COVID Now
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/ Categories: WELLNESS, 2022

COVID Now

As the effects of the COVID-19 pandemic on society recede, we must recognize that health risks remain, particularly for older individuals and those with compromising health conditions. Fortunately, the mortality and rate of severe illness have declined with the use of vaccines and treatments. Here is the latest.

  • COVID-19 hospitalizations in the U.S. are rising, similar to last year at this time
  • One difference is that hospitalizations are primarily limited to people above 65 this season due in part to population immunity from vaccination and prior infection(s)
  • Models forecast continued growth in hospitalizations through January
  • An increase in illness from other respiratory viruses has put a severe strain on hospitals
  • New variants are not causing worse disease thus far

Mitigation and prevention

  • Doctors and epidemiologists continue to recommend risk assessment in considering mitigation measures such as masking and avoiding crowds
  • Someone above the age of 65 or who has an underlying medical condition may choose to wear an N95 mask whenever in public, whereas a healthy, young person may choose to mask only when in crowded areas or not at all
  • In addition to age and underlying health, a risk assessment includes one's tolerance for becoming ill
  • No one, whether they are at risk for severe disease or not, wants to be ill while on vacation or during another significant event and thus may choose to mask for several days prior

Risk

  • Risk can be a difficult concept
  • Take, for example, a situation in which there is a 5% chance you will be exposed, perhaps attending a crowded, indoor venue
  • Many healthy people may elect to take that chance
  • However, there is a cumulative effect when the activity is repeated
  • If the individual attends the same venue 15 times, that 5% chance increases to a greater than 50% chance of exposure

Vaccine

  • There are demonstrable benefits to the individual and the community in remaining up to date with COVID-19 vaccine recommendations
  • Those who are up to date with the vaccine and become infected have a
    • Shorter duration of illness, and
    • Reduced severity of disease
  • They are also less likely to experience long-term sequelae from the disease
  • The COVID-19 vaccine schedule continues to be modified and will likely become an annual series

Trey Dobson, MD, is the chief medical officer at Southwestern Vermont Medical Center, part of Southwestern Vermont Health Care, in Bennington. 

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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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