This webinar was recorded on Thursday, August 11, 2022
As a medical and social community, we are learning new things about COVID-19 on a daily basis. Join us as we bring you what YOU need to know about COVID-19, vaccines and medical treatments. We will spend some time discussing the new pediatric vaccines so you can make informed decisions.
Speakers:
- Dr. Purvi Parikh
- Tonya Winders
Resource:
Transcript: This transcript is automatically generated. While this transcript is believed to be accurate, errors sometimes occur. It remains your responsibility to evaluate the accuracy and completeness of the information in this transcript. This transcript is not intended to substitute for professional medical advice.
Speaker 2 00:06
Good afternoon. COVID-19 has caused a resurgence of illness in our country and around the world. In the past few months. We are seeing new studies published regularly with new information that we’ve learned about this pandemic virus. Thank you for joining us today as we explore what we know about COVID-19 and look at key strategies for managing this ongoing pandemic and illness. I’m Tonya Winders, the president and CEO of Allergy & Asthma Network, and we’re pleased that each of you has chosen to join us today. This webinar series is actually the 38th webinar in our COVID-19series. COVID-19 is a part of Allergy & Asthma Network living out our mission to end the needless death and suffering due to asthma, allergies and related conditions through our four mission areas of outreach, education, advocacy and research. Today’s program is a packed one. We typically have our COVID-19 medical expert doctor Purvi Parikh joining us for our webinars. Unfortunately, she has been delayed in flight, so I will be providing her insights and slides this afternoon. Our program will start, as we always do, with a current state of COVID-19 Then we’ll turn to focus on five things that are important for all of us to know. And be reminded of around the pandemic and the virus. And then finally, we will wrap up our time with the focus on vaccines and medical management of COVID. But to begin, as we always do, we like to take a poll to see who is with us today. So I’ll launch the poll, ask you to describe the category that best describes you can go ahead and enter now if you’re a physician assistant nurse practitioner, nurse, school nurse, respiratory therapist, asthma educator or health educator or a patient. We do have close to 900 people registered for the webinar today and it’s always nice to see, especially during these summer months, to see such a great turnout for a webinar. But let’s see how people are shaping up as far as their roles in that multidisciplinary team on the line today. It’s just a moment more. And I will close the poll and share the results. Once again, it’s great to see we’ve got such a broad audience with the nurses and school nurses representing over 72%, 18 % respiratory therapist asthma educators, health educators, 6 % patients and 4 % physician assistant nurse practitioners. So again, thank you for joining and taking time out of your busy schedules to be apart. So let’s go into the current state of COVID-19 as of today, August eleventh twenty, twenty two. As we always do, we like to go to the Johns Hopkins global map, the COVID dashboard. And you can see here that the case rate is still over that 587 million mark. The total vaccine doses administered are over 12 billion and the total deaths is quickly reaching that death toll of close to 6.5 million. And so again, when we look at the trends that we’re. We’ll speak more in depth here in just a moment about the trends over the last 30 days. We have seen an escalation of the COVID-19 hospitalizations and more severe cases in various regions throughout the world and certainly in different parts of the US. So when we look again at the COVID-19 data from CDC, remember the darker the blue states, the more evident the current cases of COVID are. And so you can see that we’re experiencing those peaks in the Alaska as well as Hawaii and territories and Puerto Rico and other territories as well as in that northeast portion of the state and still very dark blue in the southeast portion of much of the country. As well. Now, what about the various variants, right? Every time we turn on the news or turn around, it seems like there’s a new variant that is among us and COVID-19 infections are rising. We know that this is the Omicron BA five variant, and that’s the current dominant strain throughout the US. It’s about 2/3 of the COVID cases that we’re seeing and hearing about. Those hospitalization rates are up, although they’re not at the levels that they were in. Early 2022 and this particular strain of the virus doesn’t seem to be as serious or as severe illness causing. What we are seeing though are people that have had prior infections and booster vaccines that offer some protection and some treatment with the even the antivirals for those patients who are infected and that’s helping to keep the hospitalizations down. Now, as you know, here in the US, the government officials have urged anyone over the age of 50 who