Dr. Joel Weisblat's Blog

Labor Day2024- COVID-19 Update

Mon, 02 Sep 2024 17:10:17 GMT

Labor Day 2024 COVID UPDATE

September 2, 2024

Dear Patient,

I hope you have enjoyed the summer. Unfortunately, in addition to a slew of lovely days, we witnessed a resurgence of the Covid-19 virus. As we move towards the fall, here are my thoughts on the latest developments:

1) Case numbers are harder to track these days due to a lack of testing, but wastewater samples suggest a 6-fold increase in cases from the lows we saw in the spring. Fortunately, hospitalization and death rates remain relatively low compared to previous surges.

2) The dominant strain circulating now is the KP.3.1.1 variant, which is a descendant of the first Omicron strains seen in late 2021. The new vaccines (just released) were designed to combat KP.2, which is a close relative of KP.3.1.1. This is a much better match than the vaccines released last year.

3) People are traveling more and taking fewer precautions, so it’s not surprising that cases are up. We have lifted the mask requirement in the office, but I still encourage you to wear a mask in high-risk situations such as sitting on a plane.

4) Vaccination remains the mainstay of prevention. Immunity wanes over time, and the virus mutates enough to mitigate the benefits of early vaccines. Staying up to date on Covid vaccination has been consistently shown to reduce the risk of serious illness and also of long Covid syndromes.

5) Data show that the mRNA Covid vaccines are very safe. Serious side effects are exceedingly rare, and you are much more likely to suffer from the effects of the virus than you are to react adversely to the vaccine.

6) Unless you had Covid in the past 3 months, you are eligible to receive the new booster right away. I encourage everyone to get the Covid booster in September and the flu vaccine in October or November. We are giving the flu vaccine now in the office, though it’s better to wait at least a few more weeks.

7) So going on almost 5 years since the onset of the pandemic, it appears Covid has become endemic, which means it is here to stay. The good news is that most cases are mild, and staying up to date with vaccination can keep it that way.

8) As always, we are available to answer your questions and address your concerns at any time. Stay safe!

Joel D. Weisblat, M.D.

May 2023 - COVID-19 Update

Tue, 09 May 2023 19:30:27 GMT

SPRING COVID UPDATE

May 9, 2023

Dear Patient,

We have entered into a kind of steady state with Covid-19, but there is still much to report.

Here are my latest thoughts:

1) Omicron variants have dominated the landscape for over a year, but none has stood out as more contagious or deadly than the others. While the numbers have gone down in terms of serious cases, it remains quite prevalent.

2) Experts estimate a 20% risk over the next two years for a new strain of Covid, which may be sufficiently different from the previous variants that it escalates the risk for a new large wave of infections. We’ll let you know if there is a sign that may be happening.

3) Vaccines remain quite effective at preventing serious illness from Covid. If you haven’t had a full set of vaccines and boosters, I strongly encourage you to do so. The vaccines do lose some effectiveness over time.

4) The CDC has recently approved a second “bivalent” booster for those over 65 and the immunocompromised. The bivalent booster is Omicron-specific, and came out last fall. If you are in that high-risk category, and it’s been 6 months since your last booster, I recommend you get another one.

5) We are also learning more about long Covid, meaning the long-term effects of being infected. Of note is a significant increase in the numbers of cases of diabetes that can be attributable to the infection. Unfortunately, although many of us experience Covid as “just a bad cold”, it has the potential to be much more.

6) I continue to recommend that people wear masks when indoors in public spaces. So many of our patients have contracted Covid on airplanes. A good mask will substantially reduce that risk.

) We will continue to require masks in the office. This serves as protection for our staff but also for you. Remember that Covid is contagious before you know that you have it. A simple mask can keep us all safer.

8) I suspect that by fall we may be recommending a new Covid vaccine. Nasal vaccines which may be more effective at preventing the transmission of virus are being tested elsewhere in the world, and something similar could be on the horizon here.

9) It appears Covid is going to be with us for some time to come, but the coming of spring brings hope for the future. Enjoy the warmer weather, but please try to stay safe.

We will be here when you need us.

Joel D. Weisblat, M.D.

September 2022 - COVID-19 Update

Wed, 14 Sep 2022 14:52:03 GMT

SEPTEMBER COVID UPDATE

Dear Patient,

As we reach the end of the summer, we have unfortunately still not reached the end of the Covid saga. Here are my latest thoughts:

1) The Omicron variants which have dominated the landscape all year continue to do so. Most of the cases nationwide are of the so-called BA-5 variant.

2) August saw very high numbers of Covid cases, but fortunately the numbers of deaths and hospitalizations were lower than with previous waves. And there is a suggestion that case numbers are starting to drop in September.

3) While those who have had multiple vaccines are much less likely to get seriously ill, there remains a risk, particularly among the elderly and immunocompromised, and those who are many months removed from their latest dose of the vaccine.

