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Is the vaccine safe and effective?
The clear consensus of evidence shows that the two approved vaccines are both safe and effective. They use mRNA technology which has been successfully used in other medical treatments in the past and the mechanism by which they work is well understood. (You can read more about it here: https://www.politico.eu/article/how-coronavirus-vaccines-work-moderna-pfizer-mrna/ or feel free to ask Dr. Ryan.) The risk is quite low in absolute terms (there simply are not many reports of serious reactions and the few reactions that have happened have been well-managed). It is extremely low risk when compared to contracting COVID. Hickory Medical recommends receiving the vaccine when it becomes available to you. It is likely the best option for your health and, if our community accepts vaccination at a sufficiently high level, it will allow our lives and economies to return to normal relatively soon.
Here is a good summary of where things stand on many different vaccine candidates now: https://www.raps.org/news-and-articles/news-articles/2020/3/covid-19-vaccine-tracker
When can I get the vaccine?
Likely in the coming months, but the specific timing depends on your risk and a combination of availability and government guidelines. Currently, the vaccine is being made available to medical professionals and people residing in nursing homes. More groups of people will be included in the coming weeks. The federal government issues guidance, but so far the decisions about who receives the vaccines have all been made at the state level.
Is the virus mutating? Are there new forms that are more dangerous?
It does appear that there is a meaningfully different strain spreading in the United Kingdom right now. Preliminary evidence suggests that it is easier to contract than the coronavirus that we have been dealing with, but that it is not noticeably more dangerous otherwise. Furthermore, it appears likely that the vaccine will be effective in stopping it as well.
Masks and social distancing remain our two most effective tools.
- For masks to be effective they need to remain on at all times and cover the nose and mouth. Please note that it is particularly important that they not be removed to cough or sneeze as this is the time that they are most valuable in decreasing the spread of the virus.
- Social distancing means 6+ feet in a setting where there are regular full-air exchanges (outdoors or well-ventilated areas.) In poorly ventilated areas, even with masks, spread has been shown to occur in distances of 14 feet or more.
A good investment for the winter may well be excellent winter clothing as outdoor social distancing appears to remain effective even in cold weather. Having clothing that allows you to have socially-distant outdoor visits through the winter will help to keep transmission risk lower while maintaining social connections.
To get testing through the Logan County Health Department, our patients call the office, then we can submit a request to the health department. Patients will hear within 48 hours if they qualify for testing and results generally take 3-4 days after the test is done.
Community Health and Wellness Partners of Logan County (CHWPLC) has begun testing and simply requires that you register in advance. It is our understanding that the cost is between $0 and $50. You do not need an order from us for testing. Test results are available in less than an hour. For more information or to register, please see the CHWPLC website here: https://www.chwplc.org/coronavirus-testing/.
Mary Rutan Urgent Care is now doing COVID testing for those with symptoms. An order from us is required to be tested at this location.
A study (from Spain) of how the virus spreads: https://english.elpais.com/society/2020-10-28/a-room-a-bar-and-a-class-how-the-coronavirus-is-spread-through-the-air.html
Development of an antibody-resistant strain of the virus in mink seems to be well-managed at this point. If this does happen and it gets out, it will require a significant shift in strategy and in the duration of the pandemic as it would likely make vaccines much less effective. We are watching this closely, but at present, we would rate this as low risk and outside of our control.
Should we be changing our Holiday plans?
Generally, it is best to avoid any indoor time with anyone that does not live in your house if it is possible.
For all of us, some risks must be made taken so that that we can keep our community safe, our families together, and our economy running. The biggest problems with holiday celebrations are that they tend to be relatively long, indoors, and (because they involve eating) tend to not have masks. This means that a single person who is shedding the virus is much more likely to spread it than in other settings where masks, ventilation, and/or the time together is less. This is compounded by the fact there the gatherings are often, by their nature, bringing together people who do not see each other as often. This means that whole new groups of people are indirectly being exposed – everyone who works with anyone around the table, shops with them, or has visited them becomes a second-degree contact for everyone at the table.
With all of this in mind, there is no way that anyone can definitively weigh all that goes into such decisions. From a purely medical perspective, holiday gatherings are extremely concerning because they will contribute to more rapid spread and they tend to span communities so that the spread doesn’t stop at what might otherwise be a normal boundary.
The three things to focus on if you are getting together at any time are:
1) Limit time together (15 minutes or less if you are indoors).
2) Maximize ventilation (outside if at all possible, with windows open if you are indoors)
3) Make it hard for the virus to get from one person to another (wear masks, stay far apart, avoid singing or loud talking, etc.)
Will the vaccine work if I have been infected?
At this point, we have not been able to find research to answer this question.
