The Covid-19 pandemic continues. Immunization remains critical to individual health and suppressing the epidemic. A third dose of Pfizer vaccine suggested for those over 65 or younger people at higher risk. Moderna vaccine maintains its effectiveness. Breakthrough infections occur but hospitalizations and death largely occur in unvaccinated. OHC plans flu clinics beginning Wednesday October 13 and hopes to offer Pfizer boosters.
I have a lot of ground to cover since my last post in February. At that optimistic point it appeared we might get everyone immunized by summer and beat the pandemic if we could move quickly enough. That has not happened nor is it likely to happen. Let me summarize accurately for you in three major sections what I consider…
Covid-19 vaccines began last week for everyone over 75 in Massachusetts. The state distribution program includes websites to sign up, outreach calls from major health care organizations and pharmacies, and a new 211 call center. Most all elders should be started on vaccination this month and finish by late March. The over-65 population and younger people with several comorbidities will follow. When younger, healthy populations get vaccine late Q2 will depend on vaccine supply. While there remains lots of uncertainly, the roll-out seems to be working and even improving. Stay calm.
Covid-19 infections are peaking, with far too many infections in our practice. People are NOT being careful with non-immediate family or at work. We are set to vaccinate each of you, but do not yet have vaccine allocation from DPH. We believe (but don’t know) that the start of vaccination will be second week in February.
We use available state Covid-19 infection rates and other published data together with the binomial distribution to calculate the risk of unsuspected infections in small group gatherings. With our current high level of infections (20 times higher than summer) the risk is 5-10% for groups of 10 or 20. You DON’T want to gather indoors with other than household members this winter.
Two monoclonal antibody treatments are conditionally approved by the FDA, seem to substantially help moderately severe cases of Covid-19, and are supposed to be available for use as outpatient infusions to prevent hospitalizations and deaths. In practice they are not actually available, as I found out this weekend trying to arrange an infusion for a patient. This is another fail of our health system.
Vaccinations with the Moderna and Pfizer vaccines have started. We do not yet have any for our patients, but are poised to begin immunizations as soon as DPH supplies us. This may be February. Meantime, Covid-19 disease risk is at an all-time high in Massachusetts and may well worsen. Keep safe. DO NOT SPEND TIME INDOORS IN GROUPS other than regular household members.
The first mRNA vaccine from Pfizer has shipped. The vaccines are highly effective and will make a major difference, but most reasonably healthy people will not get vaccinated until at least Q2 next year. There also may be availability issues with the vaccines. Meantime, the Covid-19 pandemic is surging and we have to be extra cautious for this whole winter. Do not despair, but be rigorous in protecting yourselves.
We are doing in-person visits for checkups and urgent problems, but this Fall’s massive Covid-19 surge, which is expected to worsen in January, may make the face-to-face contacts too risky. Fortunately, video visits are a pretty good substitute much of the time.
Antigen testing reduces the risks of unknowingly exposing others to an asymptomatic person who is actually infectious with Covid-19. We explain how we charge for the tests when used for screening v. diagnostic purposes.
