Stay current

Information on COVID-19 changes with evolving scientific understanding. Review file photo

If you feel confused about COVID-19 now, don’t feel alone. There is a lot of confusion out there, not just because of radicals and “fake news” but even from bonafide health care experts.

True, there are groups making money from lies and misinformation but healthcare providers and medical scientists have often been fooled or overwhelmed by this new virus. Here are basic approaches to avoid the “fog of war” surrounding this virus.

Carefully select your sources of information: they must be up-to-date and reputable. The U.S. Centers for Disease Control and Prevention, major medical centers and universities, and state and county health departments are reliable sources. Just be sure that the information is current. Scientific knowledge regarding the virus is growing rapidly and the virus itself is changing so recommendations must adapt.

Beware of information from social media, sensationalistic “news” and talk programs on television, celebrities who have done their own “research” and non-credentialed health “gurus.”

In general, the experts that you can rely on for advice and information during an epidemic or pandemic are doctors who don’t care directly for people including epidemiologists and public health specialists with a MPH — master’s degree in public health — or PhD after their names. Infectious disease doctors are noteworthy in both directly caring for patients as well as understanding the spread of diseases.

Locally, we are fortunate to get regular updates on COVID-19 from San Mateo County. Here are some of the points highlighted by the county on Jan. 6.

Omicron is the name given to a variant of SARS-CoV-2, the virus that causes the COVID-19 disease. The emergence of the Omicron variant in late 2021 has stressed all health care systems with emergency visits and hospitalizations on the rise. It appears to cause fewer deaths, less lung and heart disease than the Delta variant that came before it but is more infectious and is sweeping rapidly through the unvaccinated younger population trying to get back to school.

The symptoms of the Omicron variant are similar to the original coronavirus and the Delta variant: fever or chills, cough, shortness of breath, sore throat, fatigue, muscle pain. There appears to be less effect on smell, taste and the lungs (i.e., less cough and shortness of breath).

There remain many unknowns.

"While there is still a lot we don't know about Omicron, vaccines and boosters are effective at preventing severe disease and limiting transmission of the virus,” said San Mateo County Health Officer Dr. Scott Morrow in the prepared release. “The best way to track and treat COVID-19 cases is through testing.”

Vaccination includes two shots of an mRNA vaccine, or the single Johnson and Johnson shot, and a booster (that’s three injections for most) and masks should be worn in public indoor settings, regardless of vaccination status. Masks must cover the nose and mouth without gaps for air passage. Multiple layered cloth masks are minimally protective and N-95 or KN-95 masks are preferred.

Some of the terms associated with the virus can be confusing. Take, for instance the difference between isolation and quarantine.

Isolation relates to behavior after a confirmed infection. Isolation for five days followed by wearing a mask minimizes the risk of spreading the virus to others. People with COVID-19 should isolate for five days and if they are asymptomatic or their symptoms are resolving (no fever for 24 hours), follow that by five days of wearing a mask when around others to minimize the risk of infecting people they encounter.

Quarantine refers to the time following exposure to the virus or close contact with someone known to have COVID-19. Currently, the recommended quarantine period for anyone in the general public who is exposed to COVID-19 depends upon vaccination status.

For people who are unvaccinated or are more than six months out from their second mRNA dose (or more than two months after the J&J vaccine) and not yet boosted, quarantine for five days is followed by strict mask use for an additional five days. Alternatively, if a five-day quarantine is not feasible, an exposed person should wear a mask at all times when around others for 10 days after exposure.

Individuals who have received their booster shot do not need to quarantine following an exposure, but should wear a mask for 10 days after the exposure. For all those exposed, best practice would also include a test for SARS-CoV-2 at Day 5 after exposure. If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19.

Two types of tests are appropriate: Rapid antigen tests and PCR tests. Antibody tests are more useful in research settings and not for diagnosis. Both require nasal swabbing but this can be done by the person tested and does not require “the brain jab” initially recommended.

Hospital emergency departments are not testing centers. Do not seek urgent care for testing.

PCR test results can take days. If you’ve been tested, you should self-isolate, staying home from work or school, while you wait for your results.

