The New CDC Guidelines

In a significant turn of events, the U.S. Centers for Disease Control and Prevention (CDC) announced updated isolation guidelines for individuals testing positive for COVID-19. Amid the evolving dynamics of the pandemic, these revised protocols mark a pivotal shift from the agency’s previous guidance, aiming to balance public health safety with the changing realities of the virus’s impact.

The CDC’s latest update provides a more flexible approach to isolation for those who test positive for COVID-19. Under the new guidelines, individuals with mild and improving symptoms are advised they no longer need to isolate for a strict five-day period. Instead, they can return to their regular activities provided they have been fever-free for at least 24 hours without the aid of fever-reducing medications. However, the CDC emphasizes the importance of continued vigilance, recommending that individuals wear masks and maintain distance from others as additional safety measures post-isolation.

Implications of the Updated Guidelines:

This update is a nod to the growing understanding of COVID-19’s transmission and the widespread immunity developed through vaccination or past infections. By adjusting guidelines to reflect these realities, the CDC aims to mitigate the disruption to daily life and the economy. However, these changes have sparked a debate among health experts. While some applaud the flexibility, others express concern that relaxing isolation rules could pose risks, particularly to those more susceptible to severe illness.

Background on CDC’s Evolving Guidance:

The CDC’s isolation guidelines have evolved throughout the pandemic, reflecting the deepening knowledge of the virus’s behavior and transmission. Initially recommending a 10-day isolation period, the agency later reduced this duration to five days for asymptomatic individuals or those with brief illnesses. This progression underscores the agency’s commitment to adapt its recommendations based on emerging evidence, which suggests that individuals are most infectious in the days surrounding symptom onset.

What Stays the Same:

Despite the relaxed rules for the general public, the CDC has made no changes to its isolation guidelines for high-risk settings, such as nursing homes and healthcare facilities. The agency maintains strict protocols in these environments to protect vulnerable populations from the virus.

Prevention is Still Key:

The CDC continues to stress the importance of preventative measures to curb the spread of COVID-19. Vaccination, handwashing, and improving indoor air quality with fresh outdoor air are crucial steps everyone should take to protect themselves and others. While the isolation guidelines have been updated, the overarching message remains clear: prevention is paramount.


The CDC’s updated isolation guidelines represent an adaptive response to the current state of the COVID-19 pandemic. By allowing people with mild symptoms to resume normal activities sooner, the agency acknowledges the balance between reducing transmission risk and recognizing the public’s accumulated immunity. However, the emphasis on precautionary measures remains, highlighting the ongoing need for vigilance in the face of a virus that continues to evolve.

As we navigate these changes, staying informed and adhering to public health recommendations is essential. By doing so, we can protect not only ourselves but also those around us, particularly the most vulnerable among us.

For the most accurate and up-to-date information, visit the CDC’s website. Stay informed, stay safe, and together, we can continue to adapt to this ever-changing pandemic landscape.

Navigating the Current Landscape of Respiratory Illnesses: CDC Report Highlights Trends

In the ever-evolving landscape of public health, staying abreast of the latest updates from authoritative sources is crucial. Recently, the Centers for Disease Control (CDC) provided an insightful update on the status of respiratory illnesses in the United States. The report, released last Friday, sheds light on the prevalence of fever-inducing coughs and sore throats, prompting individuals to seek medical care. As we delve into the details, it becomes evident that while there have been some decreases, respiratory illnesses remain elevated across the nation.

Current Scenario:

The CDC’s update revealed that over the past two weeks, a significant number of jurisdictions – 22 to be exact – experienced high or very high activity in terms of respiratory illnesses. This is a notable decrease from 37 jurisdictions reported two weeks prior. The decline indicates a positive trend, albeit with certain regions still grappling with heightened levels of respiratory ailments.

Key Findings:

  1. COVID-19, RSV, and Flu Positivity Rates: Despite the overall elevated status of respiratory illnesses, the report brings attention to a nuanced picture. While COVID-19, Respiratory Syncytial Virus (RSV), and flu positivity rates remained elevated nationally, there was a glimmer of improvement. Both COVID and RSV rates saw a decrease compared to the previous week, while flu rates remained relatively stable.
  2. Emergency Room Visits: The post-holiday season witnessed a decline in emergency room visits related to respiratory illnesses. This dip is attributed to the country gradually returning to work after festive gatherings, which contributed to the spread of viruses during the peak of the flu season. It is encouraging to see a reduction in emergency room visits, signaling a potential easing of the burden on healthcare facilities.
  3. Wastewater Analysis: An intriguing aspect of the CDC update is the analysis of wastewater, providing a unique perspective on the prevalence of COVID-19. Although levels remained elevated, there was a shift from “very high” to “high,” with concentrations primarily observed in the Southern regions of the country. This insight into wastewater can aid in monitoring and predicting the trajectory of respiratory illnesses.
  4. Regional Disparities: States with a “very high” level of respiratory illness include New York, Tennessee, South Carolina, and Louisiana. Understanding these regional disparities is crucial for targeted public health interventions and resource allocation.

