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This is a bi-weekly Q and A column written by Dr. Lydia S. Segal, M.D. in conjunction with Chaffee County Public Health. This column is focused on questions readers have about COVID-19 news and sciences.  As Segal points out, ‘Everything I write today is valid for today. COVID-19 news and science are rapidly evolving, assume updates will be made”

QUESTION: What is the new variant Omicron about?

Lydia S, Segal, MD, MPHANSWER: The new variant is termed Omicron and was first isolated in southern Africa. On November 26, 2021, the WHO termed this a variant of concern. At this point, not enough is known to say what it will mean locally, nationally, and internationally. Because a number of different parts of the spike protein (the part of the virus that attaches to a cell and allows it to get inside the cell and replicate) appear altered, there are three major concerns. Those concerns are transmission, i.e., level of contagiousness, level of severity, responsiveness to vaccines, and current treatments.

Like the virus itself, this is going to be a rapidly changing situation.  Expect more informed information in about 10 to 20 days. Though I rarely suggest podcasts to readers, my non-medical spouse found the following to be clear in explaining the Omicron variant. The podcast is The Daily: November 30 “What we know about the Omicron Variant.” It should be available for free wherever you listen to podcasts.

QUESTION: Who is eligible for a booster?

ANSWER: Because of the new Omicron variant, the CDC recommends that all adults 18 and older should receive a booster. This means a third shot of either Pfizer or Moderna or a second of J&J.

Public health and other medical and pharmacy locations are administering vaccines including boosters. For local information as to where to get boosters, or initial vaccine series, see the dashboard mentioned below:

https://datastudio.google.com/u/0/reporting/51ff040d-f850-4a41-ade1-f9cbf1bd8bc4/page/zPEZB

For information directly from the CDC about boosters please see the link below:

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html?s_cid=11706:covid%20vaccine%20booster:sem.ga:p:RG:GM:gen:PTN:FY22

QUESTION:  Why is the county experiencing increased positivity and hospitalization rates? And how many of the folks hospitalized have been vaccinated?

ANSWER: The recent positivity rate is running just about 7 percent in Chaffee County, the highest since COVID-19 broke out. The November case rate is over 400, the highest since numbers were reported in the spring of 2020.  About 90 percent of those that are positive are not vaccinated. The unvaccinated are the vast majority occupying the hospital beds both here and across the state and the country.

If you want to see this in graph form, go to the Chaffee County Public Health dashboard and look about three quarters of the way down. The link is as follows:   https://datastudio.google.com/u/0/reporting/51ff040d-f850-4a41-ade1-f9cbf1bd8bc4/page/zPEZB

Because the vaccines were designed to decrease the severity of disease, it was expected that about 5 percent of people who are vaccinated would still get infected, but with less severe cases.  In the county only about 2 percent of those vaccinated have gotten what is termed breakthrough cases. This would imply that those vaccinated are also using mitigation measures including social distancing and masking.

QUESTION:  This question comes up over and over, so it is worth repeating. Which immunity is better, actually being infected by COVID-19 or being vaccinated against COVID-19 with any one of the FDA-approved vaccines? The former is called “infectious-induced immunity” while the latter is called “vaccine-induced immunity.”

ANSWER: There are a number of studies that have been released recently that were reviewed in my previous mid-November column. The studies are difficult to directly compare as they were done prior to the delta variant. In addition, the sample sizes of the studies was different.  The bottom line at this point is that the best immunity in terms of the number of antibodies and how long they remain active appears to be a combination of both infectious-induced and vaccine-induced immunity. By no means am I suggesting an individual try to get Covid 19.

My medical advice is to get fully vaccinated no matter what the circumstances. Even If you already had COVID-19, get fully vaccinated. At the very least, speak to your health care provider to discuss your options.

QUESTION: What is the purpose of rapid home test kits?

ANSWER: Rapid home test kits allow a person to see if they have enough virus to be infectious with COVID-19. These kits are available via the state for free: (https://covid19.colorado.gov/covid-19-testing-at-home) or at local stores or online.  The two more readily available are the Abbott BinaxNOW and the Quidel. Both are approved by the FDA.

QUESTION:  What is the difference between mild, moderate and severe COVID-19? Do vaccines make a difference as to which level of severity I am likely to experience if I get COVID-19?

ANSWER: The CDC has parameters for assessing the severity of the disease. The severity of disease (when it occurs to those fully vaccinated) is a milder form of illness. If you are NOT vaccinated and get COVID19, you are about ten times more likely to end up in the hospital with a moderate to severe case than if you were vaccinated.

Asymptomatic cases mean that no symptoms are apparent to the individual though they have the disease and can spread it to others.

Mild disease means the individual may have one or several of the following symptoms:  fever, cough, sore throat, malaise, headache, muscle pain, nausea, vomiting, diarrhea, loss of taste and smell.  They do not have shortness of breath or abnormal chest imaging.

Moderate disease means the individual has evidence of lower respiratory disease, but is maintaining normal oxygen in their system. Any of the symptoms of mild disease may be present.

Severe disease means the individual has lower respiratory disease and does NOT have normal oxygen in their system. This means they need supplemental oxygen either through a nasal cannula or by being on a ventilator.

If you have questions you would like Dr. Segal to address in a future COVID Q and A column, please write to arkvalleyvoice@gmail.com

For more information about COVID and the vaccines, eligibility and appointments, see the links below. Pharmacies and doctors’ offices  are getting small shipments of vaccines. Information will be posted online here and on the county public health and hospital web pages.

http://chaffeecounty.org/Public-Health-Coronavirus

https://www.hrrmc.com/covid-19-updates/covid-19-vaccine/

Pharmacies with vaccine clinics:

Salida:  Safeway, Walmart and Salida Pharmacy

Buena Vista: Mt Shavano (LaGree’s), City Market, BV Drug and Valley-Wide Health,

By Lydia S. Segal, M.D., MPH