Guidelines around the COVID-19 pandemic continue to evolve. Medcor updates our clinic guidelines, triage algorithms, and health security services, including screening and testing, to reflect the latest guidance from health authorities. We also want you to have the best information on COVID-19, so we share the latest information with our clients, patients, advocates, and partners.
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There continues to be a decline in deaths and hospitalizations related to COVID-19, confirming a trend that started several weeks ago.
Vaccination has proven effective at preventing severe illness, death, and hospitalization from the COVID-19 virus. A new “bivalent” booster appears to be more specific for Omicron mutations and is strongly encouraged for all those eligible. (over age 5).
Vaccination for influenza (“the flu”) is compatible with COVID-19 boosters. Both can safely be given simultaneously. Predictions are for a more severe flu season, however the flu vaccine is predicted to have excellent coverage.
All U.S. strains are “Omicron” related variants—which is encouraging. They are highly contagious and spread easily, often avoiding immunity from previous infection. Fortunately, they tend to cause less hospitalization and death.
BA.5: remains the most common variant/mutation and has been circulating widely since early summer. It has decreased slightly, but still accounts for 80% of U.S. infections.
BF.7: subvariant of BA.5, initially spread in China and now gaining foothold in Europe (esp. Belgium) and U.S.
XBB (BA.2.10): evolved from the BA.2 Omicron subvariant (“Stealth”), spreading in Far East, especially Singapore, where it accounts for more than 50% of infection. Like most variants, it is highly transmissible, but not likely to cause severe disease.
Currently, there are no new recommendations for prevention and treatment of COVID-19 in light of current or emerging variants. As new variants emerge, cases may increase, but current protections remain effective.
Source Materials: U.S. Centers for Disease Control and Prevention (CDC)
In September, Covid-19 boosters that specifically target Omicron strains were approved and released for distribution. These bivalent mRNA vaccines are produced by Moderna and Pfizer/BioNTech and use the same platforms on which the original vaccines were based.
Who is eligible for the new boosters?
The Moderna booster is available for those 18 and over and Pfizer/BioNTech is available for those 12 and older if they have received a primary vaccination series or a booster at least two months before. Children under the age of 12 are not eligible but manufacturers have announced plans to seek approval in the coming months. Children 5 and above are eligible for a primary series and one booster shot, although not the most current bivalent vaccine.
How is this vaccine different than the previous versions?
This bivalent vaccine is very similar to previous vaccines with a few key differences. First, the vaccine incorporates mRNA to encode the “spike protein” from the original strain of Covid-19 as well as the more highly transmissible Omicron strains (BA.5, BA.5). Secondly, the bivalent vaccine has a lower dose of mRNA than that used in the primary series of vaccines.
Are these new vaccines safe and have they been tested?
Experts don’t expect any significant changes in side effects or safety given how similar these vaccines are to the prior
versions, which have been administered millions of times. Regulators authorized the vaccines based on this track record
and previous human experience with a reformulated vaccine incorporating BA.1 as well as trials in mice. Human specific
trials have begun, and we expect to see results in November. This methodology is very similar to influenza vaccines, which are updated annually and approved before human data is fully studied.
How effective are these new vaccines?
Ongoing studies in humans will help scientists to better understand the effectiveness of the bivalent vaccines. Experts chose to approve these vaccines based on the effectiveness of previous vaccines and studies looking at a reformulated vaccine based on the BA.1 variant. These reformulated vaccines were very effective in evoking an antibody response and preventing death and hospitalization. Individuals who have been recently diagnosed with Covid-19 should consider waiting 3 months until getting a booster, since infection boosts immunity and is protective for 2-3 months.
Can I get influenza vaccine and covid vaccines and boosters at the same time?
Yes. It is very important to receive an annual flu shot each year as experts are worried about a “twindemic” with both
influenza and Covid-19. Receiving both vaccinations at the same time is both safe and convenient. The vaccinations can
also be spaced out if individuals prefer.
Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization
What is COVID-19?
COVID-19 is a disease caused by a virus known as SARS-CoV-2. The virus was first identified in December 2019 in Wuhan, China and quickly spread world-wide. It is very contagious and most often causes respiratory symptoms that can feel like a cold, allergies, or the flu.
