What an internist says about COVID-19 and the immediate aftermath of the holidays

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LISTEN | An internist from Ontario talks to Windsor Morning about COVID and in the immediate run-up to the holidays:

Do tests identify all COVID [strains]?

They surely do. Nowadays, tests in general turn out a little worse than before, however, there is a strategy to use them in a way that is still very effective. And that strategy is to use them several days in a row and approximately 24 hours apart.

Check in the morning or at noon several days in a row if you think you have symptoms or if you’ve been exposed. Three negative tests in 3 days are very, very reassuring. Nothing is perfect, but it’s very reassuring that it is. non-COVID.

And remember, most of what’s circulating at any given time isn’t COVID.

Many other respiratory viruses are circulating. But if you’re going to see an elderly relative who is at higher risk or an immunocompromised friend and you need to be very careful, that’s a smart mechanism.

You also commented that they are just as effective. Why is that?

There are the actual tests that were developed way back at the start of the pandemic, and they were tailored towards the variant and the antigen. 

The antigen used through the so-called immediate antigen has been adapted precisely to this variant.

So there’s probably been a little bit of slippage over time and how well these tests work. But for typical use — my family still uses them — I have elderly parents actually in Windsor who I want to be careful when we see them, we’re not exposing them. 

We have young children going to school, so there is constantly coughing in our home, so we use those tests as a verification mechanism.

I want to reassure people maybe there’s a little bit of a change, but they’re still practically a good tool as part of a general strategy. 

What are some of the [strains] circulating lately?

Almost the same. We haven’t seen a really significant change in the way people are dealing with the pandemic.

We used to say that when the virus tends to have the highest concentration, quite a bit for you and me, if COVID spreads, what we would broadly describe as respiratory symptoms is still the simplest way. It’s not uncommon for other people to show symptoms.

And gastrointestinal symptoms are very common.

I just finished a shift at the hospital last week. . . we admitted a pretty high number of COVID [cases], I think the highest I’ve noticed in over a year, which is consistent with the sewage sign, which is at the highest point. of the year. Events that are at the climax of the year.

Several other people came in with gastrointestinal symptoms. It is another way of seeing the others present, the other elderly: days and days of diarrhea, very dehydrated, arriving at the hospital.

We’ve heard that wastewater has elevated COVID ratings. Have you noticed these effects as well?

Yes, absolutely.

You know about sewage monitoring, because most people don’t monitor themselves anymore. . . Wastewater becomes very important just to give other people an idea of ​​how much is circulating and that can be very reassuring.

So, for example, this summer was very low. The chance of being exposed if you were in a gathering was very, very low. 

Unfortunately, with less than a month going in before the holidays now it is at a high point for a year currently. 

And, you know, a lot of us say informally, you don’t need just the wastewater test. How many people do you know recently who have become positive with COVID? 

There’s your private experience and the sewage testing, which is probably strong enough to tell you there’s a lot of COVID circulating right now.

Are you surprised that we’re seeing a spike now? 

Not at all.

I should point out that as someone who works in a hospital and cares for sick patients, I’ve worked through each and every wave of the pandemic and noticed the first waves where other people were getting severe COVID pneumonia. , they were dying, they were ending up in intensive care. As a care unit, there was nothing we could do about it: it’s a very different disease today than it was then.

However, there is still a significant opportunity for security today.

What can we do to adapt so this reduces its impact on our lives as much as possible? … Will you wear a mask when you’re in a crowded indoor setting? A lot of that is not there. Realistically, walking around, I don’t see it. I hope over time we do adopt some of those protective strategies because to me, every infection prevented is a good thing.  

If we do test positive or we think we have COVID, is it still convention that we stay away from people for a couple of days? 

The recommendation in general, if you want to be conscientious — there’s no one to enforce this, but let’s say you want to reduce exposure to people at work or at school or your family. 

Generally, the rule is that as long as the fever has gone down for 24 hours, when the gastrointestinal symptoms have passed for a few days, that’s the time when you’re subsiding and your symptoms are generally improving. That’s when other people say you can go back and get in there.

Because we know that infectivity is higher at this early stage, that’s what we say regularly.

And how well does COVID vaccination work to keep us apart?

This is a very effective comparison to what’s circulating lately, and turnout in Ontario is incredibly low. And that’s where the preventative detail comes in.

Can this alter your life? It’s possible.

And vaccines, for me, are like a seat belt. We wear seat belts when we are in a car. Just do it and continue with your day. You don’t communicate too much about that. The vaccine is like that. It’s that extra layer of protection. Work the scenes. But participation is very, very low.

The scary thing to me is even among people over age 80, the highest risk group, so clear that they would benefit. The estimate from earlier this month was that only 20 per cent of people over the age of 80 had received the vaccine. That’s extremely low. That is such a missed opportunity. 

Q&A is edited for length and clarity

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