In conclusion, the CDC’s latest update paints a dynamic picture of respiratory illnesses in the United States. While there are positive signs such as decreased emergency room visits and some lowering of COVID and RSV rates, challenges persist, especially in certain regions. Staying vigilant, following public health guidelines, and adapting strategies based on regional trends will be key in navigating through these challenging times. As we move forward, continued collaboration between health authorities, communities, and individuals remains paramount in mitigating the impact of respiratory illnesses nationwide.

COVID tests: When and Where to Order the Next Batch of Free Ones

With the winter months approaching and the memories of last year’s challenges still fresh, it’s heartening to see the Biden administration taking proactive measures to ensure Americans have access to at-home COVID-19 testing. Our primary care doctors want you to have the latest information. Here is everything you need to know.

More Funds for At-home Tests

In a recent announcement, the administration unveiled a $600 million plan aimed at boosting the production of these critical tests. This move will not only replenish federal stockpiles but also help circumvent the supply chain problems that led to shortages in the past. What’s more, these tests will be manufactured right here in the USA by twelve manufacturers scattered across seven states. This means hundreds of jobs and, most importantly, 200 million over-the-counter tests for Americans.

Where to Order?

For those wondering where to get these tests, the original website will once again be your go-to place. Here, every household can order up to four free tests.

Availability Dates

Mark your calendar for September 25. Starting from this date, the tests can be ordered and will be shipped directly to your doorsteps for free, courtesy of the United States Postal Service.

Updated Vaccines: What You Need to Know

In addition to the at-home tests, there’s more good news on the vaccine front. Last week, the CDC gave its endorsement to new COVID-19 shots suitable for everyone aged 6 months and older.

For those looking for places to get vaccinated, the government’s website will list available locations, including pharmacies, health centers, and some doctor’s offices. And while the list price of each shot hovers between $120 to $130, federal assurances mean that these shots will remain free for most Americans, whether through private insurance, Medicare, or Medicaid. The CDC is also collaborating with health departments, clinics, and some pharmacies to ensure that even the uninsured or underinsured get their shots free of charge.

Flu Shot and COVID-19 Vaccine: Together?

One of the most common questions is whether one can get the flu shot and the COVID-19 vaccine simultaneously. The answer is a resounding yes. According to the CDC, there’s no difference in effectiveness or side effects whether you get both vaccines together. If you do decide to go this route, consider getting one shot in each arm for comfort. Remember, it’s recommended that almost everyone aged 6 months and up gets their flu shot, ideally by the end of October.

In conclusion, as we prepare for the colder months, these proactive measures and clear guidelines will certainly help in ensuring the health and safety of all Americans. Stay safe and stay informed!

Yes, COVID-19 Remains a Threat

Our primary care concierge doctors in Jupiter dislike being the bearers of bad news, but it’s important to know that the COVID-19 virus is still active, still mutating, and still killing people: as many as 250 Americans a day, primarily those who are immunocompromised and older adults.

That equals roughly 90,000 of us every year. This figure is well below the height of the pandemic when 4,000 Americans a day were dying. But the number isn’t insignificant if it impacts you or someone you love.

It’s also important to remember that, even if an infection doesn’t result in death, the long-term consequences even for younger, healthy people can be severe and/or debilitating.

Newest Variant

The latest omicron subvariant, XBB.1.5, now accounts for nearly 80 percent of COVID-19 cases being diagnosed in the U.S., according to the Centers for Disease Control and Prevention (CDC).

In addition, the World Health Organization has identified a new subvariant, XBB.1.16, known as Arcturus. The CDC reported last month that it is now responsible for about seven percent of coronavirus infections, up from about four percent the previous week.

The good news is that Arcturus doesn’t appear to be any more deadly than previous omicron variants. While a change in the spike protein might mean it could spread more rapidly, there’s no indication that cases will be more severe.

“We’ve seen this in the past,” Paul Hunter, a professor of medicine at the University of East Anglia in Britain, told The Washington Post.

“You look at the virus and it’s got mutations that should make it more virulent, but then, in reality, you don’t see that,” he said.

“It will probably become the dominant variant for a while in the U.S. and Europe and most countries around the world, but I don’t see it driving up severe infections more than we’ve seen in recent waves,” he added.

Still Dangerous

That doesn’t mean Arcturus or the currently dominant XBB.1.5 are benign, however.

COVID-19 remains the third leading cause of death in the U.S. Florida is currently seeing 17 new cases every day per 100,000 population, the highest in the nation (Kentucky is second, at 13 new cases per day per 100,000).

These numbers are likely undercounted because so many people have abandoned getting officially tested for COVID-19, are testing at home and not reporting positive cases, or not getting tested at all.

