January Newsletter
January, 2021
Welcome to the January newsletter. This newsletter aims to provide information and analysis of timely topics from recent articles published in the medical literature. I hope you find this information useful and helpful in your health journey. If you have comments or questions, please let us know!

The Omicron variant is the dominant variant here in Wisconsin making up virtually 100% of cases currently according to the Wisconsin State Laboratory of Hygiene. The onset of symptoms of Omicron is faster and the period of contagiousness appears to be reduced, which has led the CDC to reduce isolation times for infected individuals. It also does not seem to have the pulmonary affinity (1/10) that Delta had. Our hospitalizations with and from Covid here in Wisconsin peaked on January 12th and since that time both hospitalizations and ICU admissions are down 25%, so we appear to be trending in a good direction.

Vaccines and previous infections continue to be quite beneficial in the prevention of severe outcomes but many more vaccinated and even boosted people are contracting this variant. What I have been seeing in my practice is a lot of typical cold symptoms (nasal congestion, mild cough, sore throat, low-grade fever, fatigue, headaches) lasting 3-5 days.

The first article this month shows that as expected, the combination of vaccination immunity with acquired immunity from even a mild infection provides excellent protection from severe outcomes for most people. It still appears that we will all likely acquire or reacquire a COVID infection, but we may not know the difference between this and any other cold virus (unless we are testing for it). Our memory B cells are able to produce high levels of antibodies if we see it again and these memory B cells produce antibodies adapted against any variants! Memory B cells are like blueprints for making antibodies but can be modified on the fly. Additionally, exposure to the virus generates T-cell memory even without a detectable viral infection.
I am happy to announce that I have one of the newest diagnostic tests available. The Galleri test is a blood test that can detect over 50 types of cancer before they are apparent through regular screening testing (and many cancers don't have a screening test). The test detects methylation patterns of cell-free DNA which can indicate cancer and thus has the potential to detect cancers at the earliest stages. If you are interested in learning more about this test please let us know. I'm constantly on the lookout for cutting-edge tests and procedures for my patients and I have a few more things on the horizon that I am evaluating.
Super Immunity!
We have seen a huge increase in Covid-19 cases over the past two months. Here in Wisconsin, the incidence of the Omicron variant went from 0.1% of cases at Thanksgiving to 95% of cases by New Year’s Day. As a result, we saw a lot more infections in people who had previously been vaccinated and even boosted. What does this mean for us going forward? Does everyone need another “booster”? Should people who got infected get “boosted” and if so, when? Should our young children who have contracted the virus get vaccinated and then “boosted”? We have heard conflicting reports about infection-induced (natural) immunity throughout the pandemic. What does the research show? When informed of your positive Covid-19 test, why did I respond “welcome to hybrid immunity”?

Is Your Liver Fat?
Cancer is one of the major concerns most of us have as we age. We perform screening tests to try to detect it early so it can be treated, but there are many cancers without good screening tests. What are the signs that we are at increased risk of cancer developing? Is cancer simply a random occurrence, or are there lifestyle changes we can make to reduce our risk? Are there links between genetics, lifestyle, and cancer risk and how can we reduce our risk? What causes fatty liver and how is a finding of fatty liver related to cancer risk?

Olive Oil For Life
Can small changes in our diet really affect our mortality? This observational study of over 90,000 health professionals examined if a change in dietary intake of olive oil could be linked to lower mortality. We already know olive oil consumption lowers cardiovascular disease risk, but this study is looking at mortality from all causes. Should we increase our olive oil intake, and if so, how much olive oil do we need to lower our risk? Which diseases were found to be lower risk from more olive oil? If you have dementia concerns, you will want to read this study.

To Your Health...
Thank you for taking the time to read through this newsletter. We hope you have found this information useful. Feel free to pass this on to anyone you think would benefit from this newsletter.

Mark Niedfeldt, M.D.

Old-fashioned medicine with 21st Century convenience and technology