Now that the state and federal government has declared the COVID-19 public health emergency over, he consulted with some of Colorado’s most sensible doctors who have treated the virus firsthand for the past three years and asked them for the ultimate thought on the virus: vaccination. recommendations, long-term spread forecasts, prolonged COVID and masking.
Our panel of experts includes Dr. Diane Janowicz, who specializes in infectious diseases at St. Janowicz. Mary’s Medical Center in Grand Junction; Dr. Anuj Mehta, critical care pulmonologist at Denver Health, who spoke about vaccine allocation; and Dr. Ken Lyn-Kew, an intensive care pulmonologist at National Jewish Health in Denver.
The answers have been changed for clarity.
Have we gone from a pandemic to the endemic level of the virus?
Dr. Diane Janowicz: “We are technifying this. Endemic means that we have the disease at a steady rate, that there is no drastic accumulation of infections or outbreaks, and that we see a constant point of other people inflaming and spreading the disease in a very predictable way. But, we still see a large number of other people inflamed on a regular basis. And we don’t know how this disease will develop in the coming months, especially as we approach the fall where we expect the numbers will increase as we have noticed over the past 3 years. So we’re not there yet, but hopefully soon.
Can we expect the virus to continue mutating in the future?
Dr. Diane Janowicz: “We see other mutations, however, whether or not they are as contagious or as severe as we initially saw, it doesn’t seem to be the case, but they are still unpredictable. “
Can we nevertheless begin to let our guard down?
Dr. Ken Lyn-Kew: “I think it’s too early to let your guard down completely, but we need to keep learning to live with this virus and you never need to let your guard down in front of anything, right?Whether it’s the flu, coronavirus or whatever. And it’s here to stay; We just don’t know how it’s going to stay, so we need to make sure that, per person, we’re taking the right precautions for ourselves. If you are 90 years old and have an immunosuppressive disease, your precautions will be different than if you are 25 years old and in the best health conditions.
Do I want a vaccine or booster?
Dr. Anuj Mehta: “The Centers for Disease Control tried to simplify it for most adults, so they phased out the original first generation of COVID vaccines called monovalent vaccines. We are left with the new bivalent vaccines and for most adults, a single booster. After the original series is enough. But if you’re 65 or older, or if you’re immunocompromised, you may get a momentary booster.
And remember, the original vaccines opposed to the original virus were very effective at preventing infection. If you get vaccinated now, you can get infected, but they are still very effective at preventing you from landing in the hospital and ending up in intensive care. And there is emerging evidence that being vaccinated also potentially the dangers of a long COVID.
Can we expect to have annual COVID vaccines?
Dr. Diane Janowicz: “I think it can mimic what we see with influenza, especially once we get to a finished phase of this disease. Whether it’s an annual or semi-annual vaccine, it will be rolled out over the next few months until the end. “New Year’s Eve. “
What’s the newest in vaccines?
Dr. Anuj Mehta: “Tests are being conducted. Novavax was the one that got top approval recently through the FDA and hasn’t gained much traction. I think interest in creating new vaccine formulations has waned over time. I think what other people are looking for ahead of time is whether there’s a way to make existing vaccines more effective or we’ll have to reformulate them for some other type of variant in the future. I think the vaccines we have are good, the protection profiles are fantastic, and we’re going to have to think about what populations we deserve to target to get the most productive price for money. “
Are you seeing patients in the hospital with COVID?
Dr. Ken Lyn-Kew: “We don’t see them often, and when you think there’s about 140 patients in each and every hospital in Colorado, that’s not very consistent with the hospital, let alone the doctor in the hospital. What we see is that we will have a patient who is in an immunosuppressive state, regularly drug-induced immunosuppression because we are treating anything else like cancer or an autoimmune disease. They have a tendency to enter and cannot make the virus transparent. and having that course of infection up and down where they go in and out of the hospital. And we don’t have the equipment to make the virus transparent as easily as we’d like, so those patients are struggling to cope.
How are things going in Colorado hospitals right now?
Dr. Anuj Mehta: “Lately, most hospitals have relatively low grades of COVID patients and we don’t see them in intensive care very often. The other aspect of the coin is that hospitals are very full because we are suffering with two or 3 years of other people avoiding number one care or not receiving regime medical care. But we’re also seeing a lot of other consequences of intellectual fitness issues and addiction issues that have really evolved severely during the pandemic. “
What has happened during the last 3 years in patients with long COVID?
Dr. Ken Lyn-Kew: “I think it’s much more prevalent than we think. As a pulmonologist, I work in inpatient and outpatient settings. We have a lot of patients with persistent chronic cough after COVID, shortness of breath, fatigue and all those patients also have a tendency to complain about this brain fog challenge where they shouldn’t concentrate or concentrate as much.
Also, other people have contacted me to see what they deserve to do about it, but wait times are rarely two to three months and it is a huge challenge that will persist. I think we are just beginning to perceive the effect, depending on other people’s ability to work, the monetary and mental effect. And the problem now is that there is still no genuine, common definition.
Do you think there are other people who can’t get COVID, some call them “NOVIDS”?
Dr. Diane Janowicz: “Well, surely there are other people who haven’t stuck to COVID yet and I’m hesitant to say it, but I’m one of them. So the question is whether it’s because I have a super-boosted immune system. “reaction or if I had it and asymptomatic. There is a theory that there is some kind of genetic mutation or deletion of a specific gene that means other people cannot get COVID. There are safe viruses like HIV where other people have a safe genetic deletion that makes them immune to HIV. We don’t know and it’s the studies you want to do and the knowledge you want to gather before we can draw that conclusion.
What do other people think about wearing masks at this level of the virus?
Dr. Ken Lyn-Kew: “I advise my patients to weigh the threats and benefits for themselves, right?So I tell them what their threats are and I tell them that, at the end of the day, they should be based on how much the virus is circulating, how many other people are present, and how much threat they have. We’re not going back to mandatory masking everywhere. I think it’s been too politicized for it to happen, but I think it’s vital to give other people the team to make the most productive decisions for themselves.
As a doctor, how are you doing after 3 years of pandemic?
Dr. Anuj Mehta: “I think I’ve held up pretty well through all of this. Obviously, wasting so many patients and having public health issues was exhausting for me. I have a wonderful circle of family members who have supported me, however, I have noticed that the effect of this continues to have on my colleagues. We have lost many retired nurses at Denver Health and they are others who have been around for a long time. So it was hard.
I think we’ve moved toward a mix of burnout and ethical bias, and ethical bias stems from external points, like reports about violence against physical care personnel and the law for a variety of things that have historically been conversations between physical care staff, providers, and their patients. And now we’re being told that you have to take care of other people that way or you can’t take care of other people in a safe way and I think external ethical bias makes it very difficult to deal with burnout. I’m concerned that we’re still wasting other people’s physical care and that you’re starting to see the expansion of physical care deserts in the country.
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