4) The best way to avoid serious illness and the possibility of “long Covid” is to avoid the virus altogether. So my continued advice is to wear a mask indoors in public places, to avoid crowds, and to limit the number of people you spend time with indoors.

5) You are probably aware that a new Omicron-specific booster has been approved by the FDA and should be available this week. I would recommend that anyone who is more than 4 months removed from their last dose of the vaccine receive this new booster.

6) The expectation is that this booster, having been designed to combat BA-5, will provide better immunity than the currently available vaccines.

7) While it is true that this vaccine was advanced quickly and has not gone through the rigorous human testing done with previous Covid vaccines, testing of an earlier BA-1 specific vaccine showed excellent results, and most experts agree that it too will be proven safe and effective.

8) The future of the pandemic remains a big unknown. It is likely that a new variant will emerge before long, and then become the dominant Covid strain. The ability of the virus to mutate, along with an inadequate number of fully vaccinated people, has made herd immunity a mirage.

9) Our best hope is that future variants are less virulent, and that eventually a vaccine emerges that can prevent transmission of all strains of the virus. Until that time, your best bet is to stay cautious, and receive the recommended vaccines as they become available.

10) We have not yet determined whether we will be giving this new booster in the office. We will be giving flu shots as always. Details on our vaccine administration will follow in future messages.

Stay well, and stay safe.

Joel D. Weisblat, M.D.

March 2022 - COVID-19 Update

Sun, 06 Mar 2022 19:15:20 GMT

MARCH COVID UPDATE

March 6, 2022

Dear Patient:

As we move into the third year of the coronavirus pandemic, the news is mostly very good. But much as we’d like to believe “it’s over”, we’re not quite there. Here are my latest thoughts.

1) Case numbers, hospitalizations, and deaths from Covid 19 are all down dramatically, to rates not seen since July of last year. This is true both locally and nationally, and is of course a great relief.

2) Unfortunately, “what comes next” has been very hard to predict. As of this writing, there is no suggestion of a new variant to bedevil us. However, this virus has shown the ability to mutate in numerous ways, so it would not be shocking if it happens again.

3) My concern is that exhaustion with the pandemic will breed complacency. While lower case numbers clearly reduce the risk of exposure to the virus, we cannot pretend that the risk is now zero. I encourage you to continue to wear masks in public places, and to avoid large gatherings.

4) The data from the omicron surge is in, and while the vaccine did not prevent illness as well as with previous variants, it was extremely effective at preventing bad outcomes. The death rate for those with 2 shots was reduced by 85%, and for those with 3 shots was reduced by 96%. This puts to rest the notion that the vaccines don’t work; they clearly do.

5) Many of you have asked about a 4th dose of the vaccine, and while I suspect it will be recommended at some point, there is no indication for another booster at this time. However, I strongly urge those of you who haven’t yet completed the 3 doses to do so as soon as possible.

6) Another piece of good news is that Pfizer’s anti-Covid pill Paxlovid should now be readily available for any high-risk patients who test positive for the virus. This drug has been shown to be safe and effective against all variants, and we can prescribe it when appropriate.

Life is starting to return to normal in many ways, and I remain optimistic that the worst is behind us. We will keep you posted on new developments as they arise, and as always, we are happy to answer your questions and try to alleviate your concerns. Stay safe!

Joel D. Weisblat, M.D.

January 2022 - COVID-19 Update

Tue, 04 Jan 2022 19:13:30 GMT

JANUARY COVID UPDATE

January 23, 2022

As we close in on 2 years into this pandemic, there are hopeful signs for the future. Here are my latest thoughts:

1) Although Covid case numbers remain high, and in some areas are still rising, the numbers in Cuyahoga County are down substantially from a few weeks ago.

2) The vast majority of cases right now are due to the omicron variant, which is significantly more contagious than all previous variants, and which evades the vaccine at about a 50 percent rate.

3) Fortunately, those who have been vaccinated (and particularly those who have received a booster) are dramatically less likely to suffer severe illness from omicron. Deaths from Covid occur 20 times more often among the unvaccinated.

4) Initial vaccination increases the antibody response to Covid, but the booster dose also stimulates a strong B- and T-cell response, which is critical in preventing deeper infection.

5) This B- and T-cell response tends to be longer-lasting than the antibody response, which means that the booster is likely to retain effectiveness over time, even against the omicron variant.

6) Treatment of Covid infection is changing, as the monoclonal antibodies that were effective against delta and other variants are not effective against omicron. The good news is that a new antiviral drug has been approved for use in certain patients, and appears to be safe and effective.

7) It does not appear likely that a fourth dose of the vaccine will be necessary any time soon. However, it is possible that a reformulated vaccine (and perhaps boosters) will be recommended in the future.

8) As long as case numbers remain high, the key to staying safe is the same as ever: avoid crowds, wear a mask indoors, keep your distance from others, and limit close contact to a small circle of people. And of course: complete your vaccination, including the all-important booster shot.

9) There is reason for hope, as the trends around the world suggest omicron tends to infect susceptible individuals quickly and then recede. If that holds true here, cases should drop further in the coming weeks, resulting in a much lower risk of infection. Unfortunately, until more people are fully vaccinated, this virus will likely stay with us yet for some time.

10) These past 2 years have been exhausting, but things are getting better. Please reach out to us with your questions and concerns, and we’ll do our best to help you through it.

Joel D. Weisblat, M.D.

December - COVID-19 Update

Mon, 20 Dec 2021 17:47:51 GMT

DECEMBER COVID UPDATE

December 20, 2021

Dear Patient,

The ups and downs of this pandemic continue, with new challenges facing us at seemingly every turn. Here are my latest thoughts:

1) Case numbers nationally and locally are very high right now, with new daily Covid cases in Ohio exceeding 10,000, as high as at any time during the pandemic.

2) The increase is likely a result of two factors: the increase in potential exposure that occurs as people gather indoors for the holidays; and the spread of the new omicron variant.

3) The good news is that early evidence suggests the omicron variant is less deadly than previous variants, as it does not replicate easily in the lungs, and so is less likely to cause a dangerous Covid pneumonia.

4) The bad news is that the omicron variant is more contagious than previous variants, and it can evade some of the protection offered by the vaccine.

5) Your best protection against Covid infection remains vaccination, including the booster shot. The booster has been shown to dramatically improve the immune response to all Covid variants, including omicron. If you haven’t gotten your booster yet, I recommend doing so right away.

6) Local hospitals are very full with Covid patients right now. However, although the majority of new cases in the community are likely attributable to the omicron variant, the vast majority of hospitalized patients are due to the delta variant infecting unvaccinated people.

7) I urge you to protect yourself from this virus by following the same measures we’ve emphasized for months. Avoid gathering indoors with unvaccinated persons, wear a mask every time you are indoors in a public space, maintain social distancing, and be cautious at all times.

8) Unfortunately, Covid testing right now is not easy to obtain. We are exploring ways to help our patients get tested more readily. Please give us a call if you are unsure of the need to test, and we can try to guide you appropriately.

9) I anticipate the coming weeks will be difficult, as case numbers may continue to rise. Hopefully, once the holidays have passed, and more people receive their boosters, the numbers will dramatically fall. If the omicron variant proves in fact to be less virulent, we might actually be in good shape by the spring.

10) We at Advanced Internal Medicine wish you a happy and safe holiday season. We will continue to try our best to meet your needs during this difficult time.

Joel D. Weisblat, M.D

Thanksgiving - COVID-19 Update

Wed, 01 Dec 2021 22:33:32 GMT

THANKSGIVING COVID UPDATE

November 29, 2021

As we move into the holiday season, there are positive and negative indicators about the future of this pandemic. Here are my latest thoughts:

1) My earlier optimism about the declining number of Covid cases hasn’t come to fruition. While the numbers down south are much better, the numbers in the north have gone back up. This is likely due to people congregating indoors in the colder weather.

2) We can expect this trend to continue, as the holidays tend to spread the virus, particularly among the unvaccinated or those who are not careful.

3) It does appear that case numbers decline once a population reaches a critical mass of people who have been vaccinated or recently infected. That should still happen in Ohio and elsewhere. The fact that children as young as 5 can now be vaccinated should also help quite a bit.

4) Booster shots are effective! There is waning immunity 6 or more months after initial vaccination, but the immune response to the booster is very good, and initial reports suggest that the response is maintained better over time.

5) Even without the booster, your risk of getting seriously ill from Covid is dramatically reduced by vaccination. The vast majority of “breakthrough” cases have been mild.

6) Reports surfaced this weekend of a new variant, labelled omicron. This variant is potentially concerning because of a large number of mutations, but there are thus far no cases in the United States, and more importantly, no indication yet that this variant evades the vaccine.

7) Remember that Covid transmission requires a large inoculum of virus, such as occurs when in close proximity indoors to an infected individual for an extended period of time.

8) As always, transmission is very unlikely to occur outdoors, during brief encounters, when both parties are masked, when socially distanced, or when both parties are vaccinated.

9) There are new therapeutics on the horizon which purport to substantially reduce the severity of Covid illness, so even if we can’t soon get rid of the virus altogether, we may render it far less dangerous.

10) Please share with us any concerns or questions you may have. We are here to keep you healthy and well-informed as we continue to navigate the ups and downs of the pandemic. I urge you to remain cautious as you enjoy the holidays with friends and family.

Joel D. Weisblat, M.D.

Fall COVID-19 Update

Sun, 31 Oct 2021 15:48:59 GMT

FALL COVID UPDATE

Dear Patient,

Although the months drag on with this pandemic, and we still find ourselves masking and worrying, there is plenty of reason for optimism this Halloween.

1) BOOSTERS! The FDA has approved booster doses of the Covid vaccine for those who have completed the primary series of the Pfizer, Moderna or J&J vaccine. All J&J recipients are eligible, and all those over the age of 65 are eligible. Those under 65 who are at high risk of serious Covid infection, or high risk of exposure, are also eligible.

2) We have received a shipment of Moderna vaccine in the office, and will be giving the boosters to those meeting the above criteria, or a first/second injection for those who have not yet been vaccinated. We will be holding a Covid clinic similar to our annual flu clinic on Saturday, November 6. Please call if you’d like to come in.

3) Covid boosters should be given at least 2 months after the J&J vaccine, or at least 6 months after the second Pfizer or Moderna vaccine. There is no need to stay with the same vaccine that you received in your initial immunization.

4) Although your level of protection is good after 2 doses of Pfizer or Moderna (less so after the J&J vaccine), evidence suggests that the booster dose provides a substantially higher level of protection, against both mild and more serious forms of the disease.

5) The number of Covid cases continues to decline, both locally and nationally, though the numbers remain high compared to earlier in the year. The reason for the decline is simple: more people are getting vaccinated, and the unvaccinated are getting infected in large numbers. The result is a dwindling number of susceptible people, and thus less transmission.

6) Immunity from vaccination is estimated to be 5 times greater than immunity from infection, so please get vaccinated even if you already had Covid. It is prudent to wait 2 or 3 months after infection to get the vaccine.

7) Because there are still a large number of infected persons in the community, we continue to recommend caution in public places. Wear a mask when indoors, and avoid places where a lot of unmasked or unvaccinated people are gathered together.

8) It is not too late to get your flu vaccine as well. I recommend the flu and Covid vaccines be administered 30 days apart in most circumstances. The flu and Covid have similar presentations (though dissimilar outcomes), and your best bet to stay healthy and reduce anxiety this winter is to have immunity to both.

9) Please give us a call if you are exposed to Covid or if you test positive, and we can guide you as to the appropriate testing, quarantine, or treatment.

10) There really is a light at the end of this tunnel. Stay positive, follow the recommended guidelines, and I believe we will be able to shed our masks and our worries in the months ahead.

Joel D. Weisblat, M.D.

COVID Updates from Dr. Weisblat

Tue, 31 Aug 2021 13:46:37 GMT

COVID Updates from Dr. Joel Weisblat

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.

COVID Updates from Dr. Weisblat

Tue, 03 Aug 2021 20:35:27 GMT

AUGUST COVID UPDATE

August 1, 2021

As the Delta variant roars through the country, some things have changed, and some have not. Here are my latest thoughts:

1) The resurgence of Covid-19 throughout the U.S. is real, and Ohio is starting to feel the brunt of it as well. Daily cases in the state are averaging over 1000, a five-fold increase in recent weeks, and hospitalizations and deaths are on the rise as well.

2) The reasons for this increase are threefold: the Delta variant is up to 5 times more contagious than previous variants; large numbers of Americans remain unvaccinated; and people are for the most part not wearing masks.

3) The very good news is that the vaccines seem to be holding up well, particularly the mRNA vaccines (Pfizer and Moderna). Those who have been vaccinated are much less likely to contract the virus, and if they do get infected, are dramatically less likely to get quite ill. It is estimated that less than 1 percent of those currently hospitalized with Covid were vaccinated.

4) Much has been written in recent days about the potential of vaccinated individuals to infect others, but what hasn’t always been reported is that those who are getting infected in this way are almost all unvaccinated. It still appears that vaccinated individuals without symptoms can congregate indoors with very little risk.

5) I think the most important message today is to re-emphasize the importance of wearing masks indoors. Most outdoor settings are safe, but the risk of transmission indoors is high, particularly when one doesn’t know who’s vaccinated. Wear your mask, maintain social distancing, and try to avoid crowds.

6) I would still recommend people avoid indoor restaurants, and the safety of plane travel is an open question with cases on the rise and mask requirements in flux.

7) Another question is whether an additional dose of vaccine will be necessary. There is conflicting data here, but I suspect we will be recommending people to get another dose in the coming months. Immunity does likely wane over time, though there is no evidence that fully vaccinated individuals are unprotected after 6 or 7 months.

8) Finally, I implore those of you who are not yet vaccinated to do so now. Covid can wreak havoc on your health, even if you are not in a high-risk category, and the contagion of this variant makes it much harder to avoid than the previous ones. Please contact me if I can answer any questions you may have about the safety or efficacy of this vaccine.

9) A hopeful bit of news is that the number of people getting vaccinated has picked back up, and if that trend continues, we may yet be free from this pandemic in 2022.

Stay safe!

Joel D. Weisblat, M.D

Summer Updates

Tue, 06 Jul 2021 15:00:24 GMT

SUMMER COVID UPDATE

July 6, 2021

Dear Patient,

As we attempt to get our lives back to normal after months and months of restrictions, I want to urge everyone to stay cautious. Here are my latest thoughts:

1) The 7-day average of new Covid cases in Ohio has dropped close to 250, and in Cuyahoga County we are seeing only 25 new cases per day. These are easily the lowest numbers we have seen since the earliest days of the pandemic.

2) Unfortunately, the news is not good everywhere. The number of cases nationally is ticking upwards slightly, attributable to the spread of the more contagious Delta variant, most notably in regions where the vaccination rate is low.

3) Studies indicate that being fully vaccinated against Covid, either with the single-dose J&J vaccine or the 2-dose Pfizer and Moderna vaccines, provides strong protection against contracting Covid, and very strong protection against serious Covid infection, even in the face of the Delta variant.

4) I urge everyone who has not yet been vaccinated to do so as soon as possible. If you have concerns about the safety of the vaccine or question whether or not you really need it, please reach out to me. This virus remains a very serious threat for the unvaccinated, and failure to get vaccinated puts you and those around you at much risk.

5) Although the risk of getting sick is quite low for the vaccinated, it is not zero, and I recommend a little more caution at this time than does the CDC. I advise continued mask wearing indoors when around others who may not be vaccinated, particularly in crowded areas or when you anticipate more than a few minutes of potential exposure.

6) There is no need to wear a mask outdoors, except perhaps in very crowded spaces. The risk of outdoor transmission is quite low, particularly if one has been vaccinated.

7) All 3 Covid vaccines available in the U.S. have shown sustained immunity to the virus, so there is unlikely to be a need for boosters before next year at the earliest. The biggest concern is that a new variant will develop which evades vaccine-mediated immunity. Fortunately, there is no indication that this has occurred to date.

8) The best news I can offer for the vaccinated is that it is perfectly safe to interact indoors with others who have been vaccinated. No masking or social distancing is necessary.

9) I hope you were all able to enjoy this holiday weekend without the fear that has plagued us for months. With any luck, our numbers will stay low and life will indeed be close to normal for the foreseeable future.

10) Please give us a call with any questions. We are fully back in the office, and welcome those who have been away to schedule a visit and let us help you stay healthy going forward.

Joel D. Weisblat, M.D.

SPRING COVID UPDATE

Sun, 16 May 2021 22:41:39 GMT

Dear Patient,

I am happy to report good news on the Covid front, but there remain some concerns. Here are my latest thoughts:

1) With over 120 million Americans fully vaccinated, and nearly 50% of the population having received at least 1 dose, the number of Covid-19 cases in the U.S. (and Ohio) is dropping rapidly. Daily cases in the state are below 1000 in recent days, the lowest levels seen in 9 months.

2) The data overwhelming supports the efficacy of currently available vaccines. Those who have been fully vaccinated are at very low risk of becoming infected or transmitting the virus to others, and are at extremely low risk of becoming seriously ill or dying from Covid-19.

3) Furthermore, the safety of the vaccines remains clear. If you have not yet been vaccinated for any reason, please contact the office so we can discuss. There is unfortunately quite a lot of misinformation out there, and perhaps we can answer some questions to put your mind at ease.

4) I have mixed feelings about the CDC’s latest advice that masks are unnecessary for those who have been fully vaccinated. While it is encouraging for all of us to feel that an end to this ordeal is in sight, and we are all tired of wearing masks, some situations do yet require caution.

5) The risk of being without a mask is minimal when outdoors, or when indoors around others who have been fully vaccinated. There is also very little risk of contracting the virus from contaminated surfaces.

6) I recommend continuing to wear a mask when indoors around others who may not have been vaccinated, particularly if you anticipate an extended period of close contact with others.

7) Eating indoors at a restaurant or gathering with a large number of unmasked (and possibly unvaccinated) people indoors remains a higher risk. For now, I recommend avoiding those situations as much as possible.

8) These recommendations will likely change in the coming months. On the positive side, the fewer the number of Covid cases in the community, the lower the risk of being exposed, and the less caution that is necessary. On the negative side, it’s possible we will see new variants of the virus that are not as well covered by the vaccines. To date the latter has not occurred.

9) I am optimistic that the number of cases will continue to fall in the coming months, and perhaps life will finally return to normal. In the meantime, stay cautious, and encourage your friends and family who have not yet been vaccinated to do so promptly.

10) A reminder that we have returned to business as usual in the office, and we look forward to seeing you in person again soon.

Joel D. Weisblat, M.D.

March Updates from Dr. Weisblat

Mon, 01 Mar 2021 18:51:09 GMT

MARCH COVID UPDATE

March 21, 2021

Dear Patient,

It appears we are approaching the home stretch in our battle against the Covid-19 pandemic, but there remain some hurdles.

Here are my latest thoughts:

1) While the number of cases is clearly lower than it was over the winter months, we seem to have reached a plateau, and in some states the numbers are starting to rise. The risk of exposure to Covid-19 unfortunately remains high.

2) The reason we are no longer seeing a decline in cases is likely that more contagious variants are circulating throughout the United States. And one of these variants, B117, which was first detected in the UK last fall, appears also to carry a higher risk of mortality than the others.

