OPINION

HERE'S TO YOUR HEALTH: Is there anything really new about Covid? YES!

Dr. Wayne Strouse, MD

After two full years of the world-wide Covid pandemic, it may seem like you've heard it all before. Vaccines, masks, variants — they are all just variations on a theme.

Well, pay attention! There is definitely something new and VERY important!

Dr. Wayne Strouse

There is a new medication — an oral (pill) medication to treat (some would say to cure) Covid. Medications in the past were all given by IV. They worked, but you typically had to travel to a clinic somewhere (typically a bit of a drive — mainly to Syracuse).

Paxlovid

That's all behind us. Paxlovid — which is actually a combination of two drugs, and is taken by mouth, is available right here in Penn Yan. Several local pharmacies have this medication in stock right now.

There is one “catch” — you have to start taking Paxlovid within five days of the start of symptoms (NOT within five days of taking the test). The sooner you start, the better it works. After five days, Paxlovid just isn't effective. When taken as prescribed, studies show it to be 90% effective.

This image, provided by Pfizer in October 2021, shows the company’s COVID-19 Paxlovid pill. U.S. health regulators on Wednesday, Dec. 22, 2021, authorized the first pill against COVID-19, a Pfizer drug that Americans will be able to take at home to head off the worst effects of the virus.

It is expensive; about $700 per course of treatment — which is five days. However, it is covered by insurance or a special government program if you do not have insurance, at no cost to you. It does have number of interactions with other medications, so be sure whoever prescribes it knows what medications you are taking.

Early testing is vital

So, this means that early testing now becomes even more important. Here, again, there is good news. Tests are readily available, and can give you an answer in 15 minutes. They can be purchased online or at local pharmacies, or, better yet, you can get them free at Public Health or at your doctor's office just for the asking. You should probably keep some Covid tests always available at home.

So, if you feel unwell, get tested right away. If you test positive for Covid, call your doctor, so they can prescribe Paxlovid immediately.

From Green to Yellow

The other “new” thing is not so exciting. We are once again seeing an uptick in Covid cases. Yates County had been “green” on the CDC website (representing the lowest rate of Covid transmission). It is now “yellow.” Omicron has over 50 mutations, making it able to infect people who previously had Covid (even Delta Covid), as well as people who have been vaccinated and boosted. Mercifully, we are not seeing a huge spike in hospitalizations and deaths, although those are beginning to increase.

Omicron BA.1 is being replaced by a subvariant, BA.2, which is 10% more infectious than BA.1, and 300 - 400% more infectious than Delta. It is not as deadly as Delta, but it is still deadly. Very soon, we will have more than 1 million deaths (and 890,700,000 cases), in the United States, and 6.4 million deaths worldwide, making Covid the worst pandemic ever recorded.

Even after recovery from Covid, there is a significant minority that will develop long term symptoms such as shortness of breath, loss of taste and/or smell, so called “brain fog,” fatigue, and cough. This has been called “long-haul Covid.” We are still trying to learn why this happens, and what we can do about it. Right now, the best way to prevent long-haul Covid is to get vaccinated.

So, where are we going with Covid? Extrapolating from the most recent past, it appears we are not done with Covid. But, as Yogi Berra said, “It's tough to make predictions, especially about the future.” I foresee us being on this roller coaster for a few more iterations of variants. Covid has shown itself to be a very nimble virus, and we are really at the mercy of the random mutations of new variants, which makes herd immunity all the more difficult to achieve.

Knowing the risks

How do I synthesize all of this information, and what makes sense as to what to do for the future?

The groups that are at most risk of death and hospitalization are clearly the elderly. If you are over age 60, you are at high risk. Others at high risk are those who have medical issues, such as cancer (especially if you are under active treatment), chronic kidney disease, liver disease (like cirrhosis), chronic lung disease (like emphysema or COPD, moderate to severe asthma, or pulmonary hypertension), cystic fibrosis, diabetes, heart disease, heart failure, or stroke, and anything that causes a weakened immune system, such as HIV/AIDS, or any number of medications that treat conditions such as rheumatoid arthritis, Crohn's disease, organ transplant medication, and psoriasis. Finally, obesity (and even being overweight), pregnancy, smoking, and drug or alcohol use disorders put you at high risk.

If you are in any one of the above groups, you should absolutely get immunized! I recommend Pfizer or Moderna; Johnson and Johnson is an inferior vaccine, in my opinion. If you have previously gotten the J&J vaccine, get boosted with one of the other vaccines.

You should purchase a KN-95 or N-95 mask (they cost about $15 for a box of 50 on line), and wear it when you go into any store as well as in crowded or poorly ventilated areas. Avoid others who are ill, and you should probably avoid restaurants or bars unless you can be outside or do take-out (even alcohol can be “taken out” now).

Of course, staying away from others when you are sick (no work, no family gatherings, no parties) will also help — even if you are ill with something other than Covid.

Even if you are not at high risk, it is worth getting vaccinated, and boosted, since the other major group that is being hospitalized and dying is the unvaccinated.

That's my latest update. There is hope for the future, but we are not “out of the woods.” Covid isn't done with us yet, but we now have the means to fight it and prevent the severest consequences.

Be careful out there, and Here's To Your Health!

Dr. Wayne Strouse, MD, is a Family Practitioner in Penn Yan.