has not gotten their booster to do so here in 2022 because of that window of immunity that is provided by the active vaccine lasting anywhere from 90 days to 120 days. But knowing that, again, with these new variants, we need new boosters, and it’s time that if you haven’t, especially as we turn the corner back into a new school. Year across much of the nation to get that booster, and ensure that you are protected against COVID-19 in the new school year. Now, when we look at the headlines, what are we hearing? First off, I think we’re hearing a lot once again from Doctor Fauci who says that one of the clear things are things that’s clear from the data is that even though the vaccines are there and are administered and our shots are in arms, because of the high degree of transmissibility of this virus, it the vaccines don’t really protect overall well against getting the infection. So while they. May not protect you from getting COVID. It certainly is protecting quite well against severe disease that leads to hospitalization or death. And so again, this is often a myth or misperception that we hear at Allergy & Asthma Network where people say, well, I thought I couldn’t get the virus if I got the vaccine. And unfortunately we know that that’s simply not true that you can still get the virus. It’s just much more likely that you won’t have as severe of symptoms. That could lead to hospitalization, ventilation and death. And the HHS Health and Human Services has actually extended the COVID-19 public health emergency. We know that is now extended another 90 days and that they’ve pledged to provide at least a 60 day notice before terminating that public health emergency state. The CDC has been clear that the rate of new infections appears to be dropping at the moment right now, with the US now reporting over a hundred and seven thousand new cases each day, that’s an average that’s fallen about 12 % just in the last seven days in the last week. But what we can’t do is let up our vigilance because we know that coronavirus related deaths remain at a persistently high level. And I was reading something today in the NHS this morning. In it, around this fact that is reported here by CNN and that is that the US seems to have hit a COVID plateau in the last week with more than 40.000 thousand hospitalized and more than four hundred deaths a day over the past month. And so if you think back to the last 3045 days and I know in my own circle in my own home, we have definitely felt the impact of COVID-19 and had family members. Impacted directly by the virus and although it may not be the headline news of every single news segment as it once was, we really do need to recognize the risk and continue to take the steps to protect ourselves. Now looking at the antibodies that are responding to COVID, we have to understand here that the NIH study that was just released over the last few, couple of weeks showed that there was evidence that the immune response triggered by COVID can lead to both short term and long term neurological symptoms. It’s believed that the antibodies may attach to the cells lining the brain’s blood vessels. And that’s what really people say is that if you will, brain fog that they are experiencing or that long term fatigue and fuzziness of not being as sharp as they typically are or once were. And as many of you probably know, President Biden has tested positive for COVID and actually then had a rebound place so he was given Paxlovid and self isolated. He tested negative for two days on Monday and returned to his full activity. But again, even our nation’s leaders are not immune to getting COVID and being impacted and thankfully again with the treatment seems to be managing those symptoms fairly well at this point. In the UK, there’s a recent study that shows that sore throat and cough are certainly at the top of the list when it comes to this particular strain of COVID in Europe. So again, not all symptoms look the same for all patients. For Summit, maybe that neurological brain fog, fatigue, body aches, fever. For others it may be that sore throat or cough as the predominant symptom. All right, let’s go to our next poll question. What sources do you go to for your COVID information? So I’ll launch the poll. Is it media like online TV and print media, social media, nonprofit organizations like Allergy and Asthma Network or others, governmental organizations or your own healthcare team? And we know that you may have more than one response, but go to choose the response that’s most often. The place that you go most frequently to get your information on COVID-19 All right, we’ll give it another moment. Looks like we’ve got about a third of the people responding thus far. This is always a very interesting point when we’re doing our surveys out in the community about what sources people are trusting and the importance of going to a credible source. So it looks like we’ve got a very well informed audience here, and I’ll close the poll and share the results. So definitely about 2/3 Trusting CDC NIH, 14 % going to media online, TV, print as that primary source, and then 10 % relying