And it’s not just older Americans who are impacted. The CDC reported last month that the 18-29-year-old age group “has accounted for the largest cumulative number of COVID-19 cases compared to other age groups.”

NBC’s Today Show recently reported on a new study by Cedars Sinai Hospital in Los Angeles, which found that the age group hit hardest by post-COVID-19 heart attack deaths was people between 25 and 44. This cohort saw a 29.9 percent relative increase in heart attack deaths over the first two years of the pandemic.

“Young people are obviously not really supposed to die of heart attack,” Susan Cheng, a cardiologist at Cedars Sinai and co-author of the study, told Today in February.

“They’re not really supposed to have heart attacks at all,” she said.

In addition, a National Center for Health Statistics survey showed that nearly 20 percent of adults who had a COVID-19 infection continue to have the debilitating symptoms of long COVID.

Remember the Vulnerable

Unfortunately, most of America seems to have moved on from the pandemic. People are going about their lives as if SARS-CoV-2 was just a bad dream they’re happy to have awakened from.

“Get all the shots you wish, take all the precautions you wish, but the health of us out there are done sacrificing for the weakest of health or brain,” wrote one anonymous commenter last month on The Post website.

This attitude of “stay home forever” rankles journalist Jeanine Santucci, as she recently wrote in USA Today.

A young mother with type 1 diabetes, she is at higher risk from COVID-19. She is fully vaccinated and has loosened her self-quarantine over the past three years, now seeing friends outdoors unmasked if they have a negative COVID-19 test. She ventures out in public with an N95 mask and a portable air purifier but resents the general lack of masking in indoor public spaces.

But she called the “stay home if you’re at risk” approach “cruel” and unfair.

“The main reason I am still taking this seriously, and I hope you will, is that our country’s most vulnerable people deserve to be part of society,” she said.

Protect Yourself and Others

“With the removal of mask mandates in health care settings and essential places such as pharmacies, public transit, and grocery stores, immunocompromised people are made outcasts,” Santucci added.

“But simply putting on an N95 when you go out makes us safer. It shows us you care that we’re alive.”

Given the prevailing attitudes from both government and the general public that if you want to avoid getting COVID-19 you’re pretty much on your own, we recommend continuing to take precautions when you’re in public spaces.

This means any place that is not well-ventilated, including your own home if you have visitors whose infection status is unknown. Wear a mask in crowded settings, and stay up to date on your vaccinations.

As Santucci wrote, “I hope you’ll take into consideration just how much is at stake for you, and the fact that you’re also making a risk calculation for vulnerable people like me when you do.”

Common COVID-19 Misconceptions Linger Three Years Later

It’s been three years since the first cases of COVID-19 were diagnosed in the U.S., but our concierge primary care doctors in Jupiter are still hearing comments from friends, acquaintances, and even some of our patients that are just plain incorrect.

For instance, we were talking to someone the other day whose wife was very sick with COVID-like symptoms: body aches, severe cough, fever, chills, and so on. When we asked if she’d been tested for COVID-19, he replied, “No, she’s already had it.”

We happen to know that her previous infection was a year ago when the delta variant was the predominant strain. Today, it’s the XBB.1.5 subvariant of the omicron variant. And as with the flu, which is also a virus, it is possible to get COVID-19 more than once, even if you’ve been vaccinated (which she hasn’t).

The problem with his not knowing this is that she could have received the antiviral pill Paxlovid or similar medication early on to lessen her symptoms, instead of spending over two miserable weeks in bed. By the time we talked, it was too late—you must receive the treatment within the first five days.

Understandable Confusion

Of course, much misinformation spreads wildly on social media. And it’s not just misinformation, but dangerous, outright fabrications. For example, Dr. Anish Agarwal, an emergency physician in Philadelphia, recently told the New York Times he’s still seeing patients who believe what he called “crazy” claims that the COVID vaccines “will insert robots into their arms.”

“We battle that every single day,” he told the paper.

We believe our patients are savvy enough to discount such craziness and hope they will check with us if they read something like this that concerns them.

But many of the misconceptions we hear arise because people are busy and don’t have time to keep track of all the news about the coronavirus, or they make assumptions based on misunderstandings like our acquaintances did.

So here’s a capsule summary of the facts we know about COVID-19 and the vaccines. Again, we hope you’ll contact us with any questions.

COVID-19 Facts

Yes, COVID-19 is still a threat, in some regions of the country more than others, especially the Northeast and Midwest. Hospitalizations, including here in Florida, have declined in recent weeks. But according to an NBC News tracker, the U.S. is still averaging 524 deaths from COVID-19 every day, including 63 Floridians.

And of course, hundreds of thousands of Americans are still dealing with the devastating effects of long COVID, and while we’re learning more all the time, we still don’t have a cure or effective treatments.

Despite a recent study that seemed to question the effectiveness of wearing face masks in public places, numerous studies have found they do work, not only to help prevent the spread of COVID-19 but also to protect the wearer.

