SUMMARY JANUARY 2, 2022
COVID LEVELS HAVE INCREASED WITH OMICRON PRESENT IN THE VALLEY TO A LARGE EXTENT. WE ARE SEEING MANY CASES IN THE PRACTICE. NOW IS THE TIME THAT YOUR VACCINATIONS PAY OFF!
MORE OPPORTUNITIES FOR INFECTION, SO BEST PRACTICES REMAIN THE STRONG RECOMMENDATION FOR ALL, INCLUDING THE TRIPLE VACCINATED.
GOOD MASKS, WEARING THEM IN INDOOR PUBLIC SETTINGS IS A MUST IF YOU WISH TO AVOID COVID AT THIS TIME.
OMICRON IS A LARGE PERCENTAGE OF CASES…THE EXACT AMOUNT (50+%) IS UNCLEAR. OMICRON IS MORE CONTAGIOUS AND MILDER, CAPABLE OF INFECTING THE DOUBLE AND TRIPLE VACCINATED.
FORTUNATELY, THE VACCINATED ARE HAVING VERY MILD CASES ACROSS THE BOARD. THIS IS THE GENERAL OBSERVATION AND MY OBSERVATION IN THE PRACTICE.
STILL, AVOIDING INFECTION IS PREFERABLE, AS TREATMENT OPTIONS HAVE EXPANDED TO INCLUDE PAXLOVID (PFIZER’S COVID PILL REGIMEN), BUT THIS IS NOT GENERALLY AVAILABLE RIGHT NOW DUE TO PRODUCTION SHORTAGES, BUT WITH TIME, THIS WILL BECOME MORE WIDESPREAD AND AVAILABLE FOR GENERAL USE.
ADDITIONAL NEW INFORMATION THIS WEEK BASED ON NEW DATA:
IF YOU GET BREAKTHROUGH COVID AFTER 2 OR 3 VACCINES WE ARE SEEING MILD SYMPTOMS AND VIRTUALLY NO HOSPITALIZATIONS. RISK APPEARS TO BE SMALL FOR ANY SERIOUS COMPLICATIONS BUT IF YOU DO TEST POSITIVE, BE IN TOUCH TO COMMUNICATE FOR INSTRUCTIONS AND DIRECTION.
COVID TESTING WITH AT HOME TESTS ARE GENERALLY ACCURATE AND THEY ARE USEFUL. I RECOMMEND HAVING THEM IN CASE YOU DEVELOP SYMPTOMS AND TESTING IF YOU DO DEVELOP SYMPTOMS.
IF YOU HAVE MILD OR QUESTIONABLE SYMPTOMS OR EXPOSURE AND YOUR TEST IS NEGATIVE, IT IS LIKELY ACCURATE…. BUT, IF YOU HAVE SIGNIFICANT RESPIRATORY SYMPTOMS/FLU-LIKE SYMPTOMS AND YOUR HOME TESTING IS NEGATIVE, IT IS POSSIBLE THAT THIS IS A FALSE FINDING. IN THE SETTING OF CLASSIC SYMPTOMS, SUCH TEST RESULTS ARE SUSPECT AS THE CURRENT ANTIGEN TESTING HAS BEEN MISSING SOME OMICRON INFECTIONS.
IF THIS IS THE CASE ARRANGE FOR PCR TESTING OR BE IN TOUCH AND WE WILL HELP ARRANGE. DO NOT ASSUME YOU ARE COVID FREE IF SYMPTOMS APPEAR STRONGLY TO SUGGEST COVID…GET RETESTED WITH A TOP LEVEL TEST (PCR).
TREATMENTS:
PAXLOVID (NEW PILL FROM PFIZER) IS A VERY EFFECTIVE TREATMENT REGIMEN BUT IS NOT GENERALLY AVAILABLE. FORTUNATELY, FOR THE DOUBLE AND TRIPLE VACCINATED, THE NEED FOR AN AGGRESSIVE/EFFECTIVE ANTIVIRAL IS MINIMAL. WITH TIME, PAXLOVID WILL BECOME MORE AVAILABLE AND WE WILL BE USING IT MORE READILY, BUT FOR THE PRESENT TIME IT IS RESERVED FOR HIGH RISK VACCINATED INDIVIDUALS AND THOSE THAT ARE NOT VACCINATED.