on their own individual health team, while 7 % are turning to nonprofit health organizations and 3 % social media. So again, a very informed, educated community that’s on the line today. Not surprising if you’re devoting the time to this webinar and to listening in, but it’s very. Important that we continue to promote credible sources and share that information across our families and our communities. So let what about the COVID-19 cases by day report? Again, this is the CDC data that actually trends those numbers over time. And this is what we were talking about earlier that we’re nowhere near, even though we have seen a surge in just the last month, we’re nowhere near the point that we were back in early 2022 where we were seeing case rates. Upwards of 800,000 thousand per day. And again we’re right now in that more like one hundred one fifty mark over the last 30 days. So next, we’re going to go into the second section of our webinar today at around 5 things to know about COVID-19 And some of this will likely be a refresher or reminder, but it’s important that we cover these topics and in light of the most recent data and information that is out there. So COVID-19 has been with us since late 2019 hence the reason for the number 19. It is the year that it was characterized and we have seen multiple surges and variants. Over the last 2 and a half years, almost three years we’re coming up on the anniversary later in 2022, this year, of when we first heard about and saw the first cases of COVID-19 in China. There are three major vaccines that have been approved and are available in the US and the CDC endorses a clinical preference for the Pfizer and Moderna vaccines. The two shot vaccines versus the current J and J, which is only one shot now. The case rates have gone up and down over time. And right now, as I said before, we’re about at the same level that we saw in the fall of 2021. And then our knowledge base about COVID-19 really has continued to evolve and increase over time and again. It seems like every time we turn around, we’re hearing more, we’re learning more. Science is evolving. I’ve had some really amazing conversations with key experts at the Cleveland Clinic and Johns Hopkins and Mayo and other places here throughout the US and researchers like Doctor Parik, and they reinforced to me every day we’re learning more about the characteristics of this virus and about how we can provide treatments. And address some of the longer term effects of the virus. And again I think we’re seeing a lot of the domino effects on things like the economy and businesses and people’s beliefs and behaviors as we have continued into now that third year of the pandemic. So this is an article that came out of yell that talked about the five things we need to know and remember about COVID-19 First of all, it continues to change very rapidly. The number of people infected changes daily. The impact of that disease varies based on the individual. I can tell you in my own home, two people who had the virus within a week, very different experiences, some were basically asymptomatic. No symptoms at all, and then others had mild, persistent symptoms. Some had severe symptoms umm. And then some have gone on to experience long COVID and autoimmune disease are multisystem inflammatory syndrome. So you know again it’s really wild because we’ve had all of these thoughts around who gets COVID and why is one person having mild disease versus severe disease, is it blood type, is it you know gut health, is it all these different things and I think that the data is still coming out. What we know is that the virus is changing constantly. It’s adapting, and medical experts are studying these variants. They’re studying the vaccines and constantly looking at all of that new information to move public health forward and to continue to protect us. So the second thing here is strict measures are critical for slowing the spread of the disease. Again, we know what works to flatten the curve. We’ve seen the times where we’ve had these walls of fewer patients and hospitals that are better equipped to handle those that are in need of healthcare services. We’ve seen shutdowns, curfews, limiting the number of events, who can gather indoors, who’s supposed to wear a mask. Again, all of that guidance has changed. Over the last 2 and a half to three years and I think that we know once again that in order for us to get to that point of herd immunity, we don’t have the exact timeline. We don’t know how as the virus continues to mutate and the variance surge, how that impacts overall herd immunity. And so we have to be diligent in continuing to do the things like wash our hands and social distance, and wear masks when around individuals who you may not know if they in fact have active virus or shedding. And that leads to the Third Point, which infection prevention is key. You know, these have been good basic infection control measures that quite honestly, especially for people living with chronic lung disease like asthma or COPD, you know, should be implemented at all times. We should always have good hand washing. We should