Frequently Asked Questions about COVID-19

  “Shared expectations lead to predictability.”

  171. Impact of a mutation of coronavirus-19 in the UK is being studied.

         Q. How dangerous is the new strain of coronavirus-19 emerging in the United Kingdom?

         A:  This variant of the coronavirus-19 has just recently been identified.  Mutations of viruses are very common and authorities have speculated this virus has already mutated many, many times.  A mutation occurs when the virus replicates incorrectly in an infected person.  Many mutations don’t further become replicated and they die out.   This mutation, however, is rapidly expanding and is marked by its increased infectivity.  One study has shown this expansion is as much as a 70% increase over the earlier contagion.  The sudden rapid expansion of new cases of COVID-19 caused by this mutation has been identified in Southeast England including London.  Prime minister Boris Johnson has quickly reacted by ordering new national lockdown measures and travel restrictions in advance of the Christmas holidays.  This has caused political and public reactions, and many questions are being raised that are now being studied.

William A. Haseltine, PhD is the chairman and president of ACCESS Health International, and a recognized authority on COVID-19.  On Monday this week, he identified that this mutation was identified from mathematical modeling.  Laboratory analysis, which may take months to be completed, is now underway.  The identified mutation is on the “spikes” on the virion making it much easier to penetrate into host cells increasing the rate of replication.  He reported that parallel mutations in the seasonal influenza virus has led to the flu becoming “endemic” or more difficult to stamp out completely.  The rapid public awareness of this mutation has led many in England to relocate.  This encourages the spread of the variant virus elsewhere.  As many as 30 countries (including Canada, but not the US as of last Sunday) have restricted anyone traveling from the United Kingdom.

Moncef Slaoul, MD, chief scientific advisor for the White House Operation Warp Speed said.it was unclear whether the mutated variant has already made its way to America.  He continued, “we are, of course… looking very closely into this.”  He added that this mutation was “very unlikely” to be resistant to current vaccines, saying “We can’t exclude it, but it’s not there now.”  Other considerations are being studied, including if it results in more severe disease.  Assistant U.S. health secretary admiral Brett Giroir stated, “I don’t think there should be any reason for alarm right now.  We continue to watch.”  Stand by!

172. Importance of using a pulse oximeter to indicate the need for seeking care

         Q: What is the COVID program in Vermont encouraging pulse oximeters at home?

         A:  The Vermont Health Department has adopted a program guiding COVID-infected people when to go to the hospital for care.  Richard Levitan, MD has written about the progression of COVID-19 in an infected person.  “This disease causes pneumonia, which causes your oxygen levels to go very low.  Oxygen levels below 92 percent should prompt patients to… speak to their doctor.  If you suddenly fell to such levels, you would normally pass out in minutes.  We now know that this happens slowly in COVID patients, but many patients don’t feel short of breath until their numbers get alarmingly low.  Patients with COVID (develop) pneumonia normally 6 to 10 days after getting sick.  If we knew their oxygen level earlier, and we started treatment earlier, many fewer patients would need a ventilator.”  A pulse oximeter can help individuals monitor their own changing oxygen saturation levels.  Dr. Levitan continued, “This way, we can tell in advance if a person is silently getting sicker before more serious symptoms develop.  For the vast majority of patients, we can get ahead of it with proper monitoring.  They don’t need ventilators, and they shouldn’t be scared to come to the hospital.”

In Vermont, within 24 hours of a person testing positive for COVID-19, public health workers call the patient to trace their contacts.  This interview now includes asking if the patient has their own pulse oximeter.  Through November, the Vermont Department of Public Health has given out over 300 pulse oximeters to those who don’t have one.  Connecticut and most other states do not have such a formal program, but individuals can self-monitor and be guided when to seek medical care to best prevent more serious disease outcomes.  Anyone can obtain a pulse oximeter without a prescription from a local pharmacy or on-line source.  The cost ranges from $15 to $45 for a basic unit.

173.  Allergic reactions encountered with Pfizer’s vaccinations.

           Q:  How much of a problem is the reported allergic reactions to the COVID vaccine?

