Feb. 7, 2022 Covid Summary from Dr Peter Van Houten


As predicted, the high transmissibility of the Omicron variant has made it the sole COVID variant in the US right now. Last week we reached the peak of number of cases nationwide, and are now seeing a steady downward trend. Omicron cases appear to have lagged slightly behind in our local region of Nevada County, with a hopeful downward trend in cases in just the last few days.

We are now entering an endemic state of the COVID era in which we will all be exposed many times. The good news is that we will reach herd immunity. For those interested, Dr. Peter recommends an hour-long panel discussion UCSF entitled “The Downslope of the Omicron Surge, and What to Do as We Turn the Corner”

The main theme from this panel is that masks will gradually become less important, and we will soon be able to gather and interact with less restriction. Schools and other environments with high potential for exposure/transmissibility may continue masking a bit longer.

Vaccines
The 3 shots series are holding up extremely well. It appears that for a long period of time, this will be the last of the vaccine recommendations for general public health. The vaccine is also very well-tolerated during pregnancy.

Masks
N95 masks continue to work very well for protection. Also working well are good quality KN95 masks, followed by cloth mask over surgical mask (AKA double masking).

Testing and Isolating
Rapid antigen testing at home is becoming widely available. Visit
https://www.covidtests.gov/ and you can apply to have 4 tests sent to your home. You can also get free tests covered by insurance at any pharmacy.

The rapid antigen test is different to the PCR test which is very sensitive, being able to detect the virus even before, and much longer after symptoms show up.

The rapid antigen test looks for the protein of the virus in its infectious stage. If we get a Positive antigen result, it is likely a true positive and we are transmissible to others. In this case one can isolate for a full 10 days, or test again on the 5th day. If the new test is negative, you are no longer transmissible. If positive, continue to isolate.

The PCR testing can remain showing positive results up to a month even when transmissibility is no longer an issue. This is due to the fact that the PCR test looks for the genetic material of the virus itself.

Treatments
Paxlovid – highly effective oral medication for keeping people out of the hospital. Needs medical supervision since it can interact with other common medication.

Sotrovimab is a monoclonal antibody infusion, giving protection for 90 days. – Regeneron no longer works.

Remdesivir is a 3 day in a row hour-long infusion. But it has incomplete coverage from insurance and it is very expensive.

Molnupiravir (not as effective) improves possibility of not needing to be hospitalized by 30% chance.

Effectiveness of Lockdown
There has been some discussion as to whether lockdowns have been an effective method for keeping cases down, with a somewhat sensational meta-analysis loosely associated to Johns Hopkins drawing attention to this. Critics have identified a lack of credibility and authority (the focus of the studies and expertise of its authors were in Economics rather than Epidemiology or Public Health) in the analysis.
Dr. John Campbell gives a 20-minute commentary on the pros and cons of what the analysis sorted out about lockdowns.

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