always think about wearing a mask during a high respiratory illness throughout the year. But vaccination is still the main strategy. To avoid the worst of the infection and the symptoms, we know that infection prevention is also important in preventing severe disease, hospitalization and death. And if you’re fully vaccinated, you should wear a mask even, especially if you have a weakened immune system or some underlying medical condition like asthma or COPD. And the CDC has urged even those that are pregnant to get vaccinated. I think I shared in, you know, a webinar months ago that we had this conversation in our own home where my daughter was pregnant during the pandemic. Thankfully, he’s now eight months and she’s doing very well. He’s doing well, but she chose to get vaccinated during her pregnancy after her OBGYN really encouraged her to do so what are the preventative actions that you can take? Wash your hands with soap and water. Wash for 20 seconds. Use hand sanitizer if you don’t have soap, but make sure it’s one with at least 60 % alcohol. Stay home when you have symptoms. If you’ve got a quote, unquote just a summer cold still. Stay home. If you know that you are COVID positive, please stay home and take those extra measures to avoid touching your nose. Eyes a mouth and use a tissue to cover that cough or sneeze to really prevent from spreading the virus even further. And then wear a mask that fits snugly over your nose, mouth and chin. And of course, disposable surgical masks, and KN95 masks, really are the best in offering that protection. Now, the social distancing. I know that most of us are tired of sitting six feet apart from the people that we care about and want to visit with. But it’s still really important and understanding that a mask is not adequate to substitute for social distancing. So we need to have both of those preventative actions. It can be helpful to use household wipes or sprays to disinfect doorknobs, light switches, keyboards, cell phones. Again, when you look under a blue light and see all the things that are on your cell phone or your doorknobs, it can be quite scary. So use household wipes to spray and disinfect those surfaces and create a plan for your household. If someone gets sick, how are you going to isolate them? How are you going to keep the rest of the family healthy? What can you do to try to keep the impact of COVID-19 at a bare minimum for those that live under your roof and that you love so dearly? And then when we do think about visiting with friends and family, try to arrange those things outdoors. Think about the ventilation of the space. And if at all possible, especially as we head into what is typically the peak of infection season, avoid travel. Our fourth thing to know about COVID is that the experts are working rapidly to find solution testing has evolved, right? Realize that the connection of the audio may have glitched. So again hopefully we’re back and you all can hear us. Well now. Thank you for making note that again I was saying that multiple vaccines are being studied and doctors continue to refine their approaches to treatment and those treatments include those antiviral drugs and making sure that you get that treatment dropping. All right guys, I know that we’re having some audio issues. I see the audio dropping out, so I’m going to keep talking about that. We’ll keep moving. Because it does look like you can hear me now. So the five, the fifth thing and the five things to know, Yale article is that if you feel ill, here is what you should know and do. First, watch for symptoms of COVID-19 Anyone who thinks they’ve been exposed, stay home, stay away from others. Symptoms can appear between 2 and 14 days after that exposure. And once again, that’s different for everyone. The time that they are exposed versus the time that they’re symptomatic. And so call your medical provider if you experience COVID. And talk with them about what’s the best way to treat this in your home. Most people are going to experience mild illness and they are going to recover fully at home. But it is important. The sites are gone totally. Ok. Sorry everyone, looks like the slides have dropped out. So we’re trying to get them back. Really sorry. I just want to see it doesn’t have any right here. Life, life. Go here. Look there. It should show my iPhone. It looks like that. Perhaps we’re back. But we have lost the slides. So we’ll have this. So again, apologies for the Internet and the issues here, but again we’ll just go back to the reinforcement. If you have symptoms, certainly call your medical provider, know that most people will recover fully at home, but know the emergency signs and when to seek emergency care because again, if you are beginning to become hypoxic, if in fact you and your oxygen, oxygen rates drop and your breathing is impacted negatively. To a point that you really can’t keep anything down or have zero energy to get up and move around your, even your bedroom or your home. Go to the bathroom. It may be time to seek that emergency medical care. All right. The final section of our webinar today is around vaccines and