Dr. Vic Froelicher a board certified internist, cardiologist and professor emeritus at Stanford University, with subspecialities in sports cardiology and exercise physiology. He lives on the San Mateo County coast.

(4) comments

Sabrina Brennan

On Jan 11, 2022, we have 263 cases per 100,000 on the New York Times tracker and we’re averaging over 2000 cases per day countywide and that’s only the known cases. There’s no system in place to track rapid home tests. The statistics represent a lowball inaccurate indication of the true nature of covid’s current impacts in San Mateo County.

The uncontrolled escalating crisis indicates that County leaders should consider putting more restrictions in place to protect public health. For example stop allowing Coastside yoga teachers without vaccinations to teach maskless classes without disclosing their antivax status to their yoga students.

vicmd

Kjirsten Touhy asked, what to do if you think you have Covid:

Call your Doctor or Nurse Practitioner and get advice but simple treatments can be started till you get in touch with them. You should be seen face to face if you have any of the signs or symptoms of severe Covid-19 so a physical examination can be performed including pulse oximetry (https://www.fda.gov/medical-devices/safety-communications/pulse-oximeter-accuracy-and-limitations-fda-safety-communication),chest auscultation (listening with a stethoscope) and possibly a chest x-ray.

Typical symptoms of Covid-19 ... these can be treated by standard over the counter (OTC) agents and your Doctor may recommend prescription medications

Fever or chills - ASA, tylenol

Congestion, runny nose - decongestants, nasal/sinus lavage with salt water

Cough - Robitussen and lozenges

Fatigue - rest

Loss of taste or smell - consider it a help for correcting weight gained during the pandemic

Nausea, vomiting - OTC anti-emetics

Less common symptoms of Covid-19 ... these can be treated by standard OTC agents and your Doctor may recommend prescription agents

Sore throat - lozenges

Headache - ASA, NSAIDs (Ibuprofen, Motrin, etc)

Muscle or joint pains - same

Diarrhea - Imodium, careful diet

Rash - skin moisturizers

Red or irritated eyes - visine, optic drops

Signs or symptoms of severe Covid-19 .... these require face to face evaluation by a healthcare provider so a physical examination can be performed including pulse oximetry, chest auscultation (listening with a stethoscope) (https://www.fda.gov/medical-devices/safety-communications/pulse-oximeter-accuracy-and-limitations-fda-safety-communication), and possibly a chest x-ray.

The top three on the list below are caused by hypoxia due to lung involvement. Finger pulse oximeters can be helpful in confirming hypoxia. Values below 90% are abnormal. Auscultation by stethoscope or your unaided ears can be helpful (crackles, wheezing)

Difficulty breathing

Shortness of breath (dyspnea)

Cyanosis (blueness of lips and mucous membranes)

Persistent chest pain or pressure (ECG/EKG needed)

Confusion

Loss of speech or mobility

The WHO outlined specific symptoms to keep alert for if you’re worried about hospitalization amid the surge of the omicron variant.

“Depending on the age of the person in your care, their symptoms may look different,” the WHO said. “Adults may look dehydrated, have shortness of breath or chest pains. They may also complain of light-headedness. Children may suddenly appear confused or refuse to eat. Their face or lips may turn blue. Babies may be unable to breastfeed. These symptoms are warning signs that urgent care is needed.”

here ya' go

“The best way to track and treat COVID-19 cases is through testing.” And sadly, the results data are incomplete. Have you taken an at-home test to travel, for work, or for peace of mind? Were you able to report your results each time to any public health entity so they could be compiled and reported? No, of course not. Essentially none of those at-home test results are baked into the numbers and graphs the media loves to few you.

vicmd

Points well taken. Let's not even get into the issues surrounding the diagnostic qualities of the tests. Proper sensitivity/specificity studies are rare. Hopefully we will be better equipped for the next pandemic. Medical progress continues to amaze me. Efforts are also being applied to making health messages to the public more effective. We have to be better than Fox news at changing behaviors. Let's all hang in there, be kind to one another and have a good 2022.

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