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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Meet Dr. Disha Spath

Dr. Disha Spath, an internal medicine physician originally from Georgia, was excited to start a new position at Twin Rivers Medical, P.C., in Hoosick Falls, NY, on April 20th. But then COVID-19 struck. As practice appointments plummeted and the potential for a surge of COVID-19 patients rose, Dr. Spath volunteered to take a temporary assignment serving in-patients with SVMC’s Hospital Medicine Department.

SVMC: Already new to the health system, what was it like to have your plans change from practice-based medicine to hospital medicine so suddenly?
DS: Well, to be honest, it was a little scary given the times. I had to come to terms with the fact that I could possibly expose my family to SARS-CoV-2. My husband and I had some tough conversations and came up with a risk-mitigation strategy… [Then] I actually reached out to Trey, [the chief medical officer,] and volunteered to help out in the hospital. I've been a primary care physician recently, but I'm not too far removed from hospital medicine. In fact, I was already planning on picking up some per diem hospitalist work later this year. I just decided to move the timeline forward a bit to help with COVID-19.  This is what I'm trained for. I felt it was my duty to step up and help during the pandemic.  

SVMC: How has it been working with the hospitalists to treat both COVID and non-COVID patients?
DS: The hospitalists have been so kind and generous. They have really taken the time to bring me up to speed with the hospital and have been very gracious with training me on the computer system. I am really thankful that they have included me in their top-notch team. I'm also so very impressed by how involved and thoughtful the leadership is. The way the hospital leadership has ensured adequate PPE for staff and has created the workflows so quickly to deal with COVID-19 is truly inspiring.  

SVMC: What have you noticed or learned about the culture of the health system or the area?
DS: I am really struck by how everyone is so interconnected and how supportive the community is of its healthcare staff. It is very touching to see all the donations of homemade masks, skullcaps, and food to the hospital. I also love that the hospital staff seems to know their patients' home situations and their medical histories so well. 

SVMC: How do you expect your work at Twin Rivers will be affected by your having started your position at the hospital?  
DS: Yes, since hospitalists and primary care physicians often hand off patients, I'm really looking forward to building rapport with the hospitalists. I'm also hoping to meet the specialists I will be referring to. It will be helpful to have an insight into the workflow of the hospital when I refer patients for admission. And I'm already starting to meet some of our lovely patients in Hoosick Falls. Overall, I believe this will be a really positive thing for my work at Twin Rivers. I'm honored to join the area and I hope I can contribute positively to this special community.  

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