Coronavirus Update: December 23, 2021

Let me start by saying that this is not the holiday newsletter I originally wrote. The original one was cheery and upbeat and, really funny.


I can’t send that one because last night, as I sat down to do one final edit, I had literally just splashed cold water on my face and wiped miles of mascara off my cheeks. There was a healthy 2 finger rocks glass to my left, and a pile of buttery Christmas cookies on my right.


So, you ask, why the tears and bourbon and sugary treats?


While I am so glad to have all three of my kids under my roof, surrounded by their piles of inexplicably damp laundry, I am also tapped out. As in TAPPED. OUT.


Just when we thought CoVID-19 was behind us, along came Omicron. It came on with such speed and fury that I had already written the aforementioned cheery version of this letter.


Our phones have not stopped ringing in days. We are booked and double booked. We are so short on appointments, in fact, that my scheduled Christmas vacation has turned into several days of seeing sick patients.


It was enough when my team was “just” exhausted, but now they are exhausted AND coming down with CoVID. This means the healthy among us are coming in early, staying late, and running like lunatics from CoVID test to flu test to booster vaccine and back again.


So last night, it had suddenly hit me that we were doing it all again — thus the tears, bourbon, and sugary treats.


But, as the bourbon warmed my soul from the inside, my heart rate slowed down, and I heard the tinkle of Hadley’s gorgeous giggle in the next room. And then, the truth materialized.



THE GOOD NEWS

Yes. People are sick. BUT, for the most part, they are only a LITTLE sick. They are clamoring for appointments not because they are short of breath, need oxygen, or are at risk of hospitalization. The vast majority simply want reassurance before they head out for the holiday.


Yes. The phones are ringing off the hook. But, it is not people calling grief-stricken over sickened loved ones on their death beds that they are not able to visit. They are calling to ask about things like the validity of at-home tests and whether they can get their booster shot in our office.


Yes. We are testing positive for CoVID, BUT we are NOT nearly as sick with CoVID as our friends and colleagues who had it last year at this time.


In our office, vaccines AND boosters are mandatory. So, NONE of the people who have tested positive have been seriously sickened.


THAT is the difference between this year and last year. VACCINES and BOOSTERS have made this go-around so, so much easier.


About a year ago, a line was drawn in the sand. Those that stepped over it and were vaccinated will be ten times less likely to be hospitalized with CoVID — Alpha, Delta, or Omicron.


Our kids 5 and up are eligible for vaccines. Our schools and college campuses have been open for in-person learning. We are traveling and seeing our friends and family.


Yesterday, two huge studies confirmed what we have suspected for the past two weeks — Omicron definitely causes less severe disease. Whether this is because by its nature, this variant is less dangerous, or it is because we have much more immunity among the vaccinated and previously sickened, we will never truly understand. What matters is that THIS time, despite a virus that is 50 times more contagious than the last, we are in a much, much better place.


One year ago today, my mother-in-law told me she was planning on attending Christmas Eve service and my heart nearly stopped. Today, we talked about ham sandwiches between Longwood Gardens and church on Friday night and the only thing I worried about was having all my presents wrapped in time.


This week, South Africa saw a 20% drop in their CoVID cases. If that trend holds true for us, we should be on the other side of this surge faster than we have in previous surges. In the meantime, if you are vaccinated and boosted AND get CoVID, it is OK. The worst-case scenario for us is most likely a 10-day quarantine.


Please know that if you are vaccinated but it has been 6 months and you have not gotten your booster, you may as well be unvaccinated. Get your booster now. We have Moderna in our office, which is appropriate for everyone regardless of initial vaccination. My only recommendation is that boys/men aged 16-29 get Pfizer as it had a lower incidence of myocarditis.


If you have not gotten ANY vaccine yet, please reconsider.


If you have had a CoVID infection, and a vaccine, you still should get a booster. We have seen very few reinfections among vaccinated people who have also had a case of CoVID in the past. So, there definitely is something about natural immunity that augments that of the vaccines. But, we can’t count on it.


Many people are discouraged by the idea of another booster and another and another. I don’t know what will happen with vaccines in the future BUT if that is our worst-case scenario relative to 2020, so be it.



A NOTE ABOUT THERAPIES

First of all, we actually HAVE SOME. That, in and of itself, is a change.


Unfortunately, our existing monoclonal antibody treatment is not effective against Omicron BUT new antibody formulations are in the works, and just yesterday, Pfizer got EUA for its oral drug: Paxlovid. For now, it is ONLY indicated for those 12 and up at risk of hospitalization or death. In other words, it will be of greatest value to those 40 million people who still have not been vaccinated. We don’t know exactly where and when this treatment will be available. Eligibility for it will continually change, but we will keep you posted.



RAPID TESTING

Rapid tests have been instrumental in our ability to identify people needing to quarantine. However, in our area, they are becoming harder and harder to find. In our practice, we will do rapid tests on our patients. It is important to wait at least two days from the onset of symptoms or these tests are not reliable. If you are asymptomatic, vaccinated, and had a close exposure, you will need a test 5 days after that exposure.


If you do an at-home rapid test and it is positive, IT IS POSITIVE. The likelihood of a falsely positive test is next to zero. There is no need to confirm an at-home positive test. If you test negative at home, it could be false especially if you are early in the course. A negative at-home test in a symptomatic person who thinks they may have CoVID should be repeated a day or two later.


Whether by rapid test or PCR test, if you test positive for CoVID, we have a downloadable guide to caring for yourself and easing your symptoms.


Vaccines, boosters, reliable rapid tests, an oral treatment, AND a virus that may have just mutated itself toward oblivion are all things to celebrate. I am sorry I broke down earlier. I will blame my 50-year-old transitioning hormones, my kids baking cookies together for the first time in a long time, and this Ingrid Michaelson song that came on and ALWAYS makes me cry. I think it is because it is a song Maisy and Vishal have sung together for us in much, much simpler times.


I love this version with Jason Mraz (I mean Jason Mraz in jeans and a fedora — what’s not to love?)


Enjoy it and know that we will get through this, too… You and I.

-C



 


Holiday Office Hours


We will be closed tomorrow (12/24, Christmas Eve) and Saturday (12/25, Christmas Day) and back in on Sunday, 12/26. We do have a provider on call for emergencies only. We all desperately need some downtime with our families, so please reserve these calls for true emergencies. To reach the on-call provider please call the office at (610) 363-0100.


Please know that as of this moment, we will not be able to do any further CoVID testing until Sunday.


As we all head out of the office, we wish you all a happy and peaceful holiday weekend.

— Christine Meyer, MD and Associates —

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