COVID Updates - August 4, 2020
Dr. Joel Weisblat • August 4, 2020
COVID Updates - August 4, 2020
August 4, 2020
As this difficult summer winds down, I wanted to share with you my latest observations and plans for the office going forward. My family and I, like so many of you, are struggling with the restrictions this virus places on our lives, but finding new ways to enjoy the time together.
1) As you all know, the number of Covid cases has been steadily rising nationally and locally in recent weeks. We are consistently averaging over 1000 cases per day in Ohio, which is on the low side compared to many states, but still at a dangerous level.
2) We are understanding more clearly how the virus is transmitted, and airborne transmission in enclosed spaces remains the primary mechanism. Outdoor transmission is possible though much less likely. If all members of a group are wearing masks and keeping a social distance the risk goes down significantly but is not eliminated. The length of contact time is an important factor. Transmission via infected surfaces also appears to be less risky than previously thought.
3) In light of the above, we believe it remains risky to see patients in the office. I understand that many offices are seeing patients, and that many venues are open for business. However, that is not based on a scientific analysis of the risk, and exposing oneself to other people indoors should not be done more than necessary. Buying groceries is a necessity; eating at a restaurant is not.
4) We continue to be available to our patients via phone and telemedicine, and we are developing a plan to see some patients in the office for acute visits only in the coming weeks. Routine visits, and particularly preventative visits (“physicals”), involve longer person-to-person contact, and we believe that puts our patients and staff at unnecessary risk.
5) There are several promising vaccines being tested, but we remain many months away from being able to vaccinate millions of people. We have made some progress in the treatment of severe infection, but there is definitely not a cure. And the evidence supporting the use of hydroxychloroquine is poor. This is a dangerous drug which should not be used for Covid-19.
6) I am encouraged by the mandate to wear masks in Cuyahoga County and elsewhere, and in my experience most people are complying. However, I am concerned about the possibility of schools reopening, as well as the plethora of open bars and indoor restaurants. It is hard to be optimistic about the coming weeks and months when so many are putting themselves at risk.
7) Testing availability has improved since the spring, but is still not keeping up with demand. Most of our patients have been able to get tested at local pharmacies, either by signing up online, or with an order from their physician. We will try to facilitate testing as much as possible for our patients who need it.
8) Please give the office a call, or shoot us a message online, if you have any questions, or need some help managing the stress of these times. We can all get through this together if we support one another and take our responsibility to each other seriously.
Dr. Joel Weisblat's Blog
When: Friday, August 28 and Saturday, August 29: closed for the move. Monday, August 31: open at the new address.
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Dear Patient: There has been a lot of news about the pandemic in recent weeks, and also a lot of confusion. Today’s update is in the FAQ form, in response to many of your concerns. 1) What is the current state of the Covid-19 pandemic? Obviously, it isn’t good, but there may be reason for optimism. The number of cases nationally seems to have plateaued, albeit at a high level, and the number of people vaccinated is steadily growing. Unfortunately, in Ohio, things are likely to get worse before they get better. Case numbers in the state are averaging above 4000 daily, higher than in many months. 2) What can I do to protect myself from infection? The same things we’ve been recommending all along. Wear a mask indoors in public places, keep your distance from those who may not have been vaccinated, and of course, if you haven’t been fully vaccinated, get it done today. 3) I thought the vaccines were effective, why are people talking about boosters? The Pfizer, Moderna and J&J vaccines have all proven to be quite effective at preventing serious Covid infections. However, we are seeing some waning immunity after 6 months, which is leading to a number of “breakthrough” cases. The good news is that the vast majority of these cases are mild or asymptomatic, with no more than a few days of illness. Even 6 or 8 months after completing vaccination, you remain very unlikely to contract a serious Covid infection. 4) What is a booster shot? Should I get it, and if so, when? A booster is just another dose of the vaccine, no different that the ones you already received. It is designed to further enhance the immune system’s ability to combat the Covid virus should it enter your body in some way. The CDC currently recommends a 3rd dose of Pfizer or Moderna in those who meet their strict definition of immune compromise, or (beginning Sept. 20) in those who are 8 months out from their 2nd dose. No recommendation regarding J&J boosters has yet been made. 5) Aren’t there drugs now that can treat Covid? Two drugs have been approved for treatment of SARS-Cov-2 infections. Remdesivir is an antiviral medication that has been shown to reduce mortality and length of stay in hospitalized patients. Regeneron has created a cocktail of monoclonal antibodies (REGEN-COV), which directly attack the virus, and it has been approved for use in Covid-positive patients who are not seriously ill, and in some cases for prophylaxis. Hydroxycholoroquine (an antimalarial drug) and ivermectin (an antiparasitic drug) have not been shown to be of any benefit in fighting Covid, may in fact be dangerous, and should not be used under any circumstances. 6) What do I do if I have been exposed to Covid? A vaccinated person exposed to Covid does not need to quarantine, but should get tested several days after exposure. Vaccinated individuals who are positive do not shed as much virus as unvaccinated individuals, and so are unlikely to transmit the virus to other vaccinated individuals. Nonetheless, those who are unvaccinated or otherwise at high risk for serious Covid infection may be eligible for prophylactic monoclonal antibody treatment. 7) Where can I get treated? If you meet the criteria listed above, you are a candidate for the Regeneron cocktail. Please call the office and we can confirm your eligibility, order the injection, and direct you to a facility where you can receive it. 8) Is this ever going to end? Yes. One-third of Americans have now been infected with Covid, and over 60% of the eligible population has been fully vaccinated. This means that the pool of susceptible individuals is shrinking every day. We will reach a point where there simply aren’t enough susceptible individuals to sustain community outbreaks. The sooner people get their vaccines, the more they wear masks in risky settings, the sooner we will reach that point. Most experts believe that by early next year the virus will no longer be a serious threat in most areas of the country. 9) What can I do to do help? Encourage your friends and family who are reluctant to get vaccinated to get their shots. Keep wearing your mask indoors and practice social distancing. Let us know if you are feeling sick, so we can guide you to the appropriate treatment. And don’t despair! There is a light at the end of the tunnel. Joel D. Weisblat, M.D.