It is worth noting that your body may very well respond to a vaccine differently if you have already had the infection – we’ve seen this with other diseases and vaccines. It is clearly best practice to avoid infection if at all possible – both to ensure that your future vaccine is likely to work as intended and to help slow the current outbreak.
Will Hickory be administering the vaccine?
At this point it seems highly unlikely.
Our goal is going to be to support the systems that have the equipment and breadth to administer the vaccine quickly and appropriately as directed by the government. We fully support the effort, but do not see a good way to manage and distribute the vaccine with our limited staffing and resources.
What are the symptoms of COVID?
Symptoms of SARS-CoV2 infection include:
- Fever or chills
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
Symptoms begin 2-14 days after exposure to the virus. Some people can have infection without any symptoms.
Is it possible to get infected with COVID-19 a second time?
In the last week of August, there were several cases of reinfection reported – one in Hong Kong, two in Europe, and one in Nevada. Three of these individuals had mild cases the second time; however, the individual in Nevada had a more severe case the second time.
Hong Kong - https://www.bmj.com/content/370/bmj.m3340.long
Europe - https://www.reuters.com/article/us-health-coronavirus-netherlands-reinfe/two-european-patients-re-infected-with-coronavirus-idUSKBN25L0LF?il=0
Nevada - https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3681489
Do masks really work?
A study of mask mandates in the United States found that between 230,000 and 450,000 COVID-19 cases were prevented by mask use prior to May 22, 2020.
A study looking at mask use in various countries showed that countries where masks were generally used showed an increase of COVID-19 deaths of 15.8% per week compared to a 62% per week increase in other countries.
Some masks are more effective than others at blocking the spread of coronavirus. Masks with exhalation valves or vents should not be used as they do not prevent transmission of the virus to others.
Are face shields a good replacement for masks?
Face shields are used for eye protection for the person wearing it. At this time, it is not known what level of protection a face shield provides to people nearby from the spray of respiratory droplets. There is currently not enough evidence to support the effectiveness of face shields for source control, so face shields are not a substitute for masks.
Are there any long term-effects from having COVID-19?
A study of patients in Italy who were hospitalized for COVID-19 found that after about 2 months, only 13% had no remaining symptoms, while 55% of patients had 3 or more residual symptoms including fatigue (53.1%), shortness of breath (43.4%), joint pain, (27.3%) and chest pain (21.7%). A worse quality of life was reported by 44% after COVID-19. Even in patients with mild illness, between 10% and 15% have ongoing symptoms. A recent study of 100 patients with COVID (only 1/3 were hospitalized), found that more than 3/4 had MRI showing heart involvement and 60% had ongoing heart inflammation. There are professional athletes who will be missing at least a year due to COVID-19 related heart issues.
Should I get the Flu Shot this year?
The influenza vaccine does not increase the risk of getting COVID. With the increased number of people who are sick with COVID, it is important to minimize the number of people with influenza. With the extended quarantine for those with COVID like symptoms, getting a flu shot can keep you from missing an extra week or more from school or work if you avoid the flu.
How long should I be away from work/school if I have COVID-19 symptoms?
You need to isolate for 10 days after symptoms started or positive test AND your symptoms are better AND you have had no fever without medication for at least 1 day.
People who need to isolate include:
- People who have symptoms of COVID-19 and are able to recover at home
- People who have no symptoms (are asymptomatic) but have tested positive for infection with SARS-CoV-2
When you isolate, you need to:
- Stay home except to get medical care
- Monitor your symptoms. If you have an trouble breathing, seek emergency medical care immediately
- Stay in a separate room from other household members, if possible
- Use a separate bathroom, if possible
- Avoid contact with other members of the household and pets
- Don’t share personal household items, like cups, towels, and utensils
- Wear a mask when around other people, if you are able
How long should I be away from work/school if I have had a close contact that had COVID-19?
You should quarantine for 14 days after the last close contact with the person with COVID-19.
You have had a close contact if any of the following are true:
- You were within 6 feet of someone who has COVID-19 for a total of 15 minutes or more
- You provided care at home to someone who is sick with COVID-19
- You had direct physical contact with the person (hugged or kissed them)
- You shared eating or drinking utensils
- Someone with COVID-19 sneezed, coughed, or somehow got respiratory droplets on you
Even if you test negative for COVID-19 or feel healthy, you should stay home (quarantine) since symptoms may appear 2 to 14 days after your last exposure to the virus. You should not leave home or have visitors for any reason. If you have been around someone sick at home, your quarantine period does not start until their quarantine period has finished.
When I want to meet with others, what can I do to be more safe?
- Stay outside
- Keep 6 to 9 feet apart
- Wear a mask (and make sure that they are wearing a mask)
- Do not be around others if you are having any systems of COVID-19