The most recent study, conducted by the California Department of Public Health and published in the CDC’s journal Morbidity and Mortality Weekly Report, showed that those who reported wearing masks were about half as likely to become infected than those who didn’t. The analysis found the odds were even lower for those who reported masking “all of the time” vs. “some” or “most of the time.”

Other studies conducted over the course of the pandemic showed infection reductions from wearing well-fitting masks as high as 70-80 percent.

Vaccine Facts

COVID-19 vaccines are safe and effective. Adverse events connected with the vaccines are infrequent:

  • Myocarditis (inflammation of the heart muscle) associated with the mRNA vaccines occurred in 1,626 people out of 192,405,448 participants in one study.
  • Thrombosis (blood clots) associated with the Johnson & Johnson vaccine occurred in four out of one million people who received the vaccine.
  • And cases of both myocarditis and thrombosis were higher in those who contracted COVID-19 and hadn’t been vaccinated.

Vaccines often don’t prevent minor or even severe symptoms, but they do reduce the chance of serious disease and death. A research report by the Commonwealth Fund estimated that vaccines prevented 3.2 million deaths and 18.5 million hospitalizations in the U.S. between December 2020 and November 2022.

A primary series (two doses of the mRNA vaccine) plus a booster dose is more effective than a primary series alone; a second booster dose increases protection even better, and so on, because vaccine protection against serious illness begins to wane within four to five months after inoculation. 

Pfizer-BioNTech’s newer bivalent vaccine is more effective against both the original strain and the newer omicron and XBB variants than the original vaccine, according to a November 2022 study.

One 2022 study also found that vaccination reduces the risk of developing long COVID.

Vaccines also help to prevent transmission of the virus, as a November 2022 study found. In January, Forbes reported that those who had received the vaccine were 24 percent less likely to infect close contacts than those who were unvaccinated; those who had been previously infected were 32 percent less like to spread the virus; and those who had been vaccinated and previously infected were 41 percent less likely to transmit the virus. 

Keep in mind that even after three years of experience with the novel coronavirus, there’s still much we don’t know. But what we do know is based on solid, extensive, worldwide research, not on wild supposition or hearsay passed along on the Internet.

What to Know About the New COVID-19 Variant

As our concierge primary care doctors in Jupiter have said more than once over the past couple of years, we may be done with COVID-19, but the coronavirus isn’t done with us.

It’s still spreading, it’s still sickening and killing people, and it’s still learning how to survive. That’s why the latest report from the Centers for Disease Control and Prevention (CDC) didn’t surprise many health experts.

Late last month the CDC estimated that about 40 percent of current cases of COVID-19 are caused by the latest omicron relative, known as XBB.1.5. In December, XBB.1.5 more than doubled its share of COVID-19 cases each week, rising from about four percent of new infections in the first week to about 41 percent by the end of the month.

“For a few months now, we haven’t seen a variant that’s taken off at that speed,” Pavitra Roychoudhury, director of COVID-19 sequencing at the University of Washington School of Medicine’s virology lab, told CNN.

Latest Mutation

Mehul Suthar, who studies emerging viral infections at the Emory University School of Medicine in Atlanta, told USA Today that XBB.1.5 appears to be about five times more contagious than earlier omicron variants, which were five times more contagious than the original virus.

“The numbers start adding up,” he told the paper.

For you who are trying to keep up with the “scrabble variants,” (so-named because these letters tend to produce higher scores in Scrabble) the XBB.1.5 is related to the XBB variant, which is a recombinant of the BA.2.10.1 and the BA.2.75 sublineages.

While scientists still aren’t sure whether the XBB.1.5 causes more serious illness than its predecessors, NBC News reports that studies performed in the lab have found that XBB appears to be more contagious.

“It’s clear that there are immune evasive properties of XBB,” Isaach Bogoch, an infectious disease physician and epidemiologist at the University of Toronto, told NBC News.

In other words, the virus is evolving to get around the antibodies we’ve built up from vaccines and infections with previous strains.

Improving its Abilities

CBS News reports that the XBB.1.5 variant also contains an additional mutation called S486P, which Chinese scientists say appears to offer a “greatly enhanced” ability to bind to cells. In addition, XBB is resistant to various monoclonal antibody drugs used to treat infections.

“The mutation is clearly letting XBB.1.5 spread better,” Jesse Bloom, a computational virologist at the Fred Hutchinson Cancer Center, told CNN.

“It’s got a better ability to get into cells,” Roychoudhury added.

“We’re projecting that it’s going to be the dominant variant in the Northeast region of the country and that it’s going to increase in all regions of the country,” Dr. Barbara Mahon, director of the CDC’s proposed Coronavirus and Other Respiratory Viruses Division, told CBS News.

The question is how much of this spread is due to XBB.1.5’s enhanced abilities and how much can be attributed to the increased travel and social gatherings over the holidays.

To Worry or Not?