The COVID-19 virus continues to mutate and create “variants” of the original virus. Since the original wave of COVID in late 2019/early 2020, there have been many waves of infections with variants worldwide (e.g., Delta and Omicron). Variants that have become dominant in regions or worldwide tend to have features that enhance transmission such as higher infectivity, ability to evade immunity caused by previous infection or early vaccines, shorter incubation times, higher viral loads, etc.)
How does COVID-19 Spread?
COVID-19 spreads when a person infected with the virus breathes out the virus in droplets when coughing, sneezing, talking, or singing. These droplets can be breathed or can land in the mouths or noses of people who are nearby. The virus can also live on surfaces or objects and can be transmitted when a person touches the contaminated objects and then touches their mouth, nose or eyes.
The incubation period, the time it takes for you to develop symptoms after you were exposed. The early COVID variants had incubation times 2 to 14 days after exposure. Some of the more recent COVID variants have had shorter incubation times that have averaged between 3-5 days. Some people who are infected may not have any symptoms, so it is important to take precautions to prevent the spread of COVID-19 if you have had an exposure.
What are the symptoms of COVID-19?
The main symptoms seen with COVID-19 include:
Not everyone has all these symptoms, and people experience a wide range of symptoms with COVID-19. Most people with COVID-19 infections get better, but there are some people who may have post-COVID symptoms or may develop more serious complications. Post-COVID conditions (including “Long COVID”) are a wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with COVID-19. Older adults or people who have chronic health conditions may be at risk for developing more serious complications.
How is COVID-19 diagnosed?
SARS-CoV-2 can be suspected in anyone who has symptoms consistent with COVID-19, but a definite diagnosis requires testing. There are several kinds of tests available for COVID-19. NAAT tests (PCR and LAMP) as well antigen tests are used to detect current infection. Antibody tests can detect past infections but have been found to be unreliable in many cases and is not indicative of immunity.
To learn more about testing, visit the CDC website.
How do I prevent a COVID-19 infection?
Some things you can do to prevent a COVID-19 infection include the following:
What should I do if I have symptoms of COVID-19 or test positive for COVID-19?
Regardless of vaccination status, if you think you might have COVID-19, you should:
If I have symptoms of COVID-19 or test positive for COVID-19, when can I be around others?
If you have had symptoms of COVID-19, you should isolate right away and then either take a home test or go to a testing center for a test. Isolate until you have your test results.
If you have a negative COVID-19 PCR test, you can end home isolation. If you are using a home antigen or a rapid antigen test, you must have 2 negative tests collected 48 hours apart before ending isolation.
If your COVID-19 test is positive, you should:
What if I am exposed to someone who is positive for COVID-19?
If you were exposed to someone with COVID-19, you should wear a high quality, well-fitting mask for 10 days and watch for symptoms. You should avoid public transportation, travel, and large gatherings and be careful around others who may be at risk for severe illness. Testing 5 days after exposure is recommended.
If you develop any symptoms after a known exposure, please follow the home isolation instructions for “if you have symptoms of COVID-19.”
What should I do before and/or after travel?
While no longer a CDC requirement, testing before and after travel is a good way to protect yourself and other travelers.
Before Travel (either domestically or internationally):
After Travel (either domestically or internationally):
What if someone in my family gets sick with COVID-19?
If your family member does not need hospitalization and can be cared for at home, you should help them with basic needs and monitor the symptoms while also keeping as much distance as possible. According to the CDC, the sick family member should stay in a separate room and use a separate bathroom, if space allows. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. (Please refer to the CDC website for the most current mask recommendations.) Make sure to follow measures to prevent COVID-19.
Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization
An elusive and unpredictable complication of SARS-CoV-2 (COVID-19) infection has slowed recovery for up to twenty percent of infected individuals. Acute COVID-19 infection can cause a range of symptoms, from none to severe including hospitalization and death. After the initial infection, some have lingering or new symptoms that remain after the individual has recovered from the acute infection. These symptoms have frustrated patients and providers as researchers hunt for a clear path forward.
What is long COVID?
Long-COVID, also known as post-COVID conditions, describe a wide range of health problems people can experience four or more weeks after first developing COVID-19. Even those who do not become severely ill from COVID-19 infection may experience post-COVID conditions (PCC).
