November Updates from Dr. Weisblat
Dr. Joel Weisblat • November 16, 2020
November Updates from Dr. Weisblat
Dear Patient,
As was anticipated, the colder weather has brought a surge of Covid-19 cases which no shows no signs of abating. Here are my latest thoughts:
1) Covid cases in Ohio are exceeding levels that we have seen at any previous time. Although comparisons are not exact due to the lack of available testing in the spring, daily cases have consistently exceeded 5,000 for the past 2 weeks. Hospitalizations are also at an all-time high in the state, and throughout most of the country.
2) Theories abound as to the cause of the increase, but the most likely explanation is that people are spending too much time indoors with people outside their families. It is important to remember that masks help but that a percentage of respiratory droplets can penetrate almost every mask. Maintaining a safe distance and limiting the amount of time spent indoors with others substantially improves their efficacy.
3) The good news is that 1 or 2 vaccines appear to be quite effective, and may be approved for use before the end of the year. If that proves to be the case, we can anticipate widespread availability by spring. Life may yet return to normal!
4) I urge everyone to be more cautious than ever right now. Wear your mask, maintain social distancing, and avoid all unnecessary close contact with others. Restaurants remain particularly dangerous, and gyms and salons are also risky. Holiday celebrations with friends and extended family are a recipe for trouble, and we can advise you on appropriate precautions.
5) Please give us a call if you develop cold symptoms, cough, fever, shortness of breath, diarrhea, or loss of taste or smell, and we can discuss the need for testing. Anyone who discovers they have been in close contact with a Covid patient should also be tested.
6) We continue to see a few patients in the office for quick, essential visits. We will likely wait on the vaccine to resume routine check-ups and longer visits. We have found that much can be done via telemedicine, and we urge you to take advantage of that option.
7) Now is a great time to get your flu shot if you haven’t already. We have plenty of regular and high-dose (for seniors) vaccine available, so give us a call if you’d like to get one.
8) Check out our revamped website at advim.org or advancedinternalmedicine.health. The pandemic has limited our ability to safely care for our patients on an in-person basis, so we are rolling out new ways to support the well-being of our patients while minimizing the risk of exposure to Covid-19. Click the Wellness Center link on the homepage to learn more.
I wish you all a happy and safe holiday season. Please be in touch if we can help you through this challenging time.
Joel D. Weisblat, M.D.
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Dear Patient: There has been a lot of news about the pandemic in recent weeks, and also a lot of confusion. Today’s update is in the FAQ form, in response to many of your concerns. 1) What is the current state of the Covid-19 pandemic? Obviously, it isn’t good, but there may be reason for optimism. The number of cases nationally seems to have plateaued, albeit at a high level, and the number of people vaccinated is steadily growing. Unfortunately, in Ohio, things are likely to get worse before they get better. Case numbers in the state are averaging above 4000 daily, higher than in many months. 2) What can I do to protect myself from infection? The same things we’ve been recommending all along. Wear a mask indoors in public places, keep your distance from those who may not have been vaccinated, and of course, if you haven’t been fully vaccinated, get it done today. 3) I thought the vaccines were effective, why are people talking about boosters? The Pfizer, Moderna and J&J vaccines have all proven to be quite effective at preventing serious Covid infections. However, we are seeing some waning immunity after 6 months, which is leading to a number of “breakthrough” cases. The good news is that the vast majority of these cases are mild or asymptomatic, with no more than a few days of illness. Even 6 or 8 months after completing vaccination, you remain very unlikely to contract a serious Covid infection. 4) What is a booster shot? Should I get it, and if so, when? A booster is just another dose of the vaccine, no different that the ones you already received. It is designed to further enhance the immune system’s ability to combat the Covid virus should it enter your body in some way. The CDC currently recommends a 3rd dose of Pfizer or Moderna in those who meet their strict definition of immune compromise, or (beginning Sept. 20) in those who are 8 months out from their 2nd dose. No recommendation regarding J&J boosters has yet been made. 5) Aren’t there drugs now that can treat Covid? Two drugs have been approved for treatment of SARS-Cov-2 infections. Remdesivir is an antiviral medication that has been shown to reduce mortality and length of stay in hospitalized patients. Regeneron has created a cocktail of monoclonal antibodies (REGEN-COV), which directly attack the virus, and it has been approved for use in Covid-positive patients who are not seriously ill, and in some cases for prophylaxis. Hydroxycholoroquine (an antimalarial drug) and ivermectin (an antiparasitic drug) have not been shown to be of any benefit in fighting Covid, may in fact be dangerous, and should not be used under any circumstances. 