MONOCLONAL ANTIBODY TREATMENTS (REGENERON/LILLY) ARE NOT EFFECTIVE AGAINST OMICRON. THIS IS PARTICULARLY UNFORUNATE FOR THE UNVACCINATED WHO HAVE RELIED ON THIS APPROACH. THERE IS A VERSION FROM GLAXO THAT DOES WORK AGAINST OMICRON, BUT IT IS NOT GENERALLY AVAILABLE AT THIS TIME. IT WILL BE RESERVED FOR HIGH RISK VACCINATED, AND UNVACCINATED PATIENTS ON AN INDIVIDUAL BASIS, DECIDED AT THE HOSPITALS.
THIRD VACCINATION FOR THOSE WITH PREVIOUS COVID AND 2 VACCINES:
WITH THE NEW OMICRON VARIANT, IT IS NOW RECOMMENDED THAT THE 3RD VACCINE BE TAKEN MORE GENERALLY.
IF YOU HAVE DECIDED TO ‘HOLD’ ON THIRD VACCINATION AS YOU ALREADY HAD COVID BEFORE, IT IS TIME TO RECONSIDER THIS APPROACH AND TO GET THE THIRD VACCINE. YOU REMAIN STRONGLY PROTECTED WITH COVID + 2 VACCINES, BUT IF YOU DID NOT HAVE AN ADVERSE REACTION TO THE VACCINE THEN THE 3RD SHOT IS RECOMMENDED.
GENERAL INFORMATION SHARED PREVIOUSLY:
HOLIDAY GATHERINGS ARE AN OPPORTUNITY FOR MORE EXPOSURE DURING A SURGING PACE. IF YOU ARE VACCINATED AND BOOSTED YOU ARE AS SAFE AS POSSIBLE AND THESE EVENTS ARE APPROPRIATE BUT BE CONSIDERATE IN YOUR CHOICES.
THINK ABOUT YOUR SITUATION AND STAY AS SAFE AS POSSIBLE.
OUTDOOR VENUES/OPEN AIR IS MOST IDEAL. LOOK FOR THE SITUATIOIN WITH THE BEST AIR FLOW. DON’T HESITATE TO USE YOUR MASK IF THAT MAKES YOU COMFORTABLE.
TESTING PRIOR TO GET-TOGETHERS IS AN EXCELLENT APPROACH (HOME KITS ARE GREAT FOR THIS).
REQUESTING THAT THOSE ATTENDING BE VACCINATED IS ALSO MOST HELPFUL IN REDUCING RISK.
WHEN WE ARE SURGING, WE REMAIN AT HIGHER RISK AND MASKING IS STILL BENEFICIAL. VACCINES AND BOOSTERS ARE THE BEST ANSWER.
1. WEAR YOUR MASK IN BUSY PUBLIC SPACES KN95 OR N95 DURING SURGE. CLOTH MASKS ARE OF LIMITED VALUE.
2. GET YOUR BOOSTER!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
PFIZER BOOSTER, MODERNA BOOSTER, AND J & J BOOSTER RECOMMENDED & APPROVED FOR ALL OVER AGE 18. EVERY ADULT WILL BENEFIT FROM A BOOSTER.
MIXING AND MATCHING VACCINES IS FINE. TRY TO STICK WITH YOUR VACCINE IF YOU CAN, BUT IT’S FINE TO MIX AND MATCH (THERE MAY BE A BENEFIT…BUT THE DATA IS LIMITED).
BOOSTER FOR THE J & J…. I RECOMMEND MODERNA OR PFIZER…. I DO NOT RECOMMEND REPEATING J & J…NOT AS GOOD.
GET YOUR BOOSTER SHOT. (ONLY EXCEPTION IS FOR THOSE WHO HAVE HAD BOTH COVID INFECTION + 2 VACCINES…THEY DO NOT NEED A BOOSTER)
WALK IN APPOINTMENTS ARE BECOMING LESS COMMON…. SET UP ‘ONLINE’ WITH THE PHARMACIES (LINKS ARE BELOW).
