59th Update on Corona Virus Pandemic with Dr Peter
Dr Peter has been asked about reliable resources online for updates on the pandemic and related information. He uses and recommends this health educator:
He gives daily updates.
Vaccines and Availability
Follow the tiers and protocols to find out when you would be eligible for a vaccine. Working on those age 75 and older with high risk factors now. Nevada County – have given 3000 doses of vaccine. Expecting 2000 more doses coming. Using the Moderna vaccine.
In Oregon: Oregon Health Authority Vaccine information
Many different venues being used to distribute the vaccine. Hospitals, clinics, some pharmacies.
Take whichever vaccine is available when it is offered – both Moderna and Pfizer are effective.
The booster (the second shot) should be the same kind as the first one you get. If you want a vaccination, take it as soon as you are eligible and offered it.
Johnson and Johnson vaccine:
This is on one shot vaccine, but they are considering having a booster with this one too. Not sure when it will get approved and be available. It is easy to store and to keep ready and inexpensive.
Not sure when it will be available here. This is a two shot series. It is being given widely in the UK.
Not sure if this is a one or two shot vaccine.
In the 24 hours before you get vaccinated, avoid taking anti-inflammatory or medication such as Tylenol, Ibuprofen, Advil, etc. These dampen down the immune response and you want to get the best immune response you can when your body response to the vaccine. Allow any mild fever that comes after the vaccine to run it’s course and don’t take anti fever medication. Normal to have a sore arm, redness and warmth at site of injection is common. Usually more pronounced symptoms with the second shot.
The injection is given deep into the muscle and it is important to get it into the muscle. Don’t pull away and allow the injection to go deep. It only stays in the muscle for a short time.
Booster shots are given 21 days later (Pfizer) or 28 days (Moderna) later. Can get it up to 4 days earlier or 2 weeks late. Important to get the booster. If people are “under immunized” it creates more possibility of incubating mutations to the virus that “escape” the vaccine.
People who are younger may have a stronger immune response because their immune system is stronger.
About 70% of people in the US are saying they want to be vaccinated. This is higher than a month ago. This may go up as the variants get to be more of an issue. If you don’t want it now and change your mind down the road, you would probably still be able to make an appt and get vaccinated but better to take it as soon as possible – availability of the vaccines and other factors may change.
Statistics (2 weeks since the last update)
Nevada County (about 100k pop)
3500 cases, up about 400 cases from 2 weeks ago.
Case Positivity Rate: An average daily positivity rate (over 14 days): 13.6% down from a peak of 20% on Jan 13.
Most cases in 50 – 64 age range. Nevada County has more in this range than any other county.
Doing 150 – 200 PCR tests done per day. Many more antigen tests.
11 – 13 people hospitalized for COVID 19. ICU cases 1-3 per day, down from average of 3.
Deaths in county: 74. Case Fatality rate: 2.1 % down from 2.4%
400 cases, up from 358, in the 95959 zip code, where Ananda Village is located.
Sierra County (3100 pop)
95 cases, up from 70
Hospitalizations: 1 No deaths
Case positivity rate averaged over 14 days is 9.8%, down from12.7%
Yuba County (80Kpop)
5400 cases, up from 4800 Hospitalized: 51, down from 54 ICU 13, down from 16
CPR: Averaged over 14 days is 14.3%, down from 19.6%
Deaths: 31, up from 27
Placer County (400Kpop)
18,000cases, up 1400 from2 wks ago
CPR: 14 day average is 9.3%, down from 14.9% 2 wks ago
Hospitalized: 137, down from 161 ICU: 20 down from 29
3.3 million cases, up about 300,000 2 wks ago
CPR: 7.4%, down from 12.5%
Hospitalizations: 15,700 down from 21,000
ICU: 4,000 per day, down from 4800
US (330 mill pop)
26million cases, up 1.7 million
24,300 in ICU, down from 29,000 (will come down very slowly)
Cases per day: about 150K, down from 200K
Deaths: 452,000, up from 410,000; 3000- 3500 per day
There are areas in the world having a difficult time – primarily because of the new variants with higher transmission rates.
Portugal and Ireland are getting hit with the variant B117
This variant appears to have a 20-30% increase in severity of symptoms and number of hospital cases.
South Africa is hit with B1351 strain. Has been significantly more impactful there since about 20% of the adult population is HIV positive, with immune deficiencies which makes Covid 19 more deadly.
Brazil has their own strain. Large poverty populations with lack of clean water and other amenities.
Indigenous populations being hit as well.
UK, where the variant was first seen, seems to have peaked and numbers are coming back down, thanks to the use of the vaccine.
Public Health Department Updates from last 2 weeks
Ability to release the vaccine statewide is limited by current infrastructure. Blue Shield is taking over the distribution and hopefully this will speed things up.
The vaccines do a great deal to decrease serious disease. It is not clear exactly how efficient they are in blocking transmission, but even greatly reducing the tranmission rate is beneficial. Remember to use masks and physical distancing, etc even if you have been vaccinated. We may have to continue those measures through 2021.
After someone has had Covid 19, testing is not recommended by PCR or rapid antigen test.
However —- If you develop symptoms consistent with Covid 19, even if you have been vaccinated, it is important to go get tested. We do want to track positive tests and have people isolate to reduce community spread.
Regeneron and Banlanivimab – still being used to treat age 65 and older with significant symptoms in the first 5 days.
There are tools online that you can use to measure your risk of hospitalization based on number of symtoms you are having.
NC is aiming for 1000 vaccines a day.
Testing – a review
1) Main in-office or home test is the rapid antigen test – similar to a pregnancy test. Inexpensive and take 15 – 20 minutes for a result. At home rapid antigen tests are available for about $150 for 26 tests.
More false negatives with this test.
2) PCR test
Takes fluid from your nasal sample and amplifies the amount of virus in that sample. Send out to a lab.
This is the most sensitive test.
3) Rapid PCR test can be done in the office with the right equipment.
4) Antibody serologic testing is still not ready to use – not sure what it means.
These have different levels of sensitivity and the timing of the testing matters a lot. Testing too early – like 2 days after being infected, may give a negative result. Best to test 4-5 days after infection. This is a real issue. People can have symptoms and test negative at first and then get worse and retest and it is positive because the level of virus is now high enough.
Sometimes will do the rapid antigen and also send out a PCR test in case of a false negative, and tell people to isolate until the test results come back. If you get a negative test, especially if you have symptoms, always ask, “What does that mean and how should I behave?”
False Positive tests with the in-office rapid antigen testing is not a problem. Positive means you most likely have it. Can confirm with a PCR test sent out. Can remain positive if they have been infected in the last three months and can no longer infect others. Have to assume it’s a real positive and protect others.
Main problem with testing at home is that people often do not want to report positive test results and don’t want to isolate.
Jyotish and Devi – numbers in India are coming down.
Q: Are 14 day quarantines still in effect? A: CDC is still recommending 14 day quarantine, especially with high exposure (in an inclosed space for longer period without mask).