medical management of COVID. So again, this is the map of the US and vaccine coverage from CDC and the darker blue means the higher rates of vaccination throughout the country. So you still see that we have certain areas where the case rates are high, but the vaccination rates are low. And so again the CDC data here is very helpful in looking at both vaccine coverage as well as the case rates. Now this slide is really busy and just annoying. Sorry, we lost the slides. Where did they go? All right. This slides back. So this slide is busy, does have a lot of data, but what I will share with you here is that there’s a few key takeaways. So what we’re looking at here is the percentage of each age range that makes up the US population. Of those that are fully vaccinated, so the top green 5 to 11 year olds make up 28 million of the US population and 30 % of those are fully vaccinated. There’s another 26 6 % that are eligible for the first booster and yet only three-point 3 % have received that first booster. And so again, you can look at your own individual age range and see what those vaccination rates. Be eligible versus the actual received vaccine rates. Interestingly enough, if you look at that 65 plus population, we’re talking about close to 55 million people in the US living over 65 and that is our highest fully vaccinated population with 91.8 % ,over 50 million being fully vaccinated, 90 % being eligible for the first booster. And you can see that 64.6 % have actually received that first booster, then the second booster 61 % eligible and 25 % of those have actually received it. So again, we’re doing really well on the 1st booster in our elderly over 65 population. We still have some room to go in our second booster population. And again, when we’re talking about that children and teen, those age ranges in that lower end, CDC now recommends everyone over six months gets vaccinated and everyone over five years of age should get the booster. So there is a CDC COVID-19 booster tool that can help you to track and stay up to date with your boosters and vaccines. Now Doctor Parikh has joined us. I think she is online. So I’m going to ask her to join in here and to pick up as we talk about the total vaccine doses that have been distributed and administered and also as we get into some of your questions and answers that were posed prior to the webinar today. Doctor Parikh, hello
Hi. Sorry about that. I had flight troubles. This is very common these days but yes thank you for handing it over and for covering everything to date. But yeah as you can see on this slide it’s quite impressive every time I see it because we always keep updating it. But you know, to date there’s 700 close to 800 million distributed and 600 million administered which if you think about what this feat is, umm, it’s quite amazing. You know, this is like the largest, you know, largest vaccine campaign in history. And then as you can see in the breakdown, you know, there’s less soap for children less than five years of age and then as Tanya was just saying, you know, less so for a third and fourth. Boosters but you know, as the time goes on, we will see that uptake increase. Next slide. So you know as you can see that the dosage is also based on age similar to everything you know in children, not necessarily on size or weight. And as you can see there are some different breakdowns between the age groups as well as the different companies as well. And this has been important because you know there have been thoughts that based on this some of the efficacy studies that Pfizer may have picked too low of a dose and undershot in terms of the advocacy standpoints compared to Moderna and we see similar things even in population Moderna does. There are some studies that may show the fact that Moderna may have longer lasting immunity efficacy against some of the newer variants due likely to the higher dose. But you know again there has been no head-to-head study so we can’t definitively. Say one is better, one is not. Ultimately, they all do an excellent job of preventing against the worst outcomes of death and hospitalization and ICU admissions. Next slide. So in terms of the safety of children, and teenagers, you know, we now have millions of children, teenagers from ages 5 through 17 who received at least one dose of the vaccine. And we’ve had continued safety monitoring as well and it’s been overwhelmingly found to be very safe, very efficacious and the known, you know, risks unfortunately and possible severe complications of the actual virus confidently outweigh the potential risks of any of the vaccinations has been displayed in like multiple of these studies. And then everyone aged six months and older, you know, should stay up to date with their vaccinations, especially as we head into the fall winter seasons, which are traditionally worse in terms of all viruses. You know, we see frequent flu deaths as well in the pediatric population. And again, there’s a lot of reputable tools that I suggest that you use. You know, Allergy & Asthma Network’s being one of them, but also a lot of the other public websites stay