Melissa Harris-Perry: I'm Melissa Harris-Perry Good to be with you. The Delta variant of COVID-19 is hitting hard in the southern United States. Alabama has seen a 59% increase in hospitalizations over the past two weeks with ICUs at 100% capacity but in a state with the lowest vaccination rate in the nation, even former President Donald Trump was recently booed for recommending the shot.

Donald Trump: I recommend taking the vaccines, I did it, it's good. Take the vaccines, but you got to know that's okay. That's all right. You got your freedoms.

Melissa Harris-Perry: To help us understand what's happening in Alabama, we're joined today by Sarah Nafziger, who is Vice President of Clinical Support Services at the University of Alabama Hospital. Dr. Nafziger, welcome to The Takeaway.

Dr. Sarah Nafziger: Hi, thanks for having me.

Melissa Harris-Perry: Can you talk a little bit about how this current wave compares to previous waves in the State of Alabama?

Dr. Sarah Nafziger: Yes, this wave of cases, we've really seen an increase that's much faster than we saw in the previous surges. I think that's something that's really taken our healthcare workers by surprise. The other thing that's really different about this wave is that our patients are much younger. In the previous wave, the average age of our patients who were admitted was 65 years old. In this wave, our average age of patients is 55. We're seeing a switch to younger patients.

Now, we asked ourselves why that might be and we think it's because we actually do have a pretty good vaccination rate in our older population. They tend to have more protection. We think that's why we're really seeing the surge in more younger patients who are being hospitalized. The other things that are really different about this surge is that our staff is really exhausted. We've been dealing with this for a year and a half, and they're just tired.

Prior to the surge, we were already struggling, the staff, the hospital not only with nurses, we talk about nurses a lot but with all the support staff, environmental services, food nutrition, guest services, all the other positions that are so critical to patient care. We were already weakened going into this surge. Now, our staff is just feeling completely exhausted. We're starting to see a lot of absenteeism, not only from staff members being infected but having to stay home because their children have been affected.

School started here a couple of weeks ago, and the vast majority of our school systems are not requiring masking. We're seeing a lot of people who have children who are out sick or out with quarantines, and it's really impacting our staff. Definitely, this surge has been the most difficult for us to manage so far in the pandemic.

Melissa Harris-Perry: Can you help us understand something about what's going on with such a low vaccination rate in the state overall, it's really helpful to hear that maybe the elderly, the older population does have a decent vaccination rate, also really helpful to hear that part of what may be going on with this surge is not just being without vaccines, but being maskless in the relatively concentrated environment of schools. As you're talking to families, as you're talking to patients, do you have a sense of why only just over a third of residents of Alabama are vaccinated?

Dr. Sarah Nafziger: That's the million-dollar question that we're all asking ourselves and really struggling with right now. Because when the vaccine was first available we were in the health care sector, very excited. It was the miracle that we had all been praying for, and it arrived. We were just astonished when our vaccination rates tapered off. We've done a lot of focus groups and had a lot of conversations about why the vaccination rates are so low. It's really multifactorial, and what it boils down to are several things.

The first one is a lot of misinformation is out there about the safety of the vaccine and people looked a lot to social media and other resources for their news. It's really difficult, I think, for people to distinguish real news and real science from something that might be misinformation. A lot of concerns about pregnancy and fertility, a lot of concerns about some of the more outlandish things like, "Is this going to inject a microchip into me? Is it going to magnetize me? Is it going to change my DNA?" There's a lot of that misinformation out there.

Melissa Harris-Perry: Do you want to answer real quick the questions about being magnetic-- I don't mean to be silly here, but genuinely, if those are concerns, and maybe most importantly, the fertility concern.

Dr. Sarah Nafziger: The big one is the fertility concern. All the other things that seem so outlandish to us, it's really quick to just dismiss and say there's no evidence that this vaccine will magnetize you, there's no microchip, there's no way that this alters your DNA because of the science of how they work. The pregnancy and fertility one, I think is a big one that people need to hear. There's absolutely no data that shows that these vaccines, compromise your pregnancy, that they cause any adverse outcomes with pregnancy or fertility.

In fact, COVID is much worse. People who have COVID, who are pregnant have terrible outcomes, compared to people who don't have COVID. Really trying to get that word out that there are big studies and lots of pregnant women that show that the vaccines don't cause any increase in adverse events but in fact, pregnant women who get COVID have a much worse outcome than pregnant women who don't get COVID. Trying to get that information out there has just been a heavy lift for us and people still just don't trust what they see.

I think that really leads to the big reason why people are not getting vaccinated here. It's simple, it's mistrust. They don't trust the government, they don't always trust the health care sector. They say, "Hey, you've told me last year X, Y, and Z, you came back and said something different now." Trying to explain that, "Hey, well, we say something different now because we learned something different, that's science. We study things, we learn new things, and we change our recommendations based on many things that we've learned." A lot of people really have a hard time with that and it's been difficult particularly here to overcome that mistrust.

Melissa Harris-Perry: I so appreciate that, because I get that, I get why that can feel hard. I can remember feeling that way myself early on around the masking recommendations. Thank you so much, not only for joining us today but for your continued work on the ground there in Alabama. I know it's tough times and I hope that both you and your staff are able to hold up through this. Dr. Sarah Nafziger is Vice President of Clinical Support Services of the University of Alabama Hospital. Dr. Nafziger, thank you so much for joining.

Dr. Sarah Nafziger: Thank you for having me.

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