Another looming question is whether it will make people sicker. The data so far are unclear.

While XBB.1.5 shows an ability to evade immunity, Bogoch told NBC News that even if cases begin to rise significantly, he doubts there’ll be the dramatic spike in hospitalizations or deaths we saw in previous waves.

In addition, other parts of the immune system can work to protect against the virus, and vaccines along with prior infections should offer some protection from severe disease.

“We might certainly have a wave, but it’s just much less likely to be as deadly or overwhelming to healthcare systems compared to earlier waves before we had this degree of hybrid immunity,” he said.

Still, experts worry that the falloff in vaccination boosters could create problems.

“We aren’t in 2020, but people still do need to take this seriously and protect themselves,” the CDC’s Mahon told NBC.

Get Protection

One way to protect yourself, which most people are resisting, is to wear masks in public because it’s safer to avoid getting infected at all, Suthar told USA Today.

“The ‘it’s OK if I get infected’ attitude is not the most viable,” he said, adding that he still wears a mask when in public indoor spaces.

And all of the experts are concerned that less than 15 percent of the population has received the latest boosters against the coronavirus. Although they aren’t designed for the XBB.1.5 variant, they will offer some degree of protection.

Michael Osterholm, who directs the University of Minnesota’s Center for Infectious Disease Research and Policy, told CNN he sees reason for hope from the updated bivalent boosters, which target the original coronavirus as well as the omicron strains BA.4 and BA.5.

“They still provide a level of immunity that may not prevent you from getting infected but may have a significant impact on whether you become seriously ill and die,” he said.

“I mean, right now, the most recent data we have shows that for those who have the bivalent vaccine, they have a three-fold lower risk of dying than those who don’t,” he added.

Are You Sick? How to Tell Which Virus You Have

As most of us have shed our pandemic masks in favor of returning to less restricted socializing, some of the viruses we didn’t have to deal with for the last two winters have resurfaced—with a vengeance.

According to the Centers for Disease Control and Prevention (CDC), seasonal flu activity is “elevated across the country.” The respiratory virus RSV is 10 times higher than normal, and more than 40,000 new cases of COVID-19 are being reported daily.

So if you’re sick, our concierge primary care doctors in Jupiter want to help you figure out which of these highly contagious viruses may be causing your symptoms, and what to do about them.

The ‘Tripledemic’

The flu season began six weeks earlier than normal this year, with at least 880,000 reported cases as of the end of October, including 6,900 hospitalizations and 360 flu-related deaths. This is the highest number recorded since the 2009 H1N1 swine flu pandemic.

“The Southern Hemisphere has had a pretty bad flu season, and it came on early [there],” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Bloomberg News. So officials weren’t especially surprised when it hit early and hard here, too.

At the same time, the respiratory syncytial virus, or RSV, has been flooding children’s hospitals with cases. And while the media’s attention has largely been focused on children, RSV can also hit older adults and those who are immunocompromised.

Meanwhile, COVID-19 cases have leveled off, but as of the end of November, the CDC was reporting 281,000 new cases and 2,222 deaths a week, with cases expected to rise this winter.

And, of course, without universal masking, colds are also making a comeback. To make matters worse, it is possible to be infected with more than one virus at the same time.

Similar Symptoms

With all these viruses hitting at once, it’s doubly difficult to know which one you have, because all of them have overlapping symptoms.

“At this stage of the pandemic, it’s really difficult to differentiate between the flu, COVID, common colds, and even seasonal allergies,” Céline Gounder, an infectious disease specialist, epidemiologist, and senior fellow at the Kaiser Family Foundation, told CNBC’s Make It.

“I, even as an infectious disease specialist who’s been practicing for a couple of decades now, cannot differentiate just on an exam,” she said. “You really need to do a test.”

Early on, it was easier to tell the difference at least at least with COVID-19, because of such distinctive symptoms as loss of smell and taste and red eyes or toes. But Gounder explained that because most people now have some degree of immunity, either through vaccination or infection or both, our bodies aren’t reacting the same way. Second, the newer variants are behaving differently than the original strain.

Ways to Tell

It helps to know which virus you have because they are not treated the same. With COVID-19, you can receive antiviral therapies, which can short-circuit the severity of the illness. But the antiviral treatments you can get for the flu are different.

As for RSV, Vandana Madhavan, clinical director of Pediatric Infectious Disease at Mass General for Children, told HuffPost that doctor’s offices are overrun right now, and if you bring your child in for mild symptoms that might otherwise get better at home, there’s a risk they could pick up something else while they’re there.

So how do you tell? As Gounder pointed out, there’s no way to know for sure, but here are some typical symptoms of each.

