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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5 Questions with the Chair of the Department of Surgery

Malcolm Paine, MD, of SVMC OB/GYN, serves as the chair of the Department of Surgery. We asked him five questions about COVID-19 and how it feels to deliver care right now.

SVMC: What would you like to share with patients at this time?
MP: First, on behalf of the Department of Surgery, I would like to acknowledge how tough it has been for our community members who have been affected by this pandemic. We see such tremendous strength in those who have been ill or lost loved ones to illness and in those who are working hard to get by without a job or while homeschooling their children. We are proud to be part of this community, whose careful social distancing efforts have prevented an unmanageable surge.

We are grateful, too, that as restrictions loosen, we can get back to seeing patients and providing care in a timely way. On the surface, the care may look or feel a little different—everyone will be wearing masks, for instance—but once we get accustomed to the changes, we hope that you will recognize the same level of personalized care we all enjoyed before COVID-19.

SVMC: What are the potential risks associated with postponing care?
MP: There are many types of surgery that can be delayed for a short time, often without any negative repercussions . However, surgery is often for situations that cause pain, and delaying the procedure can result in that pain getting worse or not getting better. Sometimes, there are situations where a minor surgery, if delayed, can turn into a more major or emergency surgery, and the patient can become very sick.

SVMC: In general, what additional precautions have been put in place to ensure that care is safe?
MP:
We are absolutely committed to the safety of our patients, staff, and the community. We know how important it is for patients to be able to know and trust that we have their safety in mind at all times. We always want to use the best science and advice from the State to guide our practices. We have put several new measures in place.

We screen all patients and advocates who come to the hospital to make sure they do not have a fever or possible symptoms of COVID-19. All staff also undergo daily screening for fever and symptoms to make sure those looking after patients are healthy. We are also testing all patients with planned surgical procedures for COVID-19. This is performed as an outpatient test at no cost to the patient and increases our confidence that we are not putting patients or staff at increased risk. Patients with a scheduled surgery are encouraged to call ahead if they are feeling unwell, and after surgery, patients will be asked to check for fever for 14 days to make sure they stay healthy.

SVMC: How would patients be notified if COVID risk increased rapidly?
MP:
There is always the chance that there may be a new "surge." In that case, a directive to stop elective procedures would likely come from the State. We may also decide, as a hospital, to stop these procedures in order to keep everyone safe. In that case, we would call the patients to let them know that their scheduled case is delayed until the risk decreases.

SVMC: How would you estimate the risk of contracting COVID-19 at the hospital right now?
MP:
We are tracking these numbers on a daily basis. With all of these safety measures in place and due to the very low numbers of cases we are seeing in this area at the present time, we estimate this risk is extremely low.

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