6) What do I do if I have been exposed to Covid? A vaccinated person exposed to Covid does not need to quarantine, but should get tested several days after exposure. Vaccinated individuals who are positive do not shed as much virus as unvaccinated individuals, and so are unlikely to transmit the virus to other vaccinated individuals. Nonetheless, those who are unvaccinated or otherwise at high risk for serious Covid infection may be eligible for prophylactic monoclonal antibody treatment. 7) Where can I get treated? If you meet the criteria listed above, you are a candidate for the Regeneron cocktail. Please call the office and we can confirm your eligibility, order the injection, and direct you to a facility where you can receive it. 8) Is this ever going to end? Yes. One-third of Americans have now been infected with Covid, and over 60% of the eligible population has been fully vaccinated. This means that the pool of susceptible individuals is shrinking every day. We will reach a point where there simply aren’t enough susceptible individuals to sustain community outbreaks. The sooner people get their vaccines, the more they wear masks in risky settings, the sooner we will reach that point. Most experts believe that by early next year the virus will no longer be a serious threat in most areas of the country. 9) What can I do to do help? Encourage your friends and family who are reluctant to get vaccinated to get their shots. Keep wearing your mask indoors and practice social distancing. Let us know if you are feeling sick, so we can guide you to the appropriate treatment. And don’t despair! There is a light at the end of the tunnel. Joel D. Weisblat, M.D.
August 1, 2021 As the Delta variant roars through the country, some things have changed, and some have not. Here are my latest thoughts: 1) The resurgence of Covid-19 throughout the U.S. is real, and Ohio is starting to feel the brunt of it as well. Daily cases in the state are averaging over 1000, a five-fold increase in recent weeks, and hospitalizations and deaths are on the rise as well. 2) The reasons for this increase are threefold: the Delta variant is up to 5 times more contagious than previous variants; large numbers of Americans remain unvaccinated; and people are for the most part not wearing masks. 3) The very good news is that the vaccines seem to be holding up well, particularly the mRNA vaccines (Pfizer and Moderna). Those who have been vaccinated are much less likely to contract the virus, and if they do get infected, are dramatically less likely to get quite ill. It is estimated that less than 1 percent of those currently hospitalized with Covid were vaccinated. 4) Much has been written in recent days about the potential of vaccinated individuals to infect others, but what hasn’t always been reported is that those who are getting infected in this way are almost all unvaccinated. It still appears that vaccinated individuals without symptoms can congregate indoors with very little risk. 5) I think the most important message today is to re-emphasize the importance of wearing masks indoors. Most outdoor settings are safe, but the risk of transmission indoors is high, particularly when one doesn’t know who’s vaccinated. Wear your mask, maintain social distancing, and try to avoid crowds. 6) I would still recommend people avoid indoor restaurants, and the safety of plane travel is an open question with cases on the rise and mask requirements in flux. 7) Another question is whether an additional dose of vaccine will be necessary. There is conflicting data here, but I suspect we will be recommending people to get another dose in the coming months. Immunity does likely wane over time, though there is no evidence that fully vaccinated individuals are unprotected after 6 or 7 months. 8) Finally, I implore those of you who are not yet vaccinated to do so now. Covid can wreak havoc on your health, even if you are not in a high-risk category, and the contagion of this variant makes it much harder to avoid than the previous ones. Please contact me if I can answer any questions you may have about the safety or efficacy of this vaccine. 9) A hopeful bit of news is that the number of people getting vaccinated has picked back up, and if that trend continues, we may yet be free from this pandemic in 2022. Stay safe! Joel D. Weisblat, M.D