Most people recover from COVID-19 within a few days to a few weeks in an uncomplicated, predictable manner. People who develop long COVID have symptoms that typically last at least 4 weeks or more after their initial infection with symptoms that do not mimic their original illness. People who had asymptomatic COVID-19 can also develop long COVID symptoms.
Long-COVID can lead to a number of health problems that can affect multiple body systems. There are currently no tests to diagnose long-COVID. The diagnosis is made by a healthcare provider based on past positive results, symptoms, and findings from physician examination. The cause is poorly understood and follows an unpredictable course of recovery.
What are the symptoms of long COVID?
People with long-COVID symptoms can experience a wide range of symptoms lasting anywhere from a few weeks to a few months. Symptoms can go away and then come back, but most people improve over time.
COVID-19 infections can affect multiple body systems, and past infection can increase the risk of developing chronic diseases such as diabetes, heart or neurological conditions when compared to people who have never been infected with COVID-19.
Who is at risk of developing long-COVID?
Researchers are working to understand who is at a higher risk of developing long-COVID. Studies have shown that people who have had severe illness, specifically needing hospitalization or intensive care, people with underlying chronic health conditions, and people who have multisystem inflammatory syndrome (MIS) during or after COVID-19 infection are more likely to develop long-COVID. Studies have found that people who have been vaccinated against COVID-19 are less likely to develop long-COVID than those who have not been vaccinated. Long-COVID is also a reason to avoid infection by masking, social-distancing, and isolating when appropriate. The different variants of COVID-19 virus also contribute to long-COVID in different and poorly understood ways.
What should you do if you think you have long-COVID?
If you are concerned you have long-COVID, it is important to see your healthcare provider. Before your visit, make a list including:
Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization
What is the Omicron Variant BA.2?
The Omicron Variant (B.1.1.529) currently accounts for the majority of new infections in the United States. The strain was originally identified in Botswana and South Africa in November 2021. A new subvariant, BA.2 has a high affinity for hACE2 receptors and does have higher transmission rates (30% more
transmissible) than previous variants of concern. Subvariant BA.2 has replaced BA.1 as the predominant strain in many areas of the globe, causing about 20% of all infections worldwide.
What are the key characteristics of the Omicron Subvariant BA.2?
All Omicron variants appear to evade certain immune pathways
in the body and are associated with a higher reinfection risk in patients previously infected with other coronavirus strains. Reinfection is possible, but rare. An individual with past COVID-19 infection, including other subvariants or Delta can be infected with BA.2, but primarily among the unvaccinated. The resulting infection is generally mild. There were no hospitalizations or death among BA.2 reinfections. Danish and South African studies indicate that increased transmissibility has NOT led to increased numbers of hospitalizations or death.
Currently, monoclonal antibodies are ineffective against Subvariant BA.2 infections. Novel agents Paxlovid and Molnupirovir appear to remain effective at preventing disease progression, hospitalization, or death from infection.
Are the symptoms different?
While BA.2 may spread more easily, preliminary data demonstrates similar disease severity as BA.1. Headache, sore throat, myalgias, fatigue and runny nose are among the most frequently reported symptoms. Fever and cough are
generally less severe. Vaccinated patients report much milder symptoms. Taste and smell abnormalities do not seem to be nearly as common as seen with previous strains. Omicron and its subvariants can also cause a wide range of symptoms which cannot be differentiated from other variants or other respiratory viruses.
Are vaccines still effective?
Vaccines remain effective but concerns of waning immunity in those having received a primary vaccination series have led to widespread recommendations of boosting with an additional dose of mRNA vaccine (Moderna/Pfizer). Preliminary studies show a roughly 30% vaccine efficacy increased to over 70% against Omicron variant after receiving a booster. Regardless, vaccines show a clear role in preventing severe symptoms and hospitalization. Efforts to increase boosters have become a clear CDC objective and should be strongly considered by those eligible.
Does Omicron require different testing?
Currently all known variants and subvariants of interest and concern are detectible with existing approved tests. Although the levels of sensitivity and specificity vary across the different testing platforms and modalities, these tests do not need to be altered to detect Omicron subvariant BA.2. A handful of nucleic acid testing modalities were unable to detect the variant; they are currently being held by distributors. Home testing can detect Omicron with similar ability as for other strains.
If I’m fully vaccinated, what can I do (per CDC)?
What precautions do I need to take even if vaccinated (per CDC)?
Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization
