From the time we’re little kids, any mention of bowel habits can trigger giggling embarrassment. We’re not sure why that is, because the intestine is simply another organ in the body. Nevertheless, our concierge primary care doctors in Jupiter know that talking about bowel disorders can be uncomfortable for our patients.
Despite the fact that most COVID-19-related restrictions have been lifted across the country, and the death toll has been dropping, it’s unfortunately a fact that the coronavirus is still with us, and will be for some time.
If you think your allergies have been getting worse over the last few years, you’re not imagining it.
Mask mandates are dropping rapidly across the country. It’s becoming unusual these days to see someone wearing a face mask for protection against COVID-19.
But is universal unmasking a good idea at this point? That’s what many of our patients have been asking, so our primary concierge doctors in Jupiter want to explore the pros and cons.
Latest research
One study, published earlier this month in the journal The Lancet Public Health, suggests that erring on the side of caution when it comes to masking could not only prevent a large number of COVID-19 cases, hospitalizations, and deaths, but also save a substantial amount of money for businesses, the healthcare system, insurance companies, taxpayers, and others.
The study was led by the Public Health Informatics, Computational, and Operations Research (PHICOR) team at the City University of New York Graduate School of Public Health and Health Policy (CUNY SPH), along with a team from the National School of Tropical Medicine at Baylor College of Medicine. The team based their projections on the delta variant of the virus, but found even greater savings with the more infectious variants such as omicron and the newer BA.2.
Using a computer simulation model of the entire country, researchers projected a total savings of $2.9 billion in direct medical costs for anyone paying for health care if universal masking continued beyond certain thresholds. This includes individuals, insurance companies, and the healthcare system. They also projected a cost savings of $20.1 billion in productivity losses to employers and taxpayers.
The thresholds included in the study were an 80 percent vaccination rate across the population and a viral reproductive rate of five (that is, how contagious and infectious the current variant is). The researchers included a cushion of two to 10 weeks beyond achieving those two thresholds as optimal benchmarks to achieve their projected savings.
Mixed messaging
“The messaging about face mask use has been inconsistent throughout the pandemic as there has been back and forth about the use of face masks,” Bruce Y. Lee, CUNY SPH professor, executive director of PHICOR and the study’s lead author said in a statement. “First there was a focus on social distancing and then the focus turned to face mask-wearing. Then attention turned towards the COVID-19 vaccines once they came out.
“Instead, as long as the pandemic is continuing, there’s a need to consistently layer multiple interventions on top of each other, since each complement and enhance each other.”
Yet still only 65 percent of Americans are fully vaccinated, 66.2 percent of Floridians. Only 18 percent of children between the ages of five and 11 are fully vaccinated, and only 44 percent of Americans have received a booster vaccine (38.4 percent in Florida).
Therefore, continued widespread use of masks in the U.S. would appear to be beneficial, even though few seem to be doing so now.
Unpredictable virus
The problem with the SARS-CoV-2 coronavirus is being able to predict what it will do next. Every time health officials believe it is under control or on the run, it pops up again in a slightly different form.
The latest entrant in the COVID-19 version of whack-a-mole is the even more contagious BA.2 subvariant of the omicron variant. In several Western European nations that have relaxed their various mitigation measures, BA.2 has caused as much as a 50 percent spike in cases within a matter of weeks once it appears.
So far, what happens in Europe doesn’t stay in Europe, at least as far as COVID-19 goes. Our case increases have been following theirs by a few weeks each time a new variant arises, and we’ve already seen several thousand cases of BA.2 infection here, the White House announced earlier this month.
While early indications are that it’s not hitting our population as hard as Europe’s, health experts are concerned because our vaccination rates are lower than theirs. This might mean we’ll see cases, hospitalizations, and deaths begin to increase again, possibly surpassing the case numbers seen in Europe.
Weighing the risks
So should you keep wearing a mask in indoor spaces?
With every state either rescinding mask orders or planning to do so, it’s up to individuals to decide for themselves. If you’ve been fully vaccinated, aren’t in any of the high-risk categories for severe illness or live with someone who is, and are in an area of low transmission such as Florida is at the moment, you may feel comfortable in not wearing one, at least until another variant such as BA.2 begins to spread more widely.
If you prefer to err on the side of caution, however, wearing a mask indoors might protect you from becoming infected. Remember that the SARS-CoV-2 coronavirus—regardless of variant—is transmitted primarily through aerosols that linger for hours in the air. The vaccines offer one layer of protection, masks another.
“Why wouldn’t [the BA.2 subvariant of omicron] come here?” Kimberly Prather, a professor of atmospheric chemistry and an expert on aerosol transmission at the University of California at San Diego, asked The Washington Post recently.
“Are we vaccinated enough? I don’t know. So I’m wearing my mask still. I am the only person indoors [wearing a mask] and people look at me funny, and I don’t care,” she added.
There are so many reasons we love our pets: companionship, loyalty, entertainment, and unconditional love. It’s estimated that at least 68 percent of American homes have at least one pet.
