“Sometimes it’s the smallest decisions that can change your life forever.” Keri Russell
“Your life changes the moment you make a new, congruent, and committed decision.” Tony Robbins
Who is at risk for severe COVID-19? I feel it is important to constantly review the medical conditions and new medical conditions that place people at risk for COVID -19. COVID-19 is a new disease and 15 months later we are learning more about it every day as it mutates and more variants are being discovered. We are still learning a lot about the long- and short-term effects of the virus.
Among adults, the risk for severe illness from COVID-19 increases with age, with older adults at highest risk. Severe illness means that the person with COVID-19 may require hospitalization, intensive care, or a ventilator to help them breathe, or they may even die. People of any age with certain underlying medical conditions (which now include pregnancy) are also at increased risk for severe illness from SARS-CoV-2 infection.
People with the following medical conditions are at most risk: CANCER, CHRONIC KIDNEY DISEASE, CHRONIC LUNG DISEASE (COPD, Asthma, interstitial lung disease, cystic fibrosis and pulmonary hypertension), DEMENTIA and other Neurologic disorders, DIABETES (Type 1 and Type 2), DOWN SYNDROME, HEART DISEASE, HIV, IMMUNOCOMPROMISED, LIVER DISEASE, OBESITY, PREGNANCY, SICKLE CELL, THALASSEMIA, SMOKERS, TRANSPLANT PATIENTS, CERBROVASCULAR DISEASE, STROKE AND SUBSTNACE ABUSE.
NEW MASK WEARING GUIDANCE: Cautious optimism is the word of the day. The CDC issued new guidance on Thursday 5/13/2021 allowing vaccinated people to drop their masks indoors, with some exceptions, and outdoors entirely, even in crowds.
"Anyone who is fully vaccinated can participate in indoor and outdoor activities, large or small, without wearing a mask or physical distancing," said CDC Director Rochelle Walensky, MD, MPH. "We have all longed for this moment."
She said that "based on the continuing downward trajectory of cases, the scientific data on the performance of our vaccines, and our understanding of how the virus spreads, that moment has come for those who are fully vaccinated."
The only exception to the rule is in certain crowded indoor spaces, such as buses, and planes, and in congregate settings, such as hospitals, homeless shelters and jails, where CDC still recommends people mask up.
The science has shown that those who are fully vaccinated -- 2 weeks since their second dose of either the Pfizer or Moderna vaccines or since having a single dose of the Johnson & Johnson vaccine -- are protected against COVID-19, said Walensky.
What does this mean? (1) It is a mixed message. While the CDC has said it is OK to stop wearing masks, state, local and municipal health officials are assessing this recommendation before allowing this “guidance” to take effect. The CDC is leaving it up to businesses to figure out what they want to do with respect to wearing masks or not into their business. No clear message is being sent here.
(2) Only 36% of the country is fully vaccinated. Far short from the 60-70% herd immunity science (NIH, CDC and the medical community at large) is looking for to feel that this virus is under a reasonable degree of control and
(3) Even though hospitalizations and deaths are decreasing, I do not feel that they are decreasing in a significant number to warrant such a “overnight” change in policy. On May 1,2021 there were 59,590 daily new cases and 715 COVID -19 daily deaths. On May 14,2021, there were 42,294 new daily positive cases and 745 new daily deaths.
What we are doing in our office: We are going to continue with our current protocols we have in place which is: One patient in, One Patient out. Wait in your car until called into the office. Once in the office you will receive hand sanitizer for hand washing and a pulse ox and temperature check until either: (1.) We have achieved 100% patient vaccination levels, currently we are at 95+% or (2) The state achieves at least a 65-70% full vaccination rate which will produce herd immunity. Currently we are at a state percentage of 38%. I will keep you apprised as things change.
WHY DO I HAVE TO PRE-RINSE BEFORE MY DENTAL PROCEDURE: Our office has been ahead of the COVID -19 curve since the pandemic started with the modification of our HVAC system and introducing HEPA filters in all areas of the office to minimize the aerosol nature of COVID-19. We’ve been having you rinse with 3% hydrogen peroxide since our re-opening in June 1, 2020 based on science as another way of neutralizing the aerosolization of COVID-19 virus. Now, researchers from The Ohio State University (OSU) School of Dentistry took a close look at the origin of bacteria and viruses in dental aerosols in their article, “Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols.” They investigated the bacterial and viral content of aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures performed on 28 patients. Aerosol condensate was gathered from clinicians’ face shields, patients’ chests, and areas 6 feet way from where treatment was provided. Through DNA microbiome analysis, the study authors were able to determine that main source of contamination within dental aerosols was the dental irrigant. Interestingly, they did not find saliva to be a significant carrier of bacteria or viral debris; however, patients used a pre-procedural antimicrobial mouth rinse before treatment and high-volume evacuation was utilized throughout all procedures. The results were published in the Journal of Dental Research.
BREAKTHROUGH COVID INFECTIONS:
According to the science, the COVID-19 vaccines are extremely effective, but a rare few vaccinated people have gotten sick. "Breakthrough" infections are typically mild and might be less contagious than regular cases. To completely prevent infections, more of the population needs to get vaccinated.
As with any COVID-19 case, the risk of breakthrough infections is highest in close, indoor quarters where people aren't distanced or wearing masks. Dr. Purvi Parikh, an immunologist in New York City says the spread of more contagious variants could make breakthrough infections more common in crowded environments.
Right now, the B.1.1.7 variant — which was first identified in the UK — is the dominant strain in the US. Another variant, B.1.526, accounted for nearly half of the coronavirus samples genetically sequenced in New York City as of last month.
As of April 26, the CDC had received around 9,200 reports of breakthrough infections out of more than 95 million people who'd been fully vaccinated against COVID-19 by that point. Around 27% of those cases were asymptomatic, and just 1% of those people had died.
IMPORTANCE OF GETTING VACCINATED: While no medication or vaccine is 100 % fool proof, thinking if you get COVID-19 or one of its’ variant you will not get as sick or will recover uneventfully or will not end up in the hospital, on a ventilator or die is not realistic thinking. You are leaving a lot to chance.
It is important to avail yourself to getting vaccinated. It works and works well according to the numbers and the science.
Those that are refusing have never experienced someone who has had COVID -19, hospitalized due to COVID -19, placed on a ventilator as a result of COVID -19 or who has died as a result of COVID -19.
Research the science for yourself. Make your own decision based on facts, not hype, not media misinformation and not politics. Follow the science.
Relying on inaccurate social media posts which is driving the anti-vaccine movement or non-scientific reporting or hypothetical bad results to not get vaccinated is not a valid excuse. While 98% of people will recover once getting COVID -19, the same can not be said if you get the original COVID -19 or the variant which is sweeping across this country.
The current COVID -19 numbers are real. In the United States as of May 14, 2021, there has been 33,639,090 positive cases, 26,683,868 fully recovered, 6,356,470 in various stages of recovery and 598,752 dead.
The bottom line is this. The vaccine works. It works very well. Virtually everyone 65 years of age and older are vaccinated. The age group that is getting sick and ending up in the hospitals are 20-55 years of age.
The reality is this. COVID -19 and its variants will be with us for a while. There is a lot we still do not know about this virus and its long-term effects. Because the CDC says we can stop wearing masks does not mean we should not avail ourselves to the vaccine. Your decision should be made based on facts not emotion.
Until next time. Stay Safe, Stay Well, Get Vaccinated and be smart as COVID -19 mandates are being lifted. Masks are still the best tool in the tool box along with the vaccine. We are still in the grasp of COVID -19 and we are not out of the woods yet.
James A. Vito, D.M.D.