Alaska pharmacist speaks from the heart about COVID

Coleman Cutchins is a clinical pharmacist with the Department of Health and Social Services who speaks from the heart and tells it like it is. He has a Doctor of Pharmacy degree and is board certified in pharmacotherapy. He has a long professional history in the clinical management of patients, research, and working with infectious diseases. Recently we spoke about his thoughts on the ongoing COVID crisis in Alaska.

What have you been focused on recently?

I’ve been on this [COVID] team, since really right after the Wu Han flight landed. At least 80% of my time or so has been on COVID. In the last two, three weeks with cases being the way they are and hospitals being overwhelmed, it’s been more like 150%.

Do you have a message for anyone in Alaska that that has decided to not be fully vaccinated due to safety concerns? Or misinformation? I know you put up put a lot of time into this issue.

Vaccines are the safest drugs that we give to a lot of people every year. They’re safer than aspirin, they’re safer than ibuprofen, they’re safer than high blood pressure meds, and diabetes meds, and cholesterol meds. They’re also the class of drugs that have saved more lives in the last couple hundred years than any other class of drugs.

The other thing that really disheartens me is how much misinformation has been out there on vaccine. They’re only in your body for a couple days, you know, they’re not there for a long time. You give one dose, your body eliminates it — never to be seen again. You give another dose, maybe three weeks later, your body eliminates it — never to be seen again. Really, when we think about drugs that have long term side effects, it’s a drug that you take daily for a long period of time, or high toxicity drugs such as certain drugs to treat cancers, or we have concerns about certain periods in your life when your body is doing different things, possibly affecting drugs.

Vaccines are the most natural drug that we give. They don’t block receptors, and they don’t change pathways. Most other drugs that we give do something in your body that’s unnatural. Even drugs for reflux [heartburn, indigestion] block your body from doing a natural process. They change a pathway, either a chemical pathway, or a neurologic pathway, or a metabolic pathway. Vaccines don’t do any of that. Vaccines just teach your body to do what it naturally does. They kind of pre-position your army to fight invaders.

It’s always been disheartening to me that so many people are afraid of vaccines, but then they want drugs for treatment of something that’s vaccine preventable — that in terms of in your body, does a whole lot more things than vaccine would have done. These vaccines have been more studied and more scrutinized and more transparent than any other vaccine in the history of vaccines. They’ve been under the microscope every step of the way.

We have the safest drug approval process in the world. Our drug approval process is based on two fundamental pillars — that drugs have to be proven safe, and they have to be proven effective. Our whole process is set up to show that. I kind of always have to remind people of the other end of it. The way we look at drugs here on the US is they are unsafe and ineffective until proven otherwise.

Really what that goes back to is, over 100 years ago now, the snake oil salesman of the Old West. They would mislabel things, and they would put stuff in there that wasn’t [supposed to be] in there — which is why the FDA [Food and Drug Administration] was actually formed, to really combat that and make things safe.

I hear a lot of concern about long term side effects. If you think about it from a logic standpoint, these drugs are only in our body for two to three days. Then they’re gone forever. So, how is something that was only in my body for two to three days going to affect me a month from now or a year from now? I kind of equate it to, if I parked my car in the driveway and walk inside, I can’t crash my car into a tree. And really, with vaccines we’ve never had a side effect occur later than 13 days after administration in any modern vaccine. It’s really due to that fact that they’re only in your body for a short period of time.

Most of the adverse events we think of with vaccines are more due to the way your body reacts to the vaccine. So even with these vaccines, the very rare event of clotting, it’s all within the first week to 10 days. It’s due to how your body is reacting to the vaccine. We think of the myocarditis [inflammation of the heart muscle] in adolescence and younger people. Now we have really good data to say myocarditis is much more likely to occur with COVID infection than with vaccine.

Once we defeat Delta, are we done? Is that the end of COVID? What is your best crystal ball future prediction for COVID and its interactions with humans?

My first thought is that vaccine is our way out. it was our way out before this pandemic started. If you looked at every viral pandemic response plan prior to this, it said, “Figure out how the virus is spread, do everything you can to stop it. From day one, start developing a safe and effective vaccine as fast as possible. As soon as that vaccine is proven safe and effective, give it to everybody.” And that was the plan.

Look at the monumental efforts that it took to get these vaccines developed in essentially a year, and it’s actually amazing. I think this is going to be one of the things that we look back and read as a modern triumph of science, and a modern triumph of pandemic response. Our scientists and our leaders and our medical community really did everything they can.

National surveys are showing 95 plus percent of doctors are vaccinated. I can tell you here in Alaska all of our hospitalists, all of our emergency room docs, all of our intensivists are vaccinated, all of our infectious disease doctors. We’re hearing from a lot of big organizations like Mayo. over 99% of their doctors are vaccinated. For the people who are working with these drugs, first line, are very highly vaccinated.

If we were at 99% here in Alaska before the Delta surge hit, we might be at a very different place. The key to this is really going to be getting high vaccine rates. It won’t eliminate it, you know. I don’t think we ever thought we were going to be able to totally eliminate this virus from existence, but really, what high immunity rates will give us is not overwhelming the healthcare system like we’re at right now. We’re still going to have a handful of people unfortunately get severely ill from this, but it’ll be small numbers — one at a time, two at a time type thing instead of everyone showing up at once, which is really what we’re at now.

If everyone who’s unvaccinated made the choice today to get vaccinated, we would be at a very different place in two to three months. That’s our quickest way out of this with the least number of people getting severely ill, and the least number of people dying.

Do you have any last comments that you think are really important for the readers to hear?

I think the thing right now that’s really disheartening for me is how much misinformation there is about any other drugs or vitamins or nutritional supplements. You know, we’re at a really different time in the pandemic now... I think we have more hope than ever right now.

If you think about where we were a year ago — we didn’t have vaccine, we didn’t know about monoclonal antibodies, we didn’t have a very good protocol for treating hospitalized patients. It was scary a year ago. Now you fast forward to where we are. Now we have vaccine, which is our best tool. We have monoclonal antibodies, which are sort of that safety net, and we have a much better idea on how to treat hospitalized patients... Moving forward, as long as we can get our vaccine rates up and keep our hospitals from being overwhelmed, we have a much better idea how to treat and manage people with this virus.

Please look at the reliable sources like the Food and Drug Administration, The Centers for Disease Control and Prevention, The National Institutes of Health, Infectious diseases Society of America — and not fall victim to these social media and these other websites that are touting treatments and cures that are not evidence based and not grounded in any type of research.

Note: Dr. Cutchins was interviewed September 6th, 2021. These interview highlights have been edited for clarity and brevity. Originally published in Anchorage Press.