Common cold:

  • sore throat
  • runny or stuffy nose
  • coughing
  • sneezing
  • headaches
  • body aches


  • sore throat
  • runny or stuffy nose
  • muscle/body aches
  • cough
  • fever or chills
  • headache
  • fatigue


  • sore throat
  • runny or stuffy nose
  • muscle/body aches
  • cough
  • fever or chills
  • headache
  • fatigue
  • diarrhea
  • nausea/vomiting
  • difficulty breathing or shortness of breath

The CDC notes that this list does not include all possible symptoms. Symptoms may change with new COVID-19 variants and can vary depending on vaccination status.


  • runny nose
  • decrease in appetite
  • coughing
  • sneezing
  • fever
  • wheezing

The CDC reports that these symptoms usually appear in stages and not all at once. In very young children with RSV, the only symptoms may be irritability, decreased activity, and breathing difficulties. Almost all children will have had an RSV infection by their second birthday.

What To Do

With any type of respiratory virus, it’s important to keep from spreading the virus to others, especially those who may be immunocompromised or are otherwise at higher risk. There are tests for COVID-19 and the flu, but not for the common cold or RSV.

Stay home if you are sick and get in touch with us if you have any questions.

Call 911 if you see any signs of an emergency, especially with COVID-19, including:

  • trouble breathing
  • persistent pain or pressure in the chest
  • new confusion
  • inability to wake or stay awake
  • pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
  • if you think it may be an emergency

As the number of cases of all these viruses rise, it’s smart to take precautions. Wear a mask in crowded, poorly ventilated places, wash your hands frequently, eat well, and get plenty of sleep. 

And get your flu vaccine and a COVID-19 booster if you haven’t had one recently (there is no vaccine for RSV or the common cold).


Psychological Distress May Increase Risk of Long COVID

A new study suggests that certain types of common psychological distress may make people more likely to experience the debilitating effects of long COVID.

While our primary care concierge doctors in Jupiter don’t want to add to anyone’s stress, it’s important to know why everyone should continue to try to protect themselves as much as possible from contracting COVID-19, especially if they fall into one of the higher-risk groups.

The mystery of long COVID

By now, everyone is familiar with the constellation of symptoms that linger long past recovery from COVID-19, which can include:

  • extreme fatigue
  • chest pain
  • muscle pain
  • brain fog
  • dizziness
  • heart palpitations
  • headache
  • fever
  • chronic cough
  • shortness of breath
  • insomnia
  • stomach pain
  • gastroenteritis
  • loss of smell and taste

Frustrating condition

Complaints vary by individual and can include as many as 200 different debilitating symptoms.

The Washington Post reports that data from the U.S. Census Bureau collected in June, which was analyzed by the National Center for Health Statistics, found that nearly one in every five Americans who developed COVID-19 still have long COVID symptoms.

And there are no tests to help definitively diagnose the syndrome, or reliable treatments to help people recover.

“Globally, no one understands what’s going on,” Laurent Uzan, a French sports cardiologist who treats younger people with long COVID, told The Post.

“We don’t give people a miracle cure. It’s a real war for them, daily,” he said.

Latest findings

Nevertheless, researchers continue to pin down a cause for long COVID.

Last month, a study by released by researchers at Harvard T.H. Chan School of Public Health, found that psychological distress, including depression, anxiety, worry, perceived stress, and loneliness before COVID-19 infection was associated with an increased risk of long COVID.

The study, published in the journal JAMA Psychiatry, showed that the increased risk was independent of other factors such as smoking, asthma, or other health behaviors or physical health conditions.

The team looked at survey responses from nearly 3,000 Americans and Canadians from April 2020 to November 2021. Of that group, around 1,400 participants said they had long COVID, defined as symptoms lasting four weeks or longer.

They found that those who reported some type of psychological distress before infection had a 32-46 percent increased risk of developing long COVID, compared to those who did not report any such distress. Those with two or more types of psychological distress had a 50 percent increase in risk.

“We were surprised by how strongly psychological distress before a COVID-19 infection was associated with an increased risk of long COVID,” study leader Siwen Wang, a researcher in the Department of Nutrition at Harvard Chan School, said in a statement.

“Distress was more strongly associated with developing long COVID than physical health risk factors such as obesity, asthma, and hypertension,” she said.

Senior study author, Andrea Roberts, a senior research scientist in the Department of Environmental Health at Harvard Chan School, added, “The factors that we identified are more strongly associated with risk of long COVID than pretty much anything else anyone’s found.”

‘All in their head?’

Does this mean these reports of long COVID are imaginary? Quite the contrary. Scientists have known for decades that psychological stress makes people more susceptible to physical illness.

“The results shouldn’t be misinterpreted as supporting post-COVID conditions as psychosomatic,” Jacqueline Becker, a clinical neuropsychologist at the Icahn School of Medicine at Mount Sinai who wasn’t involved in the research, told NBC News.

“Having a mental health issue is always going to be more likely to predispose you to health problems later on, whether it’s COVID, long COVID, or a different post-viral illness,” she said.

Wang and her team surmised that two different factors are involved in the increased risk.

First, stress has been proven to activate molecules that produce inflammation in the body, leading to cell damage throughout the body.