3) The good news is that the currently available vaccines appear to be effective at preventing infection with the known variants, and in particular are effective at preventing serious Covid infections.

4) Vaccination against Covid-19 is clearly the best way to avoid this serious infection, and I encourage everyone to get vaccinated. The differences between the 3 vaccines (Pfizer, Moderna, J&J) are small. I recommend you get whichever one you can, as soon as you can.

5) Adverse reactions to the vaccines are common, but almost always mild and self-limited (a sore arm, lo-grade fever, nausea, or fatigue, lasting a day or two). Serious adverse reactions are rare, and to some degree predictable based on one’s allergy history. Please give us a call if you are unsure of your risk for a serious adverse reaction.

6) The CDC recommends (and I concur) that those who have been fully vaccinated remain cautious. While those who have been fully vaccinated can safely gather with one another, avoidance of crowds, limiting travel, and maintaining masking and social distancing around the unvaccinated is strongly encouraged. One is considered fully vaccinated two weeks after the final dose.

7) At Advanced Internal Medicine we continue to await word from the State as to when we will be provided vaccine for our patients. I know many of you would feel more comfortable getting your shots here, but I encourage you to make alternative arrangements in case the delay continues. We will of course be in touch as soon as we know more.

8) I am happy to announce plans to fully re-open the office on April 15. Since by that time we expect our staff and a good percentage of our patients to be fully vaccinated, we believe it is safe to resume routine office visits, including complete physical exams. We will continue to see patients primarily by telemedicine in the interim, with some visits in the office as needed.

9) It is hard to believe a year has passed since our lives were all changed by this pandemic. We thank you for your patience as we have navigated these uncharted waters. And although masks may yet be with us for some time, there is reason to believe that life will soon get back to a much more normal state.

10) Stay safe, and let us know if there is anything we can do to help guide you to that light at the end of the tunnel.

Joel D. Weisblat, M.D.

February Updates from Dr. Weisblat

Mon, 08 Feb 2021 12:50:28 GMT

FEBRUARY COVID UPDATE

Dear Patient,

Finally, there is reason for optimism that we can get to the other side of this pandemic. Unfortunately, there are still some hurdles to overcome. Here are my latest thoughts:

1. The first piece of good news is that the number of cases has clearly come down in recent weeks, both locally and nationally. Hospitalizations are down as well, and we can expect the number of Covid-related deaths to follow suit.

2. The second item is, of course, the increasing availability of the Covid vaccines. We are still awaiting word from the state as to when we will receive our first shipment of vaccine in the office. Hopefully, that will be soon.

3. In addition to the Moderna and Pfizer vaccines which are currently being distributed, we anticipate the approval of 1 or 2 others in the near future. At this point there does not appear to be any clear advantage of one vaccine over another, so my advice is to get vaccinated as soon as you can, with whichever vaccine is available.

4. The bad news is that the virus is adapting, and new strains have emerged which may delay a full return to life as we knew it before the pandemic.

5. The Covid variants that are circulating now appear to be more contagious, but not any more dangerous, than the original known strains. Early evidence suggests that the vaccines still provide immunity to the newer strains, but that previous infection may not confer the same immunity.

6. It is likely that the virus will continue to adapt, and that vaccination strategies will change over time. I expect boosters will be necessary in the future, possibly even on annual basis such as with influenza.

7. In the meantime, we must all stay cautious. Although vaccination provides substantial protection from contracting the virus, continued use of masks and social distancing is imperative until the number of cases has been dramatically reduced.

8. We anticipate opening the office more fully in the spring. Once our staff and a good percentage of our patients have been vaccinated, we can safely see patients for extended visits without worry of spreading infection.

9. We will of course be in touch with everyone when we learn the details of our vaccine availability, with a plan to vaccinate as many of you as possible within the confines of the state regulations.

10. As always, we encourage you to reach out with any questions or concerns. And keep your head up---there is definitely a light at the end of the tunnel!

Joel D. Weisblat, M.D.

COVID Updates - January 2021

Mon, 04 Jan 2021 23:55:58 GMT

January Updates from Dr. Weisblat

Dear Patient,

We enter the new year with reason to believe the end of the pandemic is in sight. There is, however, much to overcome before we reach that point. Here are my latest thoughts:

The number of cases, hospitalizations and deaths from Covid-19 remains at an all-time high, both in Ohio and nationally. And those numbers are liable to get even worse in the wake of holiday travel and family get-togethers.
A new wrinkle is the emergence of a variant of the virus which is more easily transmitted. Fortunately, this new variant does not appear to be any more deadly than before.
The same principles for avoiding exposure to Covid that we have emphasized for months hold true: wear a mask, avoid anything more than brief contact with others indoors, maintain social distancing, and stay away from crowds.
Please remember that the virus can be transmitted even if masks are worn, particularly if contact is extended or social distancing is not maintained.
Restaurants, bars, hair salons, and gyms remain risky places to visit.
As you probably know, two vaccines have been approved and have begun to be administered. Unfortunately, vaccine roll-out has been slow and only front-line health workers and long-term care residents (Phase 1A) have been approved for vaccination thus far in Ohio.
Advanced Internal Medicine has received approval from the state to administer the vaccine, but no information has been provided regarding the number of doses or the timing of vaccine delivery. We will be in touch with our patients once we know more.
By every measure, both vaccines appear to be safe and highly effective. Once we have more information regarding vaccine availability, we will provide a thorough explanation of the risks and benefits of vaccination, as well as an anticipated timeline for our patients.
We anticipate opening the office for more extended visits sometime this spring, as our patients and staff get vaccinated and the number of cases dwindles. In the meantime, please stay vigilant, and let us know how we can be of assistance.