As we’ve just passed the second-year anniversary of the SARS-CoV-2 pandemic, our concierge primary care doctors in Jupiter think we should take a moment to reflect on how far we’ve come in dealing with this often-deadly disease.
It may not seem like it, because we still have to wear masks many places and haven’t fully returned to pre-pandemic life, but we have made progress.
For instance, we know more about how it spreads (through the air, especially in enclosed spaces), and how to protect ourselves (safe, effective vaccines and high-quality masks). And even though we’re still in the grip of of this still-relatively new coronavirus, and we’ve also found effective ways to treat it (monoclonal antibodies and anti-viral drugs).
And, believe it or not, the omicron variant of the virus may have turned out to be relatively good news, even though over 2,000 Americans a day are still dying from it.
But because it appears less lethal than its predecessors, omicron may make the pandemic more manageable.
The Centers for Disease Control and Prevention (CDC) released the results of a study late last month showing that the omicron variant—which is now the dominant variant both here in the U.S. and around the world—causes less severe illness, fewer hospitalizations, and requires less time in isolation following exposure.
This is partly due to the large numbers of people who have been vaccinated and/or infected with COVID-19, as well as to the fact that the virus appears to concentrate its effects in the upper airways instead of settling deep in the lungs.
The downside is that omicron is far more transmissible than earlier variants or the original virus. This is why so many people are catching it, and why—due to the sheer numbers of infections— hospitals are still being overwhelmed and an average of 2,200 people a day are still dying from the coronavirus.
But an NBC News analysis of COVID-19 case numbers at the end of January showed that Florida is one of the many states where omicron is no longer surging.
And chief White House medical advisor Anthony Fauci said in an interview with ABC’s “This Week” that he expects the wave to subside in “most” states by the end of February.”
“As we get into February . . . it is very likely that most of the states in the country will have turned around with their peak and are starting to come down with regard to cases and then obviously hospitalizations,” he said.
While cautioning that “our work is not done,” Hans Kluge, regional director of the World Health Organization (WHO) for Europe, released a statement two weeks ago that offered a glimmer of hope to a pandemic-weary world.
“The pandemic is far from over, but I am hopeful we can end the emergency phase in 2022 and address other health threats that urgently require our attention,” he said in a statement.
“This pandemic, like all other pandemics before it, will end, but it is far too early to relax,” he added.
One recent setback in the fight against SARS-CoV-2 was the finding from the CDC, confirmed by the drugs’ manufacturers, that two of the most common monoclonal antibodies used to keep at-risk individuals out of the hospital do not work against the omicron variant.
But again, there’s good news on that front, as well, because one monoclonal antibody—sotrovimab—is effective, and is still available at most hospitals even though Florida’s outpatient centers have closed.
Those who have mild to moderate symptoms of COVID-19 (fatigue, cough, loss of smell or taste, fever) or have underlying risk factors (those over 65, diabetes, obesity, kidney, heart, or lung disease or those who are immunocompromised) can check with area hospitals to see whether they’re offering this treatment.
In addition, other effective weapons in the arsenal against COVID-19 include the intravenous antiviral treatment remdesivir and the newly authorized oral antiviral drugs, Paxlovid or molnupiravir.
Two years in, we still don’t have all the answers, and until more people in this country and around the world are fully vaccinated, SARS-CoV-2 will not be fully manageable.
Each person who remains unvaccinated not only puts themselves at risk, but others around them, as well. And each infection offers the virus another chance to mutate.
Speaking of mutations, you may have heard of another new mutation of the omicron virus that some are calling “son of omicron” or “stealth omicron” because it’s so difficult to detect in PCR tests.
The new variant, designated BA.2 (omicron is BA.1), was first reported in California in November. It has since been seen in isolated cases in Texas as well as other countries. However, while remaining cautious, at this point most virologists don’t think it’s more dangerous or more transmissible than omicron BA.1. We’ll let you know if we learn otherwise.
It’s easy to make healthy resolutions for the New Year. We’re almost compelled to, because the flip of the calendar offers the promise of wiping the slate clean and starting a whole new life for ourselves.
But often, our best intentions fall by the wayside by the end of January. So our concierge primary care doctors in Jupiter would like to suggest a few healthy resolutions you can make that will be easy to stick to but can still make a significant difference in your health in the coming year.
Our concierge primary care doctors at MD 2.0 in Jupiter don’t want to dampen the festive spirit of your first big holiday gathering since the beginning of the pandemic. But taking a few common-sense precautions to ensure a safe and healthy Thanksgiving that can still leave plenty of room for merry-making.
That includes smart plans for healthy eating, along with implementing some common-sense guidelines to keep COVID-19 at bay.
Your concierge primary doctors at MD 2.0 in Jupiter, Florida, opened our practice because we became frustrated with the “assembly-line” approach to medical care that had increasingly been forced on the medical profession by insurance companies restricting the time allotted to patient visits.
For many people summer is their favorite time of year, but no one likes the increased chances of being bitten or stung by the various pests that proliferate this time of year. In addition, the bites and stings of some insects can be serious, causing severe reactions and even life-long chronic health problems.