           A:  Many reports have been made about people having an allergic reaction to the Pfizer vaccine.  When first reported with vaccinations in the United Kingdom, severe allergic reactions were not expected, and this caused great public concern.  In the US, clinical trial data on this was reported and considered by the FDA before the Pfizer vaccine was granted its Emergency Use Authorization.  Procedures were drafted for those giving the vaccinations to prevent any serious outcomes.  Public education was provided to expect soreness at the injection site, mild temporary fevers and fatigue after receiving a dose.  Many may equate these minor results as being “allergic reactions,” but that term is used by those administering vaccines to be life-threatening reactions.  “Anaphylaxis” is an adverse over-reaction of the immune system caused by a substance the person is allergic to.  As of last week, only 5 people reacted this way – out of more than 500,000 vaccine doses given.  Peter Marks, MD, Director of the FDA Center for Biologics Evaluation and Research speculates that an ingredient in both Pfizer’s and Moderna’s vaccine: polyethylene glycol, “could be the culprit” causing these reactions.   Signs and symptoms of anaphylaxis include the rapid appearance of hives, swollen tongue or lips, struggling to breathe, dizziness, or a feeling of weakness.  It can lead to loss of consciousness and sometimes death.  People who have experienced even mild anaphylaxis from previous vaccinations are cautioned not to take the Pizer vaccine.  For everyone, after receiving the vaccine dose, they should stay at the vaccination site visible to vaccination staff.  If any of the signs of anaphylaxis appears, staff can react.  The remedy for severe anaphylaxis is to use an EpiPen to inject epinephrin (adrenaline).  Relief is usually quite rapid.

174.  Priorities and scheduling for receiving vaccinations are updated.

           Q: I am 70 years old and in good health.  When will it be my turn to be vaccinated?

           A: The CDC convened an advisory group last week to further plan for who gets the vaccine and in what priority ranking.  These recommendations go to the states where the final decisions are made.  Thus, the exact order of priorities may differ between neighboring states.  The CDC recommended that people over age 75 be given vaccinations before those aged 65 to 74.  But Connecticut combines these into one group – age over 65.   At first, it was anticipated that this group would be able to receive vaccinations after mid-January.  Last week, this was revised to be after the end of January.  The latest projection is in February.  Future revisions are expected based on the variable future of numbers available.  Other decisions remain to be made.  CVS and Walgreen pharmacies are now expected to offer vaccinations in their retail stores.  Yet if everyone must wait 15 minutes after their shot to be certain they don’t have an allergic reaction, there would be as many as 30 people continually present inside the pharmacy for each employee giving the shots.  Another consideration is how to qualify people coming in for their shots.  If physicians offices can administer the vaccines, they will have qualifying information available.  But at public clinics and pharmacies, what will prevent a retired 60-year-old from “jumping ahead” by saying he/she is an essential worker as the next round begins?  Also, while the vaccine is offered at no charge to the patient, what fee will be charged for administrating the shot?

175. COVID scams have been identified.

          Q.  I was offered a low cost COVID home test by a phone call last week. Is this legitimate?

          A:  No.  The US Department of Health and Human Services Office of Inspector General is alerting the public about fraud scams related to COVID-19.  “It is unlawful to advertise that a product can prevent a disease unless you can prove it with scientific evidence.  Scammers are using telemarketing calls, text messaging, social media platforms, and door-to-door visits to promote these bogus offers.”

  • Be vigilant. No state or federal government representative will call to request money, personal information to enhance your ranking, or to receive services relating to COVID.
  • Beware of scammers pretending to be COVID contact tracers asking for your Medicare number or financial information including payment for a COVID test they offer to schedule for you.
  • If you suspect a COVID-19 health care fraud, report it immediately to 800-HHS-TIPS (800-447-8477).

The most recent CDC guidelines on celebrating winter holidays can be found at[1]:

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/winter.html?ACSTrackingID=USCDC_2067-DM45255&ACSTrackingLabel

[1] To open, copy the following URL and paste it into your browser.