(WANING IMMUNITY OCCURS WITH THE CURRENT VACCINES AND A BOOSTER IS REQUIRED FOR MAXIMUM PROTECTION SO THAT YOU CAN BE ACTIVE IN PUBLIC WITH MAXIMUM CONFIDENCE.)
3. CHOOSE YOUR EXPOSURES WISELY AT THIS POINT. A-OK TO GO OUT IF VACCINATED BUT BE SELECTIVE AND SMART UNTIL THE SURGE IS OVER.
ONCE SURGE IS OVER, PUBLIC ACTIVITIES SHOULD RESUME TO NORMAL, PRE-COVID LEVELS. IF YOU ARE VACCINATED AND BOOSTED YOU SHOULD LIVE LIFE AS NORMAL, UNLESS YOU ARE AT HIGHEST RISK DUE TO IMMUNE SUPPRESSION.
4. GET A COVID SELF-TEST KIT NOW.... TO HAVE AVAILABLE FOR SELF-CHECK SHOULD YOU HAVE SYMPTOMS THAT SUGGEST COVID. SELF TEST KITS ARE IN SHORT SUPPLY, SO GET YOURS NOW...AND IF YOU CANNOT FIND ONE...KEEP LOOKING. YOU WILL BE GLAD YOU DID.
5. DO NOT CALL US FOR SHOTS...... WE DO NOT HAVE BOOSTER SHOTS.... PHARMACIES WILL BE GIVING OUT BOOSTER SHOTS.... SEE LIST BELOW.
YOU CAN TRY A ‘WALK IN’ APPOINTMENT AND SEE IF THEY ARE AVAILABLE.
GENERAL COVID STATUS
SCOTTSDALE/PHOENIX/ARIZONA:
WE ARE SURGING. RED ZONE STILL.
CASES ARE AT A HIGH LEVEL …. THIS IS DISAPPOINTING NEWS FOR ARIZONA.
COVID EXPOSURE IS STILL HIGHER THAN DESIRABLE WHEN YOU GO OUT….
BEHAVIOR IN PUBLIC IF YOU ARE VACCINATED:
NOW IS THE TIME TO GET OUT YOUR GOOD MASK AND WEAR IT. ASSESS YOUR SITUATION AND CHOOSE TO WEAR A MASK ACCORDING TO YOUR ASSESSMENT OF THE RISKS INVOLVED.
I RECOMMEND YOU USE YOUR BEST MASK…. N95 OF KN95. THIS WILL MAKE A BIG DIFFERENCE. CLOTH MASKS…LESS SO.
YOU WILL GET MILDLY SICK IF YOU ARE VACCINATED AND GET COVID, BUT IF YOU DON’T WANT TO DEAL WITH COVID…. START WITH YOUR MASK AGAIN IN PUBLIC SPACES.
MASKING RECOMMENDATIONS:
I RECOMMEND MASKING IN BUSY PUBLIC SPACES SO YOU DON’T HAVE TO DEAL WITH EVEN A MILD COVID COLD.
IF YOU ARE OVER 85 OR HAVE SIGNIFICANT HEALTH ISSUES/KNOWN REDUCED IMMUNITY, THEN MASKING IS A MUST. FOR SUCH PEOPLE I RECOMMEND A KN95 OR 95 MASK TO ACHIEVE THE DESIRED PROTECTION. REGULAR MASKS WILL NOT BE PARTICULARLY HELPFUL.
PERSONAL INTERACTIONS IF YOU HAVE NOT HAD A BOOSTER:
IMMUNITY IS WANING. YOU MUST BOOST. IF YOU HAVE NOT BOOSTED AND IT IS 5+ MONTHS SINCE YOUR VACCINATION SERIES, YOU ARE INCREASING YOUR RISK WEEK BY WEEK UNTIL YOU ARE BOOSTED.
