The current version of the Corona virus continues to be a palpable presence in our community. As you can imagine, we have been staying busy addressing the multiple clinical complications and questions that arise from this very difficult virus. Some people experience severe complications such as pneumonia, hypoxia, heart problems, debilitating fatigue, and a host of other potential problems, while others are minimally symptomatic or asymptomatic.
In the midst of the ongoing pandemic, there continues to be a wave of misinformation showing up in multiple forums.
Given this backdrop, we thought it might be helpful to pass along some updated and reliable information. We have attempted to address the majority of the questions that we hear on a daily basis. As always, feel free to call the office with any additional questions or concerns that might not be addressed here.
How can I avoid getting COVID-19?
The best way to stay healthy is to get vaccinated.
The next best way is to practice social distancing and to wear a mask in public. It’s also a good idea to wash your hands regularly and apply hand sanitizer. We know these techniques work because there were practically no flu cases in 2020, a year where most people followed these safety precautions.
It’s also wise to avoid crowds or crowded places as much as possible. The more people, the more likely your chances are of contracting COVID.
Lastly, if someone in your household has developed COVID, it’s best to keep your distance from that person as much as possible.
What should I do if I develop symptoms of COVID?
Since it is virtually impossible to distinguish the symptoms of COVID from any other common virus, including flu, testing is the only way that you can tell for sure. A positive test is a definitive result, while a negative test is a “probable” result. There are approximately 10% of false negatives. In someone who we think likely has COVID infection but has an initially negative test, we will often recommend a repeat test in 2 or 3 days.
From a symptom management standpoint, the approach is the same as it is for most viruses. It is important to stay well hydrated throughout the infection. Tylenol and ibuprofen are helpful to control fever, muscle aches, headaches and other forms of discomfort that typically show up at this time.
The typical course of a COVID-19 infection includes flu symptoms that get steadily worse over the first 5-6 days, and then gradually resolve by day 10-14. It is important that you alert your physician with worsening of symptoms towards the end of that first week or sooner if there is any question. One of the most important vital signs with COVID infection is oxygen level. We encourage anyone with symptoms and signs of COVID infection to monitor their oxygen level using a “pulse oximeter” which can be purchased online or at almost any pharmacy or department store. A significantly declining oxygen level, typically drifting down into the low 90s or high 80s, is often a sign that COVID pneumonia is beginning to develop, which would trigger emergency department evaluation and possibly hospitalization.
Monoclonal antibodies are available for patients that test positive for COVID-19 virus and who are felt to be in the “high risk” category*. This single dose infusion of antibodies markedly decreases the risk of hospitalization from COVID-19 infection in these individuals, as long as it is administered within a 10 day window of the onset of symptoms. For that reason, it is important that you contact your primary care physician early on if you happen to develop symptoms and test positive for COVID-19.
We now know that medications like hydroxychloroquine and ivermectin do not help to cure or mitigate COVID-19 infections. In fact, these medications often do more harm than good in this setting. The same is true with most antibiotics. There are times when we do prescribe antibiotics during the course of a viral infection when it looks like the infection is being complicated by a bacterial infection. Otherwise, antibiotics have no role in treating viral infections.
Should I get the COVID-19 vaccine?
The short answer is—YES!!!! For most people, the benefits of getting vaccinated against COVID-19 are much greater than the risks.
Getting vaccinated greatly lowers your chances of getting infected. And while it is still possible to get COVID-19 after being vaccinated, if you do get infected, you will be much less likely to get severely ill. The majority of patients that end up in the hospital with severe COVID complications are generally unvaccinated.
In addition to protecting yourself, getting the vaccine also protects other people, including those who are at high risk of getting very sick or dying. It protects people who cannot yet get a vaccine – like young children. Even if you are not worried about getting very sick yourself, you could still spread the virus to others, even without realizing it.
There are a few exceptions to this vaccine recommendation. Patients who are acutely ill should not go for vaccination until they are completely recovered. Patients who have had severe vaccine reactions should discuss the pros and cons of vaccination with their primary care physician. Those patients who have religious or moral objections to vaccinations should consult their ministers or mentors.
Are the COVID-19 vaccines safe?
There is no such thing as a vaccine that is 100% safe. Furthermore, there is no pill that you put into your body that is 100% safe. That being said, vaccines have been around for over 100 years and have helped eradicate or dramatically decrease multiple life-threatening or life-altering illnesses. We know from this experience that there are profoundly greater benefits than harms from widespread vaccination.
From the preliminary studies on the Pfizer and Moderna vaccines, the serious adverse event rate appears to be less than 1 in 10,000. More recently, there is evidence of myocarditis (inflammation of the heart) as a rare complication in younger patients. In the Johnson & Johnson vaccine, there have been rare complications of clotting disorders in a small handful of patients.
