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COVID-19

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COVID-19

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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COVID-19 UPDATE

Trend Update for the United States: Declining Cases

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Deaths

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.

COVID

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)

FAQ
Medcor

COVID BOOSTER
FREQUENTLY ASKED QUESTIONS

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October 2022

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

FAQ
Medcor

COVID-19 FREQUENTLY ASKED QUESTIONS

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August 30, 2022

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:

  • Fever or chills
  • Cough
  • Shortness of breath or trouble breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

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.

  • NAAT tests, such as PCR or LAMP, are typically the most reliable tests for people with or without symptoms. These tests detect COVID-19 genetic material, which may stay in your body for up to 90 days after you test positive.
  • Antigen tests are rapid tests which result in 15-30 minutes. They are less reliable than NAATs, especially for people who do not have symptoms. A single, negative antigen test result does not rule out infection; a negative antigen test should be repeated at least 48 hours apart. Sometimes a follow-up NAAT may be recommended to confirm an antigen test result.

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:

  • Get vaccinated: COVID-19 vaccines are safe and are effective at protecting you from getting sick. Make sure you are have received all CDC-recommended vaccine doses.
  • Wear a mask: Wearing masks, especially indoors, can help reduce the rate of transmission of the SARS-CoV-2 virus. The CDC has the most current mask recommendations on who should wear a mask and what type of mask is the most effective.
  • Try to keep your distance: Avoid close contact with people and avoid crowds. If possible, maintaining 6 feet between someone who is sick can help prevent you from getting sick.
  • Wash your hands: Wash your hands with soap and water for at least 20 seconds after being out in public, before you eat or prepare food, after you blow your nose, cough or sneeze into your hands, after caring for someone sick, after using the restroom, or after changing a diaper. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
  • Cover coughs and sneezes: Always cover your mouth and nose with a tissue or the inside of your elbow to help prevent the spread of potentially infectious droplets.
  • Clean and disinfect: Clean high-touch areas such as doorknobs, countertops, tables, handles, phones, toilets, and sinks. If someone in your household has tested positive for COVID-19, make sure to frequently disinfect surfaces with an EPA-approved disinfectant.

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:

  • Stay home: Most people with COVID-19 recover at home without medical care. It is important to stay home except if you are going to get medical care.
  • Contact your healthcare provider: Contact your healthcare provider to inform them of your symptoms and/or positive COVID-19 test. Your healthcare provider may want to see you for a visit or may recommend that you stay hydrated and take OTC medications to help with any symptoms you may be experiencing.
  • Get tested: If you have symptoms of COVID-19, you should try to get a test including either a home self-test or you can visit a testing location.
  • Watch for signs of serious illness: If you experience concerning symptoms including trouble breathing, pain or pressure in the chest, confusion, difficulty staying awake, and changes in the color of your skin, lips or nail beds to pale, gray or blue. If you experience any of these symptoms, call 911 to get immediate medical care.
  • Wear a mask: When you are out in public, wear a mask to help prevent the spread of illness.

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:

  • Isolate for at least 5 days. Your first day of isolation starts the day after your symptoms began.
  • You can end isolation after a full 5 days when:
    • Your symptoms are improving or resolved, and
    • You have not had a fever or used fever-reducing medication in the last 24 hours, and
    • You continue to wear a well-fitting mask for an additional 5 days at all times when leaving the home.
    • You should avoid travel, eating out at a restaurant, or going to a gym until a full 10 days have passed since your symptoms began.
  • If you had moderate symptoms, including shortness of breath or trouble breathing, or if you were hospitalized for your symptoms, you should isolate for a full 10 days.

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):

  • Consider getting tested with a viral test 1-3 days before you travel.
  • If your COVID-19 test is positive before or after your travel, do not travel and immediately home isolate.

After Travel (either domestically or internationally):

  • Consider getting tested 3-5 days after travel and monitor for symptoms.

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

FAQ
Medcor

LONG COVID

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Frequently Asked Questions:

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.

  • General fatigue or tiredness
  • Feeling tired after any physical or mental activity
  • Fever
  • Trouble breathing
  • Cough
  • Chest pain
  • Difficulty focusing
  • Headaches
  • Issues with sleep
  • Lightheadedness
  • Depression or anxiety
  • Stomach pain
  • Diarrhea
  • Joint or muscle pain
  • Rash

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:

  • Past medical and surgical history before you were diagnosed with COVID-19
  • Past COVID-19 test results and diagnosis of COVID-19 infection
  • Approximate date when your symptoms began
  • List of symptoms you have had and currently are experiencing
  • List of any symptoms that worsen with activity
  • List of any activity restrictions you may have after your infection
  • List of any medications or supplements you take
  • Communicate any concerns you have with your healthcare provider so that you can work together to set goals to help create a treatment plan specific to you.

Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization

FAQ
Medcor

COVID-19 OMICRON SUBVARIANT BA-2

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Frequently Asked Questions:

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)?

  • If eligible, a booster is recommended by the CDC.
  • If infected, discuss new treatment options with your healthcare provider. These seem particularly effective in preventing milder infections from becoming more severe and reducing hospitalization.
  • Resume domestic travel and refrain from testing before or after travel and from self-quarantine after travel.
  • Refrain from testing before leaving the United States for international travel (unless required by the destination) and refrain from self-quarantine after arriving back in the United States.
  • Refrain from routine screening testing if feasible.

What precautions do I need to take even if vaccinated (per CDC)?

  • Follow local health department recommendations regarding masking.
    • Fully vaccinated people might choose to mask regardless of the level of transmission, particularly if they or someone in their household is immunocompromised or at increased risk for severe disease, or if someone in their household is unvaccinated. People who are at increased risk for severe disease include older adults and those who have certain medical conditions, such as diabetes, obesity, and heart conditions.
  • Get tested if experiencing COVID-19 symptoms.
  • Newer recommendations for quarantine and isolation after infection and exposure were released by the CDC December 27, 2021. These apply to the general population with a separate list for healthcare providers.
  • Follow any applicable federal, state, local, tribal, or territorial laws, rules and regulations.

Source Materials: U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization

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