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Covid-19 AUGUST 2021 UPDATEs

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​Covid-19 vaccination update

According to research by the Kaiser Family Foundation, talks by family and friends have played a major role in persuading people to get vaccinated. Family members who have gotten the vaccine and demonstrated that the side effects of the vaccine were mild to non-existent have been the most powerful counter message to the myths surrounding the vaccine. Over two thirds of the Kaiser Foundation study sample answered they have tried to persuade their family and friends to get a COVID-19 vaccine.

 

Source: Kaiser Foundation Study

DELTA VARIANT

WHAT YOU NEED TO KNOW

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Severe Acute Respiratory Syndrome Coronavirus 2 (SAR S-CoV2)


Photo Source: Weill Cornell Medicine


Delta strain is one mutation of the COVID-19 virus that is now the dominant strain in the United States. It is more contagious in unvaccinated persons and appears to be more likely to lead to hospitalizations or death especially for younger people under the age of 50 yrs old who are unvaccinated.

Symptoms

  • Loss of smell or taste

  • Shortness of breath or difficulty breathing

  • Fever, chills, flu like symptoms


Mode of Transmission
Respiratory droplets spread by speaking and coughing


Vaccination Effectiveness

  • Pfizer is 88% effective 

  • Moderna is 96% effective

  • Johnson and Johnson is not reporting a percentage, but appears to be less effective

  • The effect of Booster shots for persons who have received the vaccine are currently under intense review

Source: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html

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​Covid-19 & the HOUSING CRISIS

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COVID-19 Eviction Moratorium Ends July 29 

The housing crisis we are now facing is rooted in housing policies that began in the early 1980’s. The cost of housing has significantly risen in many large cities. In the United States, many households with low incomes or lacking higher education have had to relocate and find
places with inferior construction and design. What public health officials have known even before the passing of the Federal Housing Act of 1949 is that the quality of housing has a great influence on the physical and mental health of individuals and families that make up
communities.


The eviction moratorium that is currently in place to help struggling renters will be lifted by July 31, 2021 and can set off another public health crisis. Many Black communities and low-income, less educated person will be now forced to pay rent or be evicted. The stress of this during the COVID-19 pandemic is threatening the health of millions of women, children and men. Find out what your state is doing about the lift of the moratorium here.


Source: https://www.nolo.com/evictions-ban

The Census Bureau estimates that seven million American households are behind on their rent. The survey demonstrates that almost four million children could be made homeless because of this rent problem. Mostly Black and Latino households are currently struggling and behind in rent.


Source: https://publicintegrity.org/health/coronavirus-and-inequality/what-you-should-know-about-the-eviction-moratorium/

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COVID-19 RECOMMENDATIONS

Father and Son

CDC GUIDELINES

Gatherings

The CDC continues to recommend avoiding large events and gatherings. Currently, CDC does not provide numbers to define small and large events.

Large gatherings bring together many people from multiple households in a private or public space. Large gatherings are often planned events with a large number of guests and invitations. They sometimes involve lodging, event staff, security, tickets, and long-distance travel. CDC’s large events guidance might apply to events such as conferences, trade shows, sporting events, festivals, concerts, or large weddings and parties.

Small gatherings are informal in nature and may occur with family and friends you regularly socialize with, often at someone’s residence. They typically do not involve long distance travel. Small gathering guidance might be more appropriate for social gatherings that are more intimate with close friends and family, such as small holiday parties, family dinners, and small special celebrations.

CDC offers the following guidance to help prevent the spread of COVID-19. Event planners should work with state and local health officials to implement this guidance, adjusting to meet the unique needs and circumstances of the local community. This guidance is meant to supplement—not replace—any state, local, territorial, or tribal health and safety laws, rules, and regulations with which gatherings must comply.

Risk Factors to Consider

Several factors can contribute to the likelihood of attendees getting and spreading COVID-19 at large events. In combination, the following factors will create higher or lower amounts of risk:

  • Number of COVID-19 cases in your community—High or increasing levels of COVID-19 cases in the event location or the locations the attendees are coming from increase the risk of infection and spread among attendees. Relevant data can often be found on the local health department website or on CDC’s COVID Data Tracker County View.

  • Exposure during travel—Airports, airplanes, bus stations, buses, train stations, trains, public transport, gas stations, and rest stops are all places where physical distancing may be challenging and ventilation may be poor.

  • Setting of the event—Indoor events, especially in places with poor ventilation, pose more risk than outdoor events.

  • Length of the event—Events that last longer pose more risk than shorter events. Being within 6 feet of someone who has COVID-19 for a total of 15 minutes or more (over a 24-hour period) greatly increases the risk of becoming infected and requires quarantine.

  • Number and crowding of people at the event – Events with more people increase the likelihood of being exposed. The size of the event should be determined based on whether attendees from different households can stay at least 6 feet (2 arm lengths) Physical distancing at events can reduce transmission risk—for example, blocking off seats or modifying room layouts.

  • Behavior of attendees during an event— Events where people engage in behaviors such as interacting with others from outside their own household, singing, shouting, not maintaining physical distancing, or not wearing masks consistently and correctly, can increase risk.

READ MORE: https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/considerations-for-events-gatherings.html

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COVID AND PREGNANCy

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American College of Obstetrics and Gynecologist (ACOG) issued guidelines about pregnancy and COVID vaccine. Currently, ACOG recommends vaccination in all pregnant women and women expecting to become pregnant. They also do not recommend a pregnancy test prior to getting any one of the three vaccines currently offered.


ACOG summary also includes the finding that vaccines do not cause infertility and this is an unfounded claim.

See the following from the ACOG website:


COVID-19 Infection Risk in Pregnancy


Available data suggest that symptomatic pregnant patients with COVID-19 are at increased risk of more severe illness compared with nonpregnant peers (Ellington MMWR 2020, Collin 2020,  Delahoy MMWR 2020, Panagiotakopoulos MMWR 2020 , Zambrano MMWR 2020). Although the absolute risk for severe COVID-19 is low, these data indicate an increased risk of ICU admission, need for mechanical ventilation and ventilatory support (ECMO), and death reported in pregnant women with symptomatic COVID-19 infection, when compared with symptomatic non-pregnant women (Zambrano MMWR 2020). Pregnant patients with comorbidities such as obesity and diabetes may be at an even higher risk of severe illness consistent with the general population with similar comorbidities (Ellington MMWR 2020, Panagiotakopoulos MMWR 2020 , Knight 2020, Zambrano MMWR 2020). Given the growing evidence, CDC has included pregnancy as a factor that leads to increased risk for severe COVID-19 illness (CDC). Similar to the general population, Black and Hispanic individuals who are pregnant have disproportionately higher rates of COVID-19 infection and death (Ellington MMWR 2020, Moore MMWR 2020, Zambrano MMWR 2020). Further, risk (Zambrano MMWR 2020) of ICU admission was higher for pregnant Asian and Native
Hawaiian/Pacific Islander individuals. These disparities are due to a range of social and structural factors including disparities in socioeconomic status, access to care, rates of chronic conditions, occupational exposure, systemic racism, and historic and continued
inequities in the health care system.

Source:


https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2020/12/vaccinating-pregnant-and-lactating-patients-against-covid-19

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updates in treatment

With all the focus on the COVID-19 vaccine, it is time to review the updates in treatment. We trust that all our hospitals are using evidence-based protocols to determine which patients will benefit the most from the various treatment options out there.

 

What therapies might help people with severe COVID-19 before hospitalization?
In November 2020, the Food and Drug Administration (FDA) granted the emergency use of two monoclonal antibody treatments. One is called Bamlanivimab, and the other is a combination of casirivimab and imdevimab. These treatments are for non-hospitalized adults and children over twelve with moderate COVID-19 symptoms who are at risk of developing severe COVID-19 symptoms or being hospitalized. These drugs are given intravenously by an IV soon after
developing symptoms.

What medications can doctors use for people hospitalized with COVID-19?
Dexamethasone and other corticosteroids (prednisone, methylprednisolone) are potent anti-inflammatory drugs. These drugs are readily available and inexpensive. They are widely used for patients with asthma, sarcoidosis, and rheumatoid arthritis.
Patients who required supplemental oxygen or ventilators and who received dexamethasone were less likely to die within 28 days than those who received standard care. This recommendation was based on a clinical trial from the NIH.


Remdesivir
In October 2020, the FDA approved the antiviral drug remdesivir to treat COVID-19. The drug may be used to treat adults and children ages 12 and older, weighing at least 88 pounds, and who has been hospitalized for COVID-19. Clinical trials suggest that in these patients, remdesivir may modestly speed up recovery time.

 

Baricitinib in combination with remdesivir
In November 2020, the Food and Drug Administration (FDA) issued an emergency use authorization (EUA) to use baricitinib in combination with remdesivir in hospitalized adults and children 2 years and older who require respiratory support.

Ultimately, it takes patients presenting to the health care center in a timely manner so that treatments can reverse the symptoms of the virus. It also takes physicians being aware of the treatment protocols and being aggressive with patients who are too weak to advocate for themselves.

 

To learn more on the Harvard University Coronavirus Resource Center website, click here.

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The Public’s Eagerness to Get a Vaccine is Rising Across Racial and Ethnic Groups

The share of U.S. adults who want to get the vaccine as soon as possible has increased since December among Black, Hispanic, and White adults alike, and the share who say they want to “wait and see” how it works for other people has declined among Black and White adults. However, Black adults (43%) and Hispanic adults (37%) remain significantly more likely than White adults (26%) to say they want to “wait and see,” while White adults (53%) are more likely to say they have already been vaccinated or want the vaccine “as soon as possible” compared Black or Hispanic adults (35% and 42%, respectively).

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