“Shared expectations lead to predictability.”
336. Booster shots are not available.
Q: The Delta variant really scares me. Where can I get a booster shot?
A: You need to save time and effort; booster shots are not available in the US. Some countries are using vaccines that are not as effective as the three we are using. All our vaccinations are authorized by the FDA Emergency Use Authorization (EUA) which requires it has to be given as authorized – J & J one shot, Pfizer and Moderna no more than two shots, several weeks apart. A review is underway to grant full FDA approval to the Pfizer vaccine, hopefully by Labor Day. Physicians, following expanded guidelines can then prescribe a medication be administered differently following yet-to-be approved guidelines. The reason for developing booster shots is to allow immunosuppressed patients and others with medical conditions to increase the ability of their vaccinations to develop effective levels of immunity. In Northern California, recently, vaccinated patients learned that pharmacies in Oregon were giving out shots to fully vaccinated patients. That practice was stopped as soon as authorities learned this violated the law. Even then, many continued to seek these booster shots by saying they had lost their vaccination cards, or had left them home. Last Wednesday, the World Health Organization called for a moratorium on coronavirus-19 booster vaccinations until the end of September. Given the scarcity of vaccine doses, and the global need for populations to become initially vaccinated, this moratorium was prompted to serve the greater good of public health world-wide. In spite of the WHO moratorium, the FDA is continuing to approve booster shots to protect the estimated 3% of the population who are immunocompromised.
337. The costs of COVID testing are not a barrier to maintain good Positive Test Ratios.
Q: Tests are very expensive. Won’t the number of tests slow down to save money?
A: On Tuesday, August 3, the Hartford Courant reported that on that day, 12,253 COVID tests had been given resulting in 277 positive cases. The resulting positivity rate of under 3% showed the number of tests given that day was adequate to accurately identify all of actual cases that day. Those tests were paid for by Connecticut to the 10 hospitals and independent laboratories that processed them. The contracts signed with these laboratories included setting up various clinics, taking of samples and the following laboratory processing. The costs for each test averaged nearly $91.00 Over 1.4 million tests have been administered for a total cost of about $130 million. Nationally, FEMA is responsible for reimbursing states for all testing, and partial payment has already been received in Connecticut with the rest expected soon. As long as FEMA is paying for tests, the number of tests we now offer should not remain adequate to locate, contract trace and isolate all infected patients avoiding a further increase in the surge from the Delta variant.
338. The FDA plans to fully approve the Pfizer vaccine by Labor Day
Q: When will the vaccine get full FDA approval so hesitant people can get their shots?
A: Nationally, many unvaccinated people say they feel the development of the vaccine was rushed, and it is not fully tested. It is true that all currently approved vaccines in the US have “Emergency Use Authorization” (EUA). Mandating vaccinations for groups, such as the military, universities and cities would also require full authorization. The first vaccine to receive its EUA, Pfizer, filed its application for full approval on May 7. Moderna filed for the same on June 1, but is still completing its required data submissions. Spokespersons at the FDA have stated they are taking an “all-hands-on-deck” approach to process the information without adding bureaucratic delays. The goal now is that Pfizer’s approval will come by Labor Day. Deadlines for a patchwork of mandates will certainly raise objections by many, but existing public health legislation allows for fines and penalties for not complying with government-ordered mandates. And we noted last week, the US Supreme Court has ruled that these laws mandating vaccinations are constitutional.
339. For those who are vaccinated, a review of facts with the delta variant present.
Q: I get so confused over this Delta variant! I am vaccinated so exactly what do I do?
A: Katherine J. Wu, holds a Ph.D in microbiology and immunology from Harvard University. She recently published an on-line article in the Atlantic attempting to clarify, with simplicity, the facts and factors by vaccinated people facing the Delta variant.
She clarifies that the tools already exist. The bottom line are these tools now need to be revisited: The ultimate tool is vaccination of sufficient members of the population. Other tools the individual can use include wearing masks, social distancing, and washing hands. She offers three tenets to guide us through this next stretch managing the Delta variant:
- Vaccinated people can spread the virus, but not as often as the unvaccinated people spread it. The Delta variant can build up the number of virus particles (the viral load) in the airways faster than previous strains, making the shedding of the virus more concentrated and infectious to others. The vaccinated person can actually become infected, but the immunity granted by the vaccination prevents it from spreading into the lower respiratory system and lungs.
- We have the tools we need to fight Delta. Vaccinations fortify the body’s defenses. Masks “reduce the amount of virus we each have to tussle with and send back into the world.” And physical distancing, spending more time outdoors, and ventilation reduces the infectious virus from reaching us.
- Vaccines are still the most sustainable solution for ending the pandemic. The more people that get them, the better off everyone is.
340. It’s time to review when we need to go to a hospital if we get sick.
Q: My husband refuses to get vaccinated, and my son is too young to get his shot. Do I get them to the hospital as soon as I think they might have COVID?
A:The key decisions on how to treat COVID-19 occur between days 5 to 10 from first symptoms appearing. Mark a calendar when the first suspicious symptoms emerge. “While most patients recover in a about a week, a significant minority of patients enter a very nasty second wave of illness,” says Han Swartz, MD at the University of Alberta. “After the initial symptoms, there is a secondary worsening.” Days 5 through 10 are usually the most worrisome for respiratory complications from COVID-19. Doctors warn not to get complacent.
Every home should have a pulse oximeter – the device that is clipped on a finger in a healthcare office. If you don’t have one, order it soon. They are in short supply and if you wait until symptoms appear, you may have to wait weeks for it to be delivered. This unit measures the blood oxygen levels. Without a pulse oximeter, the gradual reduction of oxygen may not be noticeable until the patient experiences sudden shortness of breath. By that time, treatments that might have been helpful could be too late. Normal blood saturation is between 96% to 99%. If the level drops slowly over time, or reaches 92%, it’s time to call the doctor. Having a portable oxygen supply at home can help if breathing difficulty emerges.
Generally speaking, it is not wise to run to the hospital when the first symptoms appear. It will be too early for a diagnosis or treatment plan to be developed. And you run the risk of spreading the disease to others – if it is COVID– or becoming infected if it isn’t.
