COVID

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 39

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Coronavirus Update #70 GOOD NEWS: This information is so important to help us all understand risk. Stratified risk is the only true way to measure personal risk. Let us look at some CDC data from the spring Omicron BA.1 and .2 spikes versus the fall 2021 delta wave.
Median age of hospitalization has increased from 60 years old with Delta to 64 with BA.1 and 71 with BA.2. Any underlying medical condition associated with hospitalization increased from 89% with Delta to 92% with BA.1 to 95% with BA.2 respectively. Length of hospital stay decreased from 4.8 to 3.9 to 3.3 days. ICU admission was down from 24% to 18% to 13% of admitted patients. Mechanical ventilation decreased from 14% to 8% to 6% of admitted patients. And Finally, death from 12% to 8% to 5% overall.

What we can glean from this data set is very clear. With successive SARS2 mutations coupled to increased population based exposure to virus via infection or vaccine, we are now seriously in a reduced risk state unless you are older than 65 years with a comorbid disease or younger than 65 with a serious disease. 95% of hospitalizations were related to a comorbid disease regardless of age. The other big takeaway was this: if you are in this high risk group, getting every available booster is vital to your survival based on the risk reduction data. For everybody else, the data is clear, you are ok – to boost or not to boost is up to you. But, absolutely work on your general health.

To your health,
Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 35

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Coronavirus Update #68

At this point the fundamentals completely point to a world of Covid mitigation based on personal risk tolerance and previous vaccination and/or disease. It no longer makes any sense for the entire population to be asked to change the way they live and exist. The messaging remains a struggle for me as people including the heads of major health organizations are pushing for measures beyond what is logical. Messaging continues to be unrealistic regarding Covid for society at large. Why?

We tackle these questions and more this week.

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 33

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Coronavirus Update 67

Natural infection provides a much better route to transmission protection than intramuscular systemic vaccination because of the induction of mucosal immunity via IgA and tissue resident T cells. (Tang et. al. 2022) If you can tolerate a natural infection without much morbidity, this seems to be a reasonable choice at this time. This is especially important now with the immune escaping variants of Omicron lineage and the reality of the current vaccine booster pool is lackluster in its effect on transmission. This calculus may change dramatically with a newer Omicron BA.5 specific vaccine that is in the works. And much more this week!

Dr. M

Dr. M’s Women and Children First Podcast #27 – Dr. Paul Offit – Covid Vaccines

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Dr. Paul A. Offit is Director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia. He is the Maurice R. Hilleman Professor of Vaccinology at the Perelman School of Medicine at the University of Pennsylvania.

Dr. Offit is an internationally recognized expert in the fields of virology and immunology, and was a member of the Advisory Committee on Immunization Practices to the Centers for Disease Control and Prevention. He is a member of the Food and Drug Administration Vaccines and Related Biological Products Advisory Committee, a member of the Institute of Medicine and co-editor of the foremost vaccine text, Vaccines.

He is a scientist, a skeptic, a thinker and an individual deeply passionate about children’s health.

This week we sit down to discuss Covid, vaccines and children’s health.

I hope that you enjoy my conversation with Dr. Offit,

 

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 31

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Coronavirus Update #66

This week is another close look at the current variants of the Omicron lineage, especially BA.5. What is the deal with this strain? Is it causing more heart ache in the United States or just an annoying highly infectious variant? In my opinion, when we have global flairs of Covid 19, there is clear evidence now that individuals that are immune compromised have unwittingly become breeding grounds for genomic mutations in SARS2 leading to variants of concern. These variants become our new circulating troublemakers. Thus, in my opinion, we should be making vaccines in this country that are high quality and targeted to the current strain. Then we should be releasing it worldwide very quickly to people in immune compromised states. This should have the effect of slowing down these emerging VOC’s that are evading our natural and vaccine induced immunity. Finally, we end with a discussion of chronic rhino sinusitis.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 27

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Coronavirus Update #64

What is the current state of affairs? We have a highly contagious and mutational SARS2 virus that is present in the United States. The mutations usually occur overseas in vaccine naive areas. The landscape here has changed as most of us have some immunity as vaccine induced, viral induced or a hybrid combination. That reality has dramatically reduced the death and hospitalization rate so that my colleagues in the ICU feel little to no stress anymore from Covid despite relatively high circulating case volume compared to other waves except wave 4. We discussed boosters and much more this week.

Enjoy,

Dr. M

Dr. M’s SPA Newsletter Audiocast Volume 12 Issue 25

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Coronavirus Update 63 plus other stuff – Lots on boosters today while the persistent world of Covid exposure drags on. Omicron US strains: newer variant BA.2 makes up 35% of current case volume based on different parts of the country while omicron BA BA 1.1.529 is at 6% and B 2.12.1 is 59%. Delta is gone by competition. Cases are increasing in some cities with little increase in hospital morbidity and mortality. In essence we are still fairing quite well in the new norm. Quick Hits and other musings!
Dr. M

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