Joel D. Weisblat, M.D.

November Updates from Dr. Weisblat

Mon, 16 Nov 2020 07:07:41 GMT

November Updates from Dr. Weisblat

Dear Patient,

As was anticipated, the colder weather has brought a surge of Covid-19 cases which no shows no signs of abating. Here are my latest thoughts:

1) Covid cases in Ohio are exceeding levels that we have seen at any previous time. Although comparisons are not exact due to the lack of available testing in the spring, daily cases have consistently exceeded 5,000 for the past 2 weeks. Hospitalizations are also at an all-time high in the state, and throughout most of the country.

2) Theories abound as to the cause of the increase, but the most likely explanation is that people are spending too much time indoors with people outside their families. It is important to remember that masks help but that a percentage of respiratory droplets can penetrate almost every mask. Maintaining a safe distance and limiting the amount of time spent indoors with others substantially improves their efficacy.

3) The good news is that 1 or 2 vaccines appear to be quite effective, and may be approved for use before the end of the year. If that proves to be the case, we can anticipate widespread availability by spring. Life may yet return to normal!

4) I urge everyone to be more cautious than ever right now. Wear your mask, maintain social distancing, and avoid all unnecessary close contact with others. Restaurants remain particularly dangerous, and gyms and salons are also risky. Holiday celebrations with friends and extended family are a recipe for trouble, and we can advise you on appropriate precautions.

5) Please give us a call if you develop cold symptoms, cough, fever, shortness of breath, diarrhea, or loss of taste or smell, and we can discuss the need for testing. Anyone who discovers they have been in close contact with a Covid patient should also be tested.

6) We continue to see a few patients in the office for quick, essential visits. We will likely wait on the vaccine to resume routine check-ups and longer visits. We have found that much can be done via telemedicine, and we urge you to take advantage of that option.

7) Now is a great time to get your flu shot if you haven’t already. We have plenty of regular and high-dose (for seniors) vaccine available, so give us a call if you’d like to get one.

8) Check out our revamped website at advim.org or advancedinternalmedicine.health. The pandemic has limited our ability to safely care for our patients on an in-person basis, so we are rolling out new ways to support the well-being of our patients while minimizing the risk of exposure to Covid-19. Click the Wellness Center link on the homepage to learn more.

I wish you all a happy and safe holiday season. Please be in touch if we can help you through this challenging time.

Joel D. Weisblat, M.D.

COVID Updates - October 2020

Thu, 22 Oct 2020 20:12:25 GMT

COVID-19 - October Updates from Dr. Joel Weisblat

Dear Patient,

We are now 7 months into this pandemic, and unfortunately it shows no signs of abating. We may in fact be headed into the most challenging period yet. Here are my latest thoughts:

1) Case numbers of Covid-19 are clearly on the rise, both in Ohio and nationally. Statewide we are averaging over 2000 cases per day for the past week. Cuyahoga County has moved from the “orange” to “red” level and is on watch for going to the highest risk level, “purple”. Daily cases in the county are twice what they were at the beginning of the month.

2) The reasons for the increase are multiple. It appears the virus transmits more easily in cold weather, but more importantly, more of us may be congregating indoors as the weather worsens. It is unclear if school gatherings are a significant factor, but continued remote learning seems the prudent course.

3) The good news is that we do appear to be treating Covid more effectively, as the mortality rates have clearly fallen. However, if a large number of cases of Covid (and influenza) overwhelm health care systems, it may be difficult to maintain those lower mortality rates.

4) More and more evidence indicates that the virus is transmitted primarily by close contact indoors. Wearing masks and maintaining social distance helps, as does limiting the amount of time in contact with an infected person.

5) Although the virus may persist on surfaces, it appears there may not be a sufficient number of viral particles to cause infection when an infected surface is contacted. Regular handwashing remains important, but avoiding close contact with people indoors is paramount.

6) Many of us are struggling with the restrictions necessary to protect ourselves and our families, as the isolation clearly takes a toll. Please let us know if there is anything we can do to help get you through this difficult time. Unfortunately, it is more important than ever that we stay vigilant, as obviously the risk of infection rises with the number of cases nearby.

