done to convince those who believe COVID is a hoax or a plot that isn’t real and dangerous?
That’s a tough one. When someone is so entrenched in a particular view, you will be met by equal force. It’s an ongoing conversation; there’s no point arguing with somebody about things that they’re so fixed on. At the end of the day, what’s important is that you’re responsible for yourself. You’re responsible for your actions, and your actions go a long way toward whether this virus gets into your household or reaches your loved ones.

When you talk about trying to limit community spread, what kinds of things should people be doing, especially as we approach Thanksgiving?
I don’t want to tell people, “OK, if you do this, you’re going to be protected.” It’s very, very infectious, and you can have young people who are totally asymptomatic and pass it on. When people congregate for a family gathering, you have no assurances what your brother or sister, who you haven’t seen, has been doing, and whether they’ve been exposed. These types of gatherings are driving the numbers.

Is it safe to do routine shopping and errands?
Risk is not dichotomous, meaning it’s either no risk and lots of risk. Each measure that you employ reduces the risk. I plan my shopping. I go off-hours. I go late. I go at times when other people are not there. For the most part, New Yorkers have been wonderful in terms of trying to adhere to the guidance, yet we still see community transmission. I cannot stress enough the importance of mask-wearing. This is one of the best things you can do in terms of being able to have normal types of activities.

What populations are included in the Dutchess count? For example, are prisoners at Fishkill Correctional Facility included, or students at Marist?
Yes, but we break out the cases to explain blips or increases. The number of cases may just be the tip of the iceberg because people usually don’t get tested unless they’re curious or they’re symptomatic. There may be an undercurrent of cases in the community. Still, the numbers are valuable because they give you a sense of the trends. That’s how we know that what’s driving the numbers is community spread because we are able to tease it out. It’s not from a nursing home; it’s not from a college; it’s not from a correctional facility.

Are the number of cases still a good indicator of coming hospitalizations and deaths?
If you look at the rest of the country, whenever you see cases go up, there is a lag of two to four weeks before those cases are reflected in hospitalizations and ICU stays or, potentially, someone who’s deceased. So, yes, if we see cases rise dramatically, I’m concerned for the health care system.

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