Quick "Yes" Answers to Covid Questions

It's getting rough out there again.

Today was exhausting, so I’m going to keep this kind of short. I think it’s important to provide some quick affirmative answers to questions I’ve been getting. I was out of the office on Monday, and today there were over 50 patient calls waiting for me… in addition to the usual workload and backlog of messages. If you feel like your primary care office responsiveness is falling short of your expectations, don’t forget that they probably have multiple staff members out with Covid right now. The docs still practicing are carrying a heavier load after more than 20% of healthcare workers have already left the field since the pandemic started. Another 20-30% are expected to leave in the next couple years. Burn out, a virus that won’t quit, politicians and institutions undermining our work, many people listening to conspiracies and anecdotes over expertise and evidence…

Is it time to up my defensive game again? Yes. Schools opening without masks have predictably caused a spike. We are feeling it in the office, and seeing it in the classrooms. BA.5 Covid can still be quite unpleasant, or worse. Many do great I must say, but why roll the dice?

Should I get the new booster? Yes. If it’s been 2-3 months since your last boost or infection, and you want some added protection against BA.4/BA.5. The consensus is that the new boosters are as safe as the billions of shots we’ve already received these two years.

The CDC just ended a universal masking requirement in healthcare settings except in areas where transmission is high. Should I still wear a good mask in the doctor’s office/hospital? Yes. Do it for yourself because Covid is rampant again, no matter how the CDC redefines it. Or the president downplays it. Or other politicians invite it. Do it for the multiple 80 year-olds waiting in the office with you. Do it for the young person in the waiting room who looks healthy, but is actually on immunosuppressants. Do it for that little baby over there. Do it because it works to reduce transmission.

Should I take Paxlovid (or another antiviral) when I have Covid? For most people, in my opinion, yes. That yes gets stronger with increasing age, weight, health problems, and less vaccination. Antivirals reduce the risks of severe disease and death. They reduce the load of viruses in the body, and one day I think they will be shown to have tempered collateral damage to the body because of that reduction (studies ongoing).

Should my kid wear a mask in school? If you want to reduce your kid’s risk of getting Covid right now, yes. Or a slew of other viruses going around. I really do realize I’m in the minority here. But a study last week showed lung damage in children and teens is very common after Covid, mild case or not, reported symptoms after Covid or not. And if you care about your kid’s teacher not getting sick, yes. I talked with three teachers, just today, with Covid. One had mild symptoms, the other two felt really poorly. One was short of breath going up and down stairs. All were vaccinated and had at least one booster (but not the new one). They reported that kids are very unmasked, and often showing signs of infections. I think many teachers are feeling this disregard, and how many of them are planning to get out?

Should kids still get vaccinated if they haven’t? Yes. This is not a once-and-done virus like chicken pox. There are more variants coming.

Should I get the flu shot? Yes. Especially this year, as I’m sure you’ve read that flu season in the southern hemisphere was bad, and our collective immunity to influenza is low right now after two very mild seasons (thanks to masking and other stuff we did to avoid Covid). So far the shots look like a good match. I’m planning to get my flu shot on Friday. I just learned of a 40 year old patient of mine that was admitted to the hospital tonight with influenza. According to the CDC map ending 9/17/22, flu activity is still “low” here, but it’s not zero.

Could I still have Covid even if I test negative with a rapid antigen test? Yes. A real world study out last week showed that rapid nasal swabs are missing at least 20-30% of cases. This is either because many people have lower viral loads with repeat infections, or tests are getting messed up by the presence of circulating anti-nucleocapsid protein antibodies. Or people aren’t swabbing well. Swabbing the back of the throat before the nose can increase accuracy by 10% or more.

Am I going to bed now? Yes. I’ll be working a long day tomorrow, but I felt this was important. If you have Covid, hang in there.

I’ll leave you with two graphs to ponder, just in case the idea of wearing a mask in closed spaces has been so undermined and scorned that you too need some encouragement when in tight situations. I can’t say that either is the definitive final proof, but you get the idea:

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Good night, and take care,

Ryan