Second, stress has been shown to suppress the immune response, making it harder to fight off viruses and other illnesses. Even obesity, type 2 diabetes, and heart disease have been linked to emotional distress.

Mind-body connection

“Your brain and your immune system are very tightly interconnected,” Roberts explained.

“Studies have shown when you’re depressed or anxious, your immune system doesn’t work as well against targets like viruses and bacteria,” she said.

Furthermore, the study’s results only underscore the critical need for better availability of mental health services in this country.

“These results also reinforce the need to increase public awareness of the importance of mental health and to get mental health care for people who need it, including increasing the supply of mental health clinicians and improving access to care,” Roberts added.

We would also stress the importance of taking precautions to avoid COVID-19, such as masking in indoor settings and being up to date on vaccines and boosters.

Despite recent statements—including from President Biden—that the pandemic is “over,” approximately 400 Americans are still dying every day from the disease.

In the words of Tedros Adhalom Ghebreyesus, director general of the World Health Organization (WHO), “We can see the finish line [of the pandemic], but now is not the time to stop running.”


Latest on COVID-19 Omicron Boosters

The Centers for Disease Control and Prevention (CDC) earlier this month approved two new booster vaccines specifically formulated to target the BA.4 and BA.5 omicron subvariants of the SARS-CoV-2 coronavirus, so our primary care concierge doctors in Jupiter want to bring you up to date on the latest information.

What’s different about this vaccine?

The COVID-19 vaccines that have been in use since they were first rolled out in 2021 were all designed to target the original strain. They also effectively reduced hospitalizations and deaths against the different variants that emerged in the following months, including the widespread delta variant.

As the newest omicron subvariants emerged and are now responsible for 90 percent of COVID-19 infections, vaccine makers Pfizer-BioNTech and Moderna developed new, more tailored versions to specifically target them.

The new formula is defined as “bivalent,” meaning it protects against both the original strain as well as the highly contagious BA.4 and BA.5 subvariants. They are the first updated COVID-19 vaccines to be cleared by the U.S. Food and Drug Administration (FDA).

“The updated COVID-19 boosters are formulated to better protect against the most recently circulating COVID-19 variant,” said CDC director Rochelle Walensky.

“They can help restore protection that has waned since previous vaccination and were designed to provide broader protection against newer variants,” she added. “This recommendation followed a comprehensive scientific evaluation and robust scientific discussion.”

Tests in mice have shown they produce a good immune system response to omicron’s BA.4 and BA.5 subvariants.

Are they safe?

Some have questioned the safety of the new versions of the shots because they haven’t been tested in humans, only in mice. But the new vaccines have merely been “tweaked” to “change the recipe,” as the University of Colorado’s UCHealth website explains.

The original Pfizer and Moderna vaccines have been fully tested in humans, and more than 600 million doses in the U.S. and millions more around the world have been given safely. The advisors and experts at both the FDA and the CDC have determined that the newly formulated booster shots are safe.

UCHealth infectious disease and COVID-19 expert Dr. Michelle Barron compared the new boosters to the flu shot, which is updated every fall as vaccine makers guess which strains of the flu will be circulating, and change the recipe to match. But the vaccine itself is not entirely new, she explained.

“We don’t test the flu shot each year. We just change it slightly,” Barron said.

“This new COVID-19 booster just tweaks the formula. The technology is the same. The safety of the vaccines will be exactly the same because it’s not a new vaccine,” she explained.

Who can get them?

The Pfizer vaccine is authorized for anyone ages 12 and older; the Moderna vaccine is authorized for adults 18 and older.

Like the previous coronavirus vaccines, the new boosters are free to the public. They will be available to anyone who has already had their primary vaccine series from any authorized U.S.-approved company regardless of how many boosters they’ve already received.

Public health officials recommend that those who are pregnant or have been pregnant recently should also get the updated boosters because they are at a slightly increased risk of more severe illness and death from COVID-19.

For those who recently received a booster of the previous vaccines, the FDA has set a minimum waiting period at two months, but advisers to the CDC recommend waiting longer: at least three months for those at high risk, or as long as six months for everyone else.

It’s also recommended that anyone who has recently recovered from a COVID-19 infection should wait at least three months to be vaccinated, not only to boost the effects of the vaccine but also to avoid the possibility of a rare side effect, heart inflammation, that sometimes affects teen boys and young men.

“If you wait a little more time, you get a better immunologic response,” CDC adviser Dr. Sarah Long of Drexel University told CBS News.

According to the CDC, side effects are expected to be similar to those associated with the current vaccine, including headache and muscle soreness, occasional fatigue, and redness and swelling at the injection site.

What about other vaccines?

As we head into the fall flu season, several of our clients have asked whether they can get a coronavirus vaccine along with a flu vaccine. The answer is yes, one in each arm.

In fact, health officials have recommended this protocol, and the government is preparing to launch a campaign that will urge Americans to do just this, due to the possibility of the high spread of flu and COVID-19 this season.