PERSONAL INTERACTIONS AFTER YOU BOOST:
BOOSTING IS ESSENTIAL. ONE WEEK AFTER BOOST YOU ARE AT NEARLY 10X THE ANTIBODY LEVELS. WE HAVE SEEN PEOPLE GO FROM UNMEASURABLE ANTIBODIES TO 100+ (MAXIMUM) ANTIBODIES FROM THE BOOSTER.
ONCE YOU ARE BOOSTED YOUR RISKS FOR SERIOUS COVID INFECTION ARE DRAMATICALLY DECREASED AND WE ARE ANTICIPATING 6-12MONTHS+ OF PERSISTING ANTIBODY RESPONSE FROM THE BOOSTER SHOT.
ONLY TIME WILL TELL US WHAT ACTUALLY OCCURS, BUT THIS IS OUR CURRENT EXPECTATION.
PERSONAL INTERACTIONS IF YOU HAVE NOT HAD ANY COVID VACCINATION:
YOUR RISK FOR COVID IS HIGH. YOU ARE BEING FOOLISH AND TAKING CHANCES WITH YOUR HEALTH AND THE HEALTH OF THOSE YOU LOVE.
YOU WILL GET COVID…. WE SEE PEOPLE EVERY WEEK GET COVID AFTER BEING ‘LUCKY’ FOR 18 MONTHS. THIS THINKING IS FOOLISH AND WILL LEAD TO UNNECESSARY HARDSHIP, HOSPITALIZATION, AND POTENTIAL LONG-TERM HEALTH CONSEQUENCES FOR YOU. DO NOT BE ONE OF THE PEOPLE THAT ‘WISHES’ YOU GOT YOUR SHOT. WE ARE STILL SEEING THIS HAPPEN…AND IT’S SAD.
FOLLOW ALL MASKING AND DISTANCING PROTOCOLS 100%. REDUCING RISK IS NOT THE SAME AS ELIMINATING RISK. THOSE AT THE HIGHEST RISK WHO ARE UNVACCINATED SHOULD NOT BE TAKING ANY CHANCES, PERIOD!
BOOSTER SHOTS:
PFIZER, MODERNA, AND J & J BOOSTER SHOTS ARE APPROVED FOR THOSE WITH REDUCED IMMUNE SYSTEMS AND OVER 65 AND HIGH EXPOSURE PROFESSIONS.
BOOSTER SHOTS PER CDC GUIDELINES:
- People 18 years and should receive a booster shot 6 months after their primary series.
VACCINATION RATES ARIZONA:
57% (+0%) ARE FULLY VACCINATED.
67% (+0%) PARTIALLY VACCINATED.
NEW VACCINATIONS ARE NEARLY AT A STANDSTILL.
ALL PATIENTS WHO HAVE RESPIRATORY SYMPTOMS SHOULD COVID SELF TEST FIRST, BEFORE THEY ARE IN CONTACT OR PLAN TO COME INTO OUR OFFICE.
IF YOU HAVE A POSITIVE COVID RESULT YOU SHOULD NOT COME INTO OUR OFFICE, BUT PLEASE NOTIFY US.
WHAT IF I GET COVID DESPITE BEING VACCINATED?
IF YOU ARE VACCINATED AND YOU GET COVID IT WILL ALMOST CERTAINLY BE A MILD ILLNESS.
I HAVE LABELED THIS A ‘COVID COLD’
THE RISK FOR SERIOUS ILLNESS IS VERY REMOTE…BUT BE IN TOUCH FOR FURTHER INSTRUCTIONS.
NEW TREATMENT OPTIONS EXIST INCLUDING:
PAXLOVID FROM PFIZER. THIS COURSE OF PILLS, TAKEN WITHIN 5 DAYS OF COVID DIAGNOSIS, WILL REDUCE THE RISK OF HOSPITALIZATION OR DEATH BY 90%. IT IS A GAME CHANGER AND HAS BEEN APPROVED. IT WILL BE AVAILABLE ON VERY LIMITED BASIS FOR THE NEXT FEW WEEKS RESERVED FOR HIGHER RISK INDIVIDUALS. (WE HAVE NOT HEARD THAT ANY IS TRULY AVAILABE IN ARIZONA), INCREASING IN AVAILABILITY WITH TIME.
