A message from the Center for Closing the Health Gap
By Clyde E. Henderson, MD
Cincinnati Medical Association
President Joseph R. Biden tested positive for COVID-19 six days ago. He had received both of his Pfizer/BioNTech vaccines at the appropriate three (3) week interval, before his January 20, 2021, inauguration. He has received both of his boosters, one in September 2021 and the second in March 2022. The essential nature of early testing after the onset of symptoms was again borne out as the President was started on the prescribed five-day protocol of Paxlovid pills. The Paxlovid remains available by prescription, under emergency use authorization, for anyone twelve and over, who has tested positive and has mild to moderate symptoms of COVID-19, and who is at high risk of severe illness. The President returned to work in the Oval Office of the White House after five days of quarantine. According to CDC protocol, he was supposed to wear a well fitted mask for ten days. Because of White House protocol he was tested at least daily. This frequent testing was done with the purpose of detecting the “rebound” phenomenon, which reportedly occurs in less than 1% of individuals who have taken the antiviral Paxlovid. This frequent testing detected a positive COVID-19 test four days after his quarantine was over, and again today 7/31/22. Experts are rethinking the frequency of “rebound” as it appears to be occurring 20%-40% of the time for Paxlovid treated Omicron BA.4 and BA.5 variant infections. The original research and clinical trials conducted for Paxlovid were done in the face of different SARS-Cov-2 variants. Just as our vaccines need to be updated, so may the oral antiviral pills. It is incumbent on us to be vigilant and understand that the science changes as does the virus.
President Biden became infected as the Omicron variants are driving current nation-wide increases. According to the CDC, https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html, all Ohio counties in the Greater Cincinnati area (Hamilton, Butler, Warren, and Clinton) as well as Dearborn County (IN), Boone and Kenton counties of Kentucky are at HIGH level of COVID-19. Campbell county of KY is at a medium level. Recall that when a county is at a HIGH level the CDC recommends that masks be worn indoors in public, people stay current with vaccinations, and early testing if symptoms are present. People at high risk for severe disease should take extra precautions such as social distancing and/or staying out of crowds. These measures remain recommendations in most localities. Mandatory mask wearing has been re-implemented in Louisville (KY) public schools as well as at Ohio University in Athens, OH.
Our protection from theses surges will come from us following recommendations because mask mandates are not coming in Ohio. Last year the Ohio Senate Bill 22 was passed. It granted lawmakers authority to strike down public health orders. The experts in public health are thus robbed of their ability to implement measures proven to be effective in a pandemic. These orders could be necessary for both urban, suburban, and rural communities in every state. The citizens affected by surges in COVID-19 and by lawmakers’ policies reside in small and large municipalities as well as rural areas. Policy decisions exasperate the racial gap apparent throughout this pandemic, even in rural areas. A recent study has revealed that Black American in rural areas died from COVID-19 at a rate 34% higher than their white counterparts. Current data shows that death rate for the unvaccinated is six (6) times higher than the vaccinated. Additionally average known daily case rates are three (3) times higher in the unvaccinated. Public health policy matters! Protecting oneself from these increases in COVID-19 will be aided by each of us following the recommendation to wear a mask.
Just as President Biden, along with many high-profile public servants, entertainers, sports figures, and millions of other Americans have been stricken and have, or are recovering, from this SARS-Cov-2 virus.
Positive outcomes are much more likely when citizens have been fully vaccinated, boosted, early tested, and treated early. The residents of all HIGH level counties including, Greater Cincinnati, should heed the recommendations of the CDC. It is time to put our masks back on while indoors, in public, until the COVID-19 level in your locality lowers to an acceptable level.