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OB-GYN discusses pregnancy and COVID-19 with Idaho health officials

In Tuesday's briefing, Dr. Guillermo Guzman cited experts who "enthusiastically recommend" the vaccine for new and expectant mothers.

BOISE, Idaho — Editor's note: Just before Tuesday's briefing, the Idaho Dept. of Health and Welfare announced that it had confirmed the state's first COVID-19 death in a child. The child died in October.

After surging in late summer and early fall, the numbers of new daily cases of COVID-19 have been dropping over the past few weeks in Idaho; so have the numbers of related hospitalizations.

Those trends -- headed in what Idaho Dept. of Health and Welfare Director Dave Jeppesen on Monday called "very heartening and very encouraging" -- continue as a COVID vaccine for children aged 5 to 11 becomes available, and as availability of monoclonal antibody treatments is increasing for some patients with COVID.

However, statewide crisis standards of care remain activated, a significant number of Idahoans remain opposed or hesitant about vaccination, and - although numbers are dropping - hundreds of new cases continue to be reported each day.

In a media briefing on Tuesday, Jeppesen noted that the percentage of COVID-19 PCR tests coming back positive is still twice that of the target of 5%. For the week that ended Oct. 30, the statewide positivity rate was 10.3%. Information about the positivity rate for the week that ended Nov. 6 is expected Thursday.

Also among the concerns is how COVID affects expectant mothers and newborn babies.

Dr. Guillermo Guzman, an OB-GYN with Saint Alphonsus Health System, joined Jeppesen and other Idaho Dept. of Health and Welfare public health officials for Tuesday's media briefing, which was streamed on KTVB.COM and the KTVB YouTube channel.

Dr. Guzman noted that pregnant women are more susceptible to COVID-19 and respiratory infections, and more susceptible to serious complications, than women who are not pregnant. In some cases, he said, women infected with COVID have not been able to carry their pregnancies for the full nine-month term -- leading to premature births that put newborn babies at greater risk for a variety of medical and developmental problems.

"A woman's body undergoes many changes to be able to adapt to a growing baby inside a mother. Some of these changes, unfortunately, make a woman more prone to certain medical conditions," Guzman said during Tuesday's briefing. "It's a well-known fact that most, if not all, respiratory infectious disorders tend to manifest more severely in a pregnant woman than in a non-pregnant woman. COVID-19 is no exception."

Guzman also said the COVID vaccine is safe for pregnant women, and he compared the vaccine to a seat belt.

"Seat belts do not prevent car accidents, but they keep you alive if you do get into one," he said. "Likewise, you can still get COVID-19 after being vaccinated, but if you do get COVID-19, you are very very much likely to survive if you do."

Guzman said current guidelines from the American College of Obstetrics and Gynecology, the Society for Maternal Fetal Medicine and the Centers for Disease Control "enthusiastically recommend" the vaccination of pregnant, recently pregnant, and lactating mothers.

"The technology that drives some of these vaccines is nothing short of amazing, especially mRNA, which carries into our cells the code for our body to produce the coronavirus spike protein and provide our immune system with instructions on how to fight COVID," he said, adding that mRNA does not enter the nucleus, and "hence, it does not alter a patient's DNA."

State epidemiologist Dr. Christine Hahn said so far in 2021, four COVID-related deaths have occurred in women who had been pregnant within a year before they died. Also, two stillbirths were recorded in cases where COVID or a recent COVID infection was listed as a cause or underlying cause on the death certificate. No such deaths were recorded in 2020 in Idaho.

Ahead of Tuesday afternoon's briefing, the 14-day moving average of new COVID-19 cases had dropped from about 1,287 cases per day on Oct. 3 to just below 772 cases per day on Nov. 8.

Hospitalization data reported for Friday, Nov. 5, show 399 people were hospitalized with COVID-19, and 127 of those patients were in an intensive care unit. COVID hospitalizations hit a record-high 793 on Sept. 24.

As of Monday, 55.6% of Idaho's population 12 years of age and older was fully vaccinated. Hahn said almost 80% of those 65 and older were vaccinated, and almost 40% are estimated to have received a booster dose. About 52% of Idaho adults younger than 65 have been fully vaccinated. According to the state, 2,257 kids 5-11 years of age have been vaccinated. 

"We're really happy that our seniors are getting vaccinated, and we do urge those that are eligible for a booster shot to get that now before the holidays when there's more travel, there's more family around. We are excited to see the number of people 65 and older getting their booster shot inching up," Hahn said. "We are concerned, however, about the vaccination rate in our younger age groups."

Out of the nearly 840,000 people who have been fully vaccinated, 15,713 "breakthrough cases" of COVID-19 have been reported -- that's less than 2% of Idaho's fully vaccinated population.

You can view the entire briefing at this link.

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