up-to-date. Johns Hopkins CDC and then the NIH as well. So, you know, there’s a lot of interesting questions that come about. You know if someone has gotten sick, the child or teen has received, has had COVID-19 should they still get vaccinated? And the short answer is yes, because of the newer variants we know can cause infections and even if you’ve been infected, it’s unclear how robust that immunity will be and for how long it will last. The dose can however be delayed from. For 90 days from when the symptoms started. And you know there are some studies that show you could even if they’re between doses the dose can be delayed as well. And can COVID-19 vaccines and other vaccines be given at the same visit. So yes you can give multiple vaccines at the same time and as frequently as done with many routine childhood immunizations. And with that, I’ll also encourage, you know, given in the last two years people have not been up to date with routine. That if other routine immunizations are behind, please get up to date with that, specifically polio because I’m sure all of you heard in the news, there have been pediatric cases especially in New York State and that child is was unvaccinated and experiencing neurological symptoms of polio, a disease which is essentially been eradicated through decades. Next slide. So, you know, again, is this safe? Is this, you know, of course everyone wants to know, every parent wants to know is this safe for children, is it safe for teenagers, you know, before any authorization or approval for child that include thousands of children and teenagers to establish their safety and effectiveness, and they’re also being monitored under the most comprehensive and intensive safety monitoring program in US history. Have there been, you know, serious health events after the COVID-19 vaccination? Again, serious reactions after COVID-19 vaccination in children and teens are rare. When they are reported, they do occur most frequently within a few days. And I will note that in the youngest age group there were far fewer adverse events or reactions. So what to do if you or someone that has been exposed to COVID-19 becomes symptomatic? So if you were exposed or had symptoms, obviously, you know, get a COVID test or do a home COVID test. You know, even though many of the mandates and restrictions have been lifted, obviously the infections are still occurring. Personally, I’ve been seeing them every single day for the last 90 days, multiple times a day. And so again, these tests are easily available. Therapeutics are easily available, so take advantage of them. We’re in much better shape than we were two years ago, and many of these test kits are free and can be sent to you for free by the government. If the test is negative, you should still consider testing again one to two days afterwards, because I’ve seen this multiple times. The day one someone tests negative, then day three days test again and it’s positive. And even if it’s not COVID, you should still stay home. You know there is this awful culture and in America, going to work sick. And that’s the worst thing you could do, no matter what you have, whether it’s a cold or COVID or flu or what have you. Because even if it may be miles for you could be infecting someone who could get married a second further spreading it. And again, if it’s positive,stay, if you can, isolate away from other people and even pets, have been picking up these viruses in your home and if possible use a separate bathroom etcetera. I know it may not always be possible for everybody and you know, tell your close contacts as well who you may have seen in the last 48 to 72 hours that you have been exposed or they’ve been exposed. So medications used to treat COVID-19 now there is a lot more in our arsenal. Obviously pain relievers and over the counter drugs are very effective as they are with any virus. But if you are in a high risk category, there are a lot of other medications now at our disposal that will keep you out of the hospital and shorten the intensity and duration of your illness. So antiviral medications, anti-inflammatory therapy. Dexamethasone and other steroids I know that you know many of you are very well aware of viruses and what that happens to your lungs being asthma and allergy sufferers. So you know that often steroids are necessary in the early onset of an illness and there’s a lot of immune based therapies as well such as monoclonal antibodies which have given early can help reduce the you know severity of illness and then some off label drugs have also been used. So for example ivermectin, Plaquenil, chloroquine and more. But these, of course, I would you know, caution. Be careful when you’re using some of these because they’re not the standard of care and evidence is very conflicting, you know. So if you are using it and not improving you may want to consider switching to something that is approved and has the data behind it. So monoclonal antibodies. You know what are they? So these are antibodies naturally produced by your body to fight off infections and what monoclonal antibodies are is that they’re they help also