IN THE MEANTIME, WE ARE USING:
STEROID INHALERS
FLUVOXAMINE (AN ANTI DEPRESSANT RECENTLY SHOWN TO POTENTIALLY REDUCE COVID INFECTION SEVERITY & HOSPITALIZATION.)
THERE IS NO WORRY IN THIS SITUATION. CONSIDER THIS VERY MUCH LIKE YOU WOULD FLU EXPOSURE DURING WINTER FLU SEASON…. BE ATTENTIVE, BUT NOT WORRIED.
AND PLEASE WAIT 10 DAYS FROM BEGINNING OF SYMPTOMS TO BE AROUND OTHERS.
TESTING FOR COVID IN PATIENTS WHO ARE VACCINATED IS NECESSARY WITH ANY SIGNIFICANT RESPIRATORY SYMPTOMS.
HOW DO I GET TESTED FOR POSSIBLE ACTIVE COVID INFECTION?
TESTING CAN BE DONE AT LOCATIONS THROUGHOUT THE CITY OR BY A SELF-TEST FROM YOUR LOCAL PHARMACY.
YOU MAY PURCHASE A HOME TEST KIT FROM AMAZON OR YOU CAN GET SIMILAR KITS AT WALGREENS OR CVS OR YOUR LOCAL PHARMACY.
I THINK IT WOULD BE A GOOD IDEA TO HAVE A HOME KIT FOR SELF-TESTING AT HOME. IT IS LIKELY YOU WILL USE IT BY THE END OF WINTER.
RECOMMENDED HOME TEST KITS FROM AMAZON ARE:
- BinaxNOW COVID-19 Antigen Self-Test
- Quidel QuickVue at-Home OTC COVID-19
FLU SEASON:
FLU SEASON ARRIVING… BE SURE TO GET YOUR FLU VACCINE!
FLU LEVELS ARE RISING AND IS ‘AVERAGE’ FOR THIS YEAR. FLU IS POSSIBLE. GETTING TESTED FOR COVID IS ESSENTIAL, BUT A GOOD TEST REVEALS ‘NO COVID,’ THEN FLU TESTING IS A CONSIDERATION.
FOR THE UNVACCINATED:
I AGREE WITH THE CDC RECOMMENDATION FOR VACCINATION OF 5-18-YEAR-OLDS. THIS IS SAFE AND IT WILL BE EFFECTIVE IN REDUCING THEIR RISKS AND THE FAMILIES' RISK OF INFECTION.
PLEASE ENCOURAGE EVERYONE YOU KNOW TO GET VACCINATED NOW AND BOOSTED!
IF THEY DO NOT GET VACCINATED, THEY WILL GET COVID AT SOME POINT.
WE ARE NO LONGER ROUTINELY TESTING IN THE OFFICE FOR COVID EXPOSURE OR ILLNESS, BUT RATHER YOU SHOULD TEST AT A FACILITY OR DO A SELF-TEST PURCHASED FROM A PHARMACY OR AMAZON.
TESTING LOCATIONS CAN ALSO BE FOUND HERE:
COVID IMMUNIZATION:
THE RATE OF PFIZER & MODERNA VACCINATION IS DECLINING NATIONALLY. BOTH OF THESE VACCINES ARE AMAZINGLY EFFECTIVE…VIRTUALLY 100% IN PREVENTING HOSPITALIZATION AND DEATH FROM COVID...BOTH OF THEM. THEY ARE SAFE FOR MEN AND WOMEN OF ALL AGES.
POSSIBLE COVID VACCINE SEVERE
ALLERGIC REACTIONS:
OCCURRING AT A RATE OF
1 IN 50,000 (VERY LOW)
YOU SHOULD PLAN ON PROCEEDING WITH IMMUNIZATION UNLESS YOU HAVE A KNOWN ALLERGY TO PEG (POLYETHYLENE GLYCOL). .... A COMPONENT OF THE CARRIER IN THE VACCINES.
YOU CAN SEE DAILY TRENDS FOR ARIZONA AND THE U.S. HERE, ON THE CDC WEBSITE…JUST CHOOSE ‘ARIZONA’ FROM THE LIST.
