• Sun. Nov 27th, 2022

Message from the Center for Closing the Health Gap

By Clyde E. Henderson, MD

Cincinnati Medical Association

We can celebrate that Hamilton County and all of its neighboring counties in Kentucky and Indiana continue to have a Community Level of COVID-19 at the LOW level. If you are at all out and about it is clear that residents of our area are taking to heart the CDC recommendations based on the current level. Masks are off indoors and out. Even though the current level is low, the virus is not gone!  Cases, on a 14-day average, are down by 12% nationwide, although the Greater Cincinnati area is experiencing a slight uptick. Nationwide hospitalizations are down 33% and deaths are down 44%. Yet, 702 Americans died from COVID-19 on March 30, 2022.                                                

Although the country is in the midst of a lull in this pandemic, many epidemiologists caution that we are likely to face another surge. Currently, there are other countries that are experiencing surges. Shanghai, China is going into a second phase of a “lockdown.” There are parts of Europe (UK and Germany), experiencing significant waves caused by the BA.2 subvariant of the Omicron variant. Some experts say that the increase in UK cases is due more to the elimination of masking as opposed to the virulence of the strain. This same BA.2 is now the dominant strain in the USA and according to the World Health Organization represents 86% of the sequenced strains globally. This same strain, formerly referred to as the “stealth variant,” is 1.5 times as transmissible as the Omicron BA.1 variant.  Thus far there is no evidence that the illness caused by BA.2 is more severe than that caused by its Omicron relative. One very key point is that people who have received a booster are unlikely to suffer severe disease, hospitalization, or death if they become infected by this newer mutation.

Considering the record that the first booster is effective as noted above, it might be asked why should I consider a second booster? This query is pertinent since the CDC and the FDA expanded the EUA for both the Moderna and the Pfizer vaccine to allow a second booster for adults over 50 years of age who have “underlying medical conditions that increase their risk for severe disease.” and for any adult over age 65.  This second booster vaccination, if given, should be administered no sooner than four months after the first booster of any COVID-19 vaccine. The rationale for offering a second booster is “waning protection” in people who are immunocompromised or elderly.  Much of the safety and efficacy data that the CDC and FDA used to make the determination to allow the additional booster came from the Israeli experience. The actual decision to proceed with the second booster remains an individual choice based on their personal risks. Our government has given us availability but not a recommendation.

Irrespectively of your decision regarding a second booster, there are measures that should be taken to prepare for a new wave. First of all, vaccination remains the best way to prevent severe disease and hospitalization. Being unvaccinated or under vaccinated leaves one vulnerable. Increasing our country’s fully vaccinated above the current 71% of the population and the boosted level over the current 45% of the eligible, is actually the best vaccination strategy. Secondly, keep a supply of well fitted masks available and mask if it makes you feel safer.  Masking should continue If you have symptoms, have tested positive, or have been exposed to someone who has tested positive.  The requirement that we remain masked when on public transportation is still in force. Next, keep track of your community level of spread. Be willing to mask up and take other recommended precautions if the level rises. Additionally, have home testing kits available (they are free from the government) and a pulse oximeter to check your oxygen level.  Also, have a plan to get an oral antiviral pill from your doctor within five days of a positive test.  Lastly, have a backup plan for major events so that you will have alternatives should a positive test or COVID-19 illness force you to socially distance. 

A summer or fall surge, just as occurred the last two years, may be on the horizon!