fight in addition to your own antibodies. So it helps neutralize the virus and decrease the viral load in your body effectively hopefully shortening the duration of your illness and stopping it from worsening and these work very well and it can be given either by I. Or a single dose injection to people diagnosed with COVID-19 and this therapy, you know, helps you fight it off as mentioned and now for some immunocompromised individuals, there are also monoclonal antibodies that are approved to prevent COVID-19 in the same way as a vaccine. And these are also very helpful for those who may be allergic to the vaccine or have had adverse events with the vaccine and now can’t get additional shots, so. The great therapy and there’s a great website actually online where you can actually identify where there are doses of both the antibodies as well as antiviral medications close to you. So I found it very useful. So if people get sick and you know they need the treatment right away, it’s easy to help identify where it is so that they can go. And this is just a nice slide of you know the different antibodies where they’re given inpatient versus outpatient, which ones are given for post exposure and high risk individuals and which are given as preventatively you know. And then the important thing too is whether they’re effective against Omicron or not all of them are, so many have been not being used as frequently, but as you can see we still have multiple ones in our arsenal. That we can use against even the newer variants. So again, and continue to monitor your condition. So if you do have trouble breathing, persistent pain or pressure in the chest, new confusion, inability to awake or stay awake, or any blue lips, dizziness, confusion, you know if you are looking unwell or your family members looking well like please call 9-1-1 and let them know that you’ve recently had COVID so they can take you to the appropriate medical facility. The majority of people though, however, should hopefully be able to recover at home, especially if you’ve been vaccinated. But again, look out for those warning signs. And so a lot of questions that you know, we’ve been getting is if I was infected one or two years ago, am I still protected? So the data you know shows that prior infection with original Omicron may not be as protective against reinfection with the newer variants though the risk of being reinfected. Really matters person to person. You know, some individuals do have very robust immunity, but again, it’s so variable that it’s hard to kind of make a generalized blanket statement. So that’s why we recommend protecting yourself in all ways possible. And that hybrid immunity we know is best. You know, having both the natural as well as immunity from the vaccine itself. If I was infected less than six months ago, am I protected from the current COVID strain? So a study from the UK found that only about 19 % of people who had earlier infections and COVID-19 were protected against getting sick from the Omicron variant. And the CDC suggests that protection from Pfizer and Moderna may start to wane around four months after the dose. Now this doesn’t mean that these vaccines are inefficacious. The protection still was strong against severe disease and hospitalization, but we are seeing. Reinfection with the newer variants, but luckily those individuals aren’t, you know, ending up in the hospital in New York State. We have seen an uptick in hospitalizations as well, but again these are primarily individuals who are not vaccinated or immunocompromised or high risk for other reasons. So other questions, is the current COVID strain more transmissible? Do people get more severe symptoms? So I’m acron is definitely more transmissible than Delta was. Data has suggested that the original Omicron strain is less severe in general. However, you know when we call it less severe or mild, it’s actually not very mild in the sense of the word. I know many individuals who have recently been ill and you know recovering at home and they said. It’s one of the worst things that they’ve experienced you know and then again as you’ve all heard our other previous webinars on long COVID, many have lingering issues for long after. So mild is not mild in the traditional sense of the word. It’s more mild as in comparison to not being intubated or hospitalized or death you know, whereas delta was causing those issues. So that. So that’s what mild really means but for the most part. People are able to recover at home though it may not be an easy recovery. And how do we really know case rates since you know, people are not getting tested at the facility and this is a real issue. So very likely they are highly underreported. I know I’ve seen, definitely an increase in uptake in my practice as I mentioned over the last 90 days, but the majority of those tests are being diagnosed by home tests. So none of those are, you know, being reported on a regular basis. The CDC is not counting many of those cases. So as you know, the CDC is now looking at the most severe cases and they’re looking at hospitalizations and drain on hospital