As for the Jynneos monkeypox vaccine, the CDC suggests that adolescent and young adult men consider waiting four weeks after receiving the monkeypox vaccine before receiving a Moderna, Novavax, or Pfizer COVID-19 vaccine, because of the risk of inflammation of the heart muscle (myocarditis) or inflammation of the tissue surrounding the heart (pericarditis).

However, the agency adds that the monkeypox vaccination “should not be delayed” due to recently receiving a coronavirus vaccine.

If you have any questions about whether or not to get the new booster, don’t hesitate to contact us for advice.

Coronavirus Pandemic

New Guidance on COVID-19 Can Be Confusing

Sometimes it seems as though we need a spreadsheet to keep track of all the changing information and recommendations on COVID-19.

  • Masks/no masks?
  • Boosters? Maybe not, maybe now, maybe later.
  • Quarantine? Yes, no, who, and how long?

Our primary care concierge doctors in Jupiter don’t mean to criticize the researchers and public officials who are responsible for keeping us healthy. The SARS-CoV-2 coronavirus is, after all, a disease we’d never seen until early in 2019. No one knew how to deal with it.

And thanks to the combined efforts of scientists around the world, we’ve made tremendous strides in the effort to combat it.

But one thing few counted on was “pandemic fatigue,” which meant many people rapidly grew tired of taking precautions and radically altering their lifestyles to help stem the spread of COVID-19.

Which may be what’s behind the latest guidance from the Centers for Disease Control and Prevention (CDC). (

A new approach

This month the CDC relaxed many of its coronavirus recommendations, leaving measures to battle to limit viral spread largely up to individuals.

According to The Washington Post:

  • “No longer do schools and other institutions need to screen apparently healthy students and employees as a matter of course.
  • “The agency is putting less emphasis on social distancing—and the new guidance has dropped the ‘six-foot’ standard.
  • “The agency’s focus now is on highly vulnerable populations and how to protect them—not on the vast majority of people who at this point have some immunity against the virus and are unlikely to become severely ill.”

In releasing the new guidance, the CDC cited improved tools like vaccination, boosters, and treatments to better protect ourselves from the virus.

“We also have a better understanding of how to protect people from being exposed to the virus, like wearing high-quality masks, testing, and improved ventilation,” Greta Massetti, a CDC epidemiologist, said in a statement.

“This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives,” she added.

Isolation changes

In one fairly substantial shift, for example, the CDC no longer recommends quarantine if you’re up to date with your vaccines and have been exposed to COVID-19. Instead, you should mask for 10 days and get tested on Day Five.

Additional CDC guidance on isolation includes the following:

  • If you’ve tested positive and have a healthy immune system, regardless of your vaccination status, you should isolate yourself for five days. On Day Six, you can end isolation if you no longer have symptoms or have not had a fever for 24 hours and your symptoms have improved.
  • Once isolation has ended, you should wear a high-quality mask through Day 10. If you test negative on two rapid antigen tests, however, you can stop wearing your mask sooner.
  • Until Day 11 at least, you should avoid visiting or being around anyone who is more likely to have severe outcomes from COVID-19, including the elderly and people with weakened immune systems.

These changes stem from a new statistic, according to Massetti: 95 percent of the U.S. population has at least some level of immunity against the virus, either from vaccination or previous infection.

What about boosters?

As for booster shots, the U.S. Food and Drug Administration (FDA) finally decided last month against allowing adults younger than 50 to become eligible for a second booster vaccine (for a total of four mRNA shots).

Currently, only those age 50 and older and children at least 12 years old with impaired immune systems can get a second booster.

This is because the agency expects to have reformulated mRNA boosters available by next month that will contain components from both the original virus and its variants, as well as from the currently circulating (and highly contagious) omicron subvariants BA.4 and BA.5.

Meanwhile, the FDA still recommends that anyone under age 50 receive a single booster shot, and people older than 50 or those with weakened immune systems receive a second mRNA booster.

The mask question

No one likes wearing masks, especially in the heat. However, our primary care concierge doctors believe it’s better to err on the side of caution, especially if you’re immunocompromised or older than 65.

Especially given the new CDC guidance revisions, there’s no harm in wearing a mask in crowded indoor situations with poor ventilation.

It’s true that we now have effective treatments for COVID-19, but given the risk of long COVID—one recent study found that as many as one in every eight people who contracted it had lingering symptoms—what’s the point in taking unnecessary chances?

It’s up to you, of course, but in a recent interview with The Post, Ziyad Al-Aly, an epidemiologist at Washington University in St. Louis, compared the current state of the country to “the Wild West.”

“There are no public health measures at all,” he told the paper.

“We’re in a very peculiar spot, where the risk is vivid and it’s out there, but we’ve let our guard down and we’ve chosen, deliberately, to expose ourselves and make ourselves vulnerable.”

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