The good news is that these vaccines all appear to dramatically decrease the incidence of COVID-19 infection and, for those vaccinated people that get the COVID-19 infection, it is generally mild and not life-threatening. Your risk of myocarditis and clotting disorders dramatically goes up with COVID-19 infection, much more so than your risk of these complications with the vaccine. In fact, there are many other dramatic and life-threatening complications of the COVID-19 virus that greatly overshadow the minimal risk of vaccination.
It is true that the COVID-19 vaccines were developed very quickly, however, these new vaccines ultimately went through the same process as other vaccines to test them for safety. Multiple clinical trials were performed involving tens of thousands of people of all ages and ethnicities. During these trials, researchers studied how well the vaccines work and how many people had side effects. The results were reviewed by doctors and clinical researchers who do not work for the drug companies that made the vaccines. These experts agreed that the vaccines are safe enough and effective enough to be given to the public.
Do I still need the vaccine if I have had COVID-19?
Yes. Experts recommend getting vaccinated even if you had COVID-19 in the past. People who get COVID-19 usually do develop antibodies that provide some protection against getting infected again. But it is not known exactly how long antibodies last after a person recovers. Also, the antibodies you get from a vaccine might give you stronger protection against new virus variants.
People who have had COVID-19 in the past might be more likely to have side effects after they get the vaccine. Keep in mind that any side effects are temporary, and it’s still important to get vaccinated.
What are “boosters” and will I need one?
A booster vaccine is a dose given some time after a person first gets vaccinated. This is because the protection you get from a vaccine can decrease over time. Experts recommend boosters for some vaccines such as tetanus to “remind” the immune system how to protect against a specific infection. Some countries, including United States, have announced plans to give COVID-19 vaccine boosters. The timing for this is currently unclear and depends on ongoing analysis of previously vaccinated patients. Unfortunately, there is significant misinformation floating around about this topic. The FDA will be making a preliminary recommendation on this sometime soon and they generally tend to follow the science instead of the headlines.
We do currently recommend that people with a weakened immune system get a third dose (which we are calling a booster dose) of the Pfizer or Moderna vaccine. Because the vaccine might not work as well in people with a weakened immune system, the extra dose can help give extra protection.
What can I do after I am vaccinated?
“Fully vaccinated” means you have had all doses of the vaccine and it has been at least 2 weeks since the last dose. (If you had a single-dose vaccine, you are fully vaccinated 2 weeks after you get the shot.)
Once you are fully vaccinated:
- If you live in an area where COVID-19 is not spreading quickly, it is generally safe to gather with other people without masks. You might also be able to go without a mask in some public places, but this depends on your local and state rules and the number of cases in your area. In general, if you choose to travel within the United States, you do not need to get a COVID-19 test or self-quarantine.
- If you have been around someone who tested positive for COVID-19, wear your mask and get tested as soon as possible. Even if you have been vaccinated, it’s still possible to get the virus and spread it to others.
- If you live in an area where COVID-19 is spreading quickly, experts recommend that you still wear a mask when you are indoors and around other people.
- No matter where you live, you should continue to wear a mask and social distance while traveling on public transit or in school buildings. Some businesses and other public spaces might also still require that everyone wear a mask. These include places like hospitals, medical offices, and nursing homes.
Some activities, like traveling to certain areas or attending certain events, might require vaccination. So, getting the vaccine will make it easier to get back to doing the things you enjoyed before the pandemic. The more people who get vaccinated, the sooner the pandemic will end.
Can I get COVID-19 from the vaccine?
No. You cannot get COVID-19 from the vaccine.
Some people worry that the vaccine actually contains the virus that causes COVID-19. The Johnson & Johnson vaccine that is available in the United States does contain virus, but it is a different virus. It is also created in a lab in a weakened form so it will not make a healthy person sick. mRNA (Pfizer and Moderna) vaccines do not contain virus at all.
Want to stay up-to-date on the latest COVID-19 information?
We encourage you to visit these sites:
- Johns Hopkins Coronavirus Resource Center
- Coronavirus disease 2019 (COVID-19) – Symptoms and causes – Mayo Clinic
- COVID-19: What You Need to Know About the Vaccine
- United States Centers for Disease Control and Prevention (CDC)
- World Health Organization (WHO)
- In the United States, you can check the level of spread where you live at this website
*High Risk Criteria for use of monoclonal antibodies:
- Older age (65 or older)
- Obesity or being overweight
- Chronic kidney disease
- Diabetes mellitus
- Sickle cell disease
- Immunosuppression (immunosuppressive disease or treatment)
- Cardiovascular disease (including congenital heart disease) or hypertension
- Neurodevelopmental disorders (eg, cerebral palsy) or other medically complex conditions that confer medical complexity
- Dependence on a medical-related technology (eg, tracheostomy, gastrostomy, or positive pressure ventilation [unrelated to COVID-19]).
We hope that this information has been helpful. As always, continue to be vigilant in guarding against this virus. Wishing each of you continued good health.