March Updates from Dr. Weisblat
Dr. Joel Weisblat • March 1, 2021
MARCH COVID UPDATE

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.
Dr. Joel Weisblat's Blog

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.

