“Some days are better than others... It's been a long journey, but we're starting to see the light at the end of the tunnel now.” Brian Robertson
“It’s easier to have courage and trust the process when you feel you’re making headway. Mastery is not persistence when you see a light at the end of the tunnel. True mastery is persistence when you don’t yet see the light.” James Arthur Ray
Are the vaccines effective against the Variants?: Israel is leading the world in its vaccination roll out, due in part to an agreement to share data with Pfizer and BioNTech. As of Wednesday, around 55 percent of its 9 million population had been given at least one dose of the Pfizer/BioNTech Covid-19 vaccine, according to Health Ministry data, and 43 percent have received both doses. An analysis of immunization data from Israel—a global leader in COVID-19 vaccination—show that Pfizer’s COVID-19 vaccine is highly effective against the United Kingdom (UK)-based variant, B117. The evaluation of data, conducted by Pfizer, found that its vaccine was 94% effective in preventing asymptomatic infections with the novel coronavirus and 97% effective in preventing symptomatic COVID-19 illness—both mild and severe—in addition to COVID-19-related deaths. More than 80% of the tests were conducted on the B117 variant. Israel has not had many cases of the South African variant so data on efficacy against it are not available.
How long after COVID infection can you schedule necessary medical surgeries: Keeping surgery on hold for at least 7 weeks after a positive coronavirus test, was associated with lower mortality risk compared with no delay, a large international study found.
Among 3,127 patients with a preoperative SARS-CoV-2 diagnosis, mortality was highest in those who had surgery very soon after testing positive, reported Dmitri Nepogodiev, MBChB, and colleagues of the University of Birmingham, England
Their results showed at 30-day postoperative mortality rates were:
9.1% for surgery within 2 weeks of diagnosis (104 of 1,138)
6.9% for surgery 3–4 weeks after testing positive (32 of 461)
5.5% for surgery 5–6 weeks after diagnosis (18 of 326)
2.0% for surgery 7 or more weeks post-diagnosis (24 of 1,202)
When compared with the adjusted 30-day mortality of 1.5% for surgery without SARS-CoV-2 infection, only the group with at least a 7-week interval between diagnosis and surgery didn't have significantly elevated risk of death at 30 days.
"While cut-offs beyond 7 weeks were not formally tested, they are unlikely to offer a significant advantage, since adjusted mortality rates for delay intervals ≥7 weeks were broadly stable," the researchers wrote.
However, those with ongoing COVID-19 symptoms had elevated surgical risk even after waiting 7 weeks or more compared with those whose symptoms had resolved or who had been asymptomatic (6.0% vs 2.4% and 1.3%, respectively).
COVID induced Stress and Oral Health: Oral health professionals reported a significant uptick in the number of patients presenting with stress-related oral problems since the global COVID-19 pandemic began impacting dental practices in March 2020, according to the American Dental Association Health Policy Institute. In a poll conducted the week of February 15, responding dentists reported an increase in the prevalence of the following conditions:
Teeth grinding and clenching: 71% increase
Chipped teeth: 63% increase
Cracked teeth: 63% increase
Temporomandibular symptoms: 62% increase
Links between Oral Health and the COVID Virus: The links between periodontology and COVID-19 are becoming clearer each day. The research in this month's issue of the Journal of Clinical Periodontology reveals a higher rate of hospitalization, ventilation, and death among people with alveolar bone loss( Periodontal disease) who contract COVID-19.
The results recommend sharing this information with patients is very important for dentists to do, not to scare them but to motivate them to pay closer attention to their oral health.
Vaccine and Nursing Mothers: Research on SARS-CoV-2 vaccination in lactating women and the potential transmission of passive immunity to the infant through breast milk is needed to guide patients, clinicians and policy makers during the worldwide effort to curb the spread of this virus. Results In a cohort study of 6 lactating women who received 2 doses of SARS-CoV-2 vaccine, it was observed significantly elevated levels of SARS-CoV-2 specific IgG and IgA antibodies in breast milk beginning at Day 7 after the initial vaccine dose, with an IgG-dominant response.
Conclusions and Relevance This study shows that maternal vaccination results in SARS-CoV-2 specific immunoglobulins in breast milk that may be protective for infants.
Efficacy of MASK Wearing and stopping the spread: A recent study published in the United States Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report found that states with mask mandates fared better when it came to the spread of COVID-19 than those without. The data were collected from March 1 to December 31, 2020, and noted significant decreases in daily case rates and number of deaths within 21 days of states issuing mandatory mask mandates. The study also found that allowing in-person restaurant dining correlated with increases in both daily case rates and number of deaths.
Can Getting the Vaccine help COVID Long Haulers: Some people suffering from long COVID have found significant symptom relief after the first dose of their COVID-19 vaccine. Akiko Iwasaki, PhD, of Yale University, proposed three potential mechanisms for long COVID: a persistent viral reservoir; viral fragments or remnants that drive inflammation; or an autoimmune response induced by the infection.
It is hypothesized that taking the vaccine is more likely to completely resolve your symptoms than it is to make you feel much worse.
It could be that vaccine-induced T-cell and antibody responses can eliminate the viral reservoir or the viral fragments/remnants, or that the vaccine somehow diverts autoimmune cells, she tweeted.
Vaccines could also help by stimulating the innate immune response, she said. That transient inflammation may divert leukocytes causing long COVID. But if that is indeed the case any benefit from vaccines wouldn't be sustained long-term.
So, until next time Stay Safe, Stay Well, Stay Distant, Avoid Crowds and Wear your Mask.
James A Vito, D.M.D.