Common COVID-19 Misconceptions Linger Three Years Later

, , COVID

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

, , , , COVID, Disease, News, Preventative Health, Vaccinations

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.

vaccine

Latest on COVID-19 Omicron Boosters

, , , , COVID, Disease, Lifestyle, Preventative Health, Vaccinations

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

, , , , , , COVID, Disease, Health Basics, Healthy Living, Lifestyle, News, Preventative Health, Vaccinations

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). (https://www.cdc.gov/media/releases/2022/p0811-covid-guidance.html) 

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.”

long-covid

Living with Long COVID

, , , , Disease, Preventative Health, Vaccinations

The post-COVID syndrome commonly known as “long COVID” or “long-haul COVID” can be debilitating.

Although not everyone experiences aftereffects from infection, some of the most common symptoms include lingering fatigue, shortness of breath after even mild exertion, trouble sleeping, “brain fog,” and symptoms that worsen after physical or mental activity. Others can include rapid heartbeat, chronic pain, dizziness, muscle weakness, and erectile dysfunction.

Read more
pandemic over

Is the Pandemic Over? Not Quite

, , , , , Disease, Lifestyle, Preventative Health, Vaccinations

Dr. Anthony Fauci’s comment that we are “certainly, right now, in this country, out of the pandemic phase” of COVID-19 sparked numerous questions to our primary care concierge doctors in Jupiter.

It also seemed to cause a great deal of confusion and misconceptions around the country at large, at least until he clarified his statement the following day.

Read more

What to Know About Infant Vaccines

, , , , , , Children, Concierge Medicine, Vaccinations

The Centers for Disease Control and Prevention (CDC) has designated this week National Infant Immunization Week (April 25-May 2) to raise awareness of the importance of childhood vaccines. This annual observance highlights the importance of protecting children two years and younger from vaccine-preventable diseases.

Read more
1 2 3