7) At Advanced Internal Medicine, we have been seeing a few patients in the office, but only for quick visits that don’t involve respiratory symptoms. We are finding that much can be done through telemedicine or telephone services. We encourage our patients to call and let us know what’s going on, so that we can determine how best to give you the care that you need.

8) We are giving flu shots in the office several days per week. If you haven’t had one yet, please give us a call. Preventing widespread influenza is a big part of fighting Covid this winter.

9) Hope remains that a safe and effective vaccine will be approved early next year. In the meantime, keep yourselves and your families safe, and have faith that life will eventually return to normal.

Best wishes,

Joel D. Weisblat, M.D

AIM Announces New Wellness Center to open this Winter

Fri, 16 Oct 2020 21:18:43 GMT

AIM Announces our new Wellness Center opening Fall 2020

Advanced Internal Medicine is pleased to announce the roll-out of our Wellness Center in January 2021. The COVID-19 pandemic has isolated many people from family and loved ones, and has limited our ability to safely care for our patients on an in-person basis. As such, we are looking for new ways to support the well-being of our patients and to more carefully track our patients’ health, while minimizing the risk of exposure to COVID-19.

The Wellness Center is focused on an integrative approach to care that relies on the latest scientific methods and a broader understanding of wellness in the mind and body. Reducing inflammation in the brain has been shown to improve memory, mood, and a host of immune-mediated processes in the body.

Over the coming months, we will be introducing a program to address that axis in the hope of improving (or preventing) an array of disease states. Stay tuned for details on this exciting new initiative.

The first Wellness Center program, My SmartHouse Doc, is geared to maintaining the safety of patients in their homes. This program gives patients the opportunity to have non-invasive sensors placed in their home in order to monitor vital signs such as pulse, blood pressure, blood sugar, and oxygen saturation, and also to detect a change in their usual pattern of behavior. We will be able to track this information online, and respond to abnormalities that might signal a problem.

The goal is to maintain close contact with patients, detecting problems at an early stage, reducing the need for emergency care and hospitalization, and allowing older people to safely stay in their homes for a longer period of time. A sample “Smart Home” complete with sensors is open for viewing in the space adjacent to our Beachwood office.

The Wellness Center will be directed by Gina Weisblat, PhD, and Jackie Carothers, our Office Manager.

Flu Shots? What are they?

Sun, 13 Sep 2020 19:54:18 GMT

Breaking it down....

WHAT ARE THEY?

Advanced Internal Medicine offers two types of injectable influenza (flu) vaccine for the 2020-21 season, the Fluzone Quadrivalent Influenza Vaccine, indicated for all adults, and the Fluzone High-Dose Quadrivalent Influenza Vaccine, indicated for patients aged 65 and over. These vaccines are made with inactivated (killed) virus, which means they do not contain live virus and cannot cause the flu.

WHO SHOULD GET IT?

The flu vaccine is designed to prevent infection with the most common strains of Influenza A and B. Influenza vaccination is recommended for all adults, particularly this year since we are also dealing with the Covid-19 pandemic. There is some evidence that a flu shot may reduce the severity of Covid-19 infection, though the mechanism by which that works is uncertain.

WHEN SHOULD I GET IT?

Vaccination against influenza lasts for 5-6 months, and flu season typically begins in December and ends in March, though we occasionally see cases as early as November and as late as April. Optimal vaccination time is thus mid-September to late October, but a late vaccination is better than none at all, and we usually continue to give injections into January.

HOW DO I SIGN UP?

Due to Covid-19, we are changing our procedure and will not be holding our traditional Flu Clinic. However, we have a nurse or medical assistant available most days to give the vaccine. Give us a call any time at 216/464-4646 to schedule your injection, or request an appointment online through our Patient Portal (link to Patient Portal).

Office Updates from Dr. Joel Weisblat - October 13, 2020

Sun, 13 Sep 2020 14:56:40 GMT

Office Updates from Dr. Joel Weisblat - October 13, 2020

Dear Patient,

I hope you are enduring this seemingly endless pandemic in good health and good spirits. Attached please find a summary of my latest thoughts on Covid-19, which will soon appear on our revamped website.

In brief, although the number of cases in Cuyahoga County has thankfully declined, the number of cases in Ohio and nationally remains high, and we are hearing anecdotally of outbreaks locally which may soon send the numbers in the wrong direction. As such, although we are seeing a few patients in the office for brief and necessary visits, we still do not believe it is safe to have patients in the office for extended periods of time such as would be required for a physical exam or other routine care.

We have received our supply of flu vaccine, and will be contacting you shortly for details on how we will be administering it this year. Needless to say, a big flu clinic is not a wise endeavor under the circumstances.

Finally, I am thrilled to announce to those of you who were not aware of it that our office manager Jackie has returned to the fold. Please let her know how happy you (and we) are to have her back!

Stay safe, and please let us know how we can be of assistance during this difficult time.

Joel D. Weisblat, M.D.

COVID Updates - August 4, 2020

Tue, 04 Aug 2020 14:59:53 GMT

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.