resources. So they are probably missing a large majority of those cases. And at what point should I seek treatment with an antiviral medication? So this is very individualized. If you test positive and are more likely to get very sick, then you should definitely seek these treatments, especially if you’re over 50 or unvaccinated or have at risk medical conditions. But even if you don’t follow in that group, I just encourage you to discuss with your physician because again, everyone’s risk profile is very different and there’s always, you know, subtleties. That these general guidelines don’t pick up. And do we know if Monoclonals work for current strain? So yeah, some of them do as we mentioned, some do and some don’t. And again, if you think you’re somebody who may benefit from it, you should contact your doctor and that way you can get the most up-to-date information as well. And then other questions are, will there likely be lockdowns again or not. So again, these are, you know, often very political discussions. But I have a feeling that as we move from pandemic to endemic, the lockdowns are less likely. But you know, nobody really knows the future. But we have a lot more at our disposal compared to when this pandemic first started. So hopefully we’re not moving in that direction again and then also. Frequent question is that you know how often these vaccinations will be needed. That also you know nobody knows no one has a crystal ball. It depends really on the duration of immunogenicity of the current vaccines and how the strains will change over time. You know each year we do have a different food vaccine as the flu virus does change more rapidly it shifts but we don’t know if again if this will be necessarily true of COVID. Or not and yet to see with the newer variants.
Speaker 2 50:24
Sorry, I accidentally went too far forward. So we’re going to go back to our polls. Doctor Parikh, thank you for jumping in there. Have you had COVID-19 Well, launch that poll yes no. Or not sure. I personally have just recovered. The month of July is quite the blur for me as I was actively infected for 12 days and then have been recovering over the latter half of July and 1st of August. And so I would answer yes here, but we’ll see how our several hundred people on the line respond to this. But just another moment. We’ll share the results looks like 51% say yes, 43% say no and 6 % not sure. So over half that have and looks like that some that aren’t quite sure given the eight you know the asymptomatic presentation. Now, I think that we’ve got one more poll right after this. And let’s launch it. If you’ve had COVID, how many times have you had it? So let’s launch this poll. Is it 1-2-3 or more than three? Again, I’ve been really surprised at how many people we’ve heard from at the network that are experiencing active infection for their second or third or even fourth time. And it does make you wonder what it is about certain individuals that seem more susceptible to this particular. Virus, even in various strains. So let’s see how the responses file in. We’ll give it just another moment. And then we’ll share the results on this. You know, I was laughing earlier and talking about the craziness of our own home and situation. We are a large family of seven and there was one point where four had it and three did not and even people sleeping in the same bed, same room, one had it, one didn’t. And so it just makes you wonder why some people are more susceptible to infection and certainly to more severe symptoms. Results here look like 78 % have had COVID at least once or one time, 18 % 2 times 2% three and then 2% more than 3. Dr. Parikh, is that sort of true to what you’ve seen in your own clinical practice? Yep, you may be on mute. That’s pretty. Maybe we lost her. All right, let’s see. Let’s go to some of your questions and see what we can respond to here in our last five minutes together today. So here’s a question on how has at home self testing affected the data that’s being collected, and I think Doctor Parikh addressed this earlier. In regard to the fact that because we do have higher home testing rates that certainly we’re not getting all of that data rolled up to the health departments or through the CDC. And so it’s very likely that even the reported rates are much less or are underreported than the actual rates see. Sorry, I know some of the comments were around the stopping of the sound and audio. Very sorry about those technical difficulties, but I think we’re good. Now let’s see, the next question comes from Rosa. How much is the percentage of patients with asthma that after getting infected with COVID increase the worsening of their asthma? And you know she was saying that there’s been patients who have stated that after they got COVID they actually developed asthma or had more. Asthma episodes and that break, are you able to respond? All right. I don’t think so. But what I’ll tell you from just the reports here at the network in my own families, lived experience, Rosa, is that the data is not clear about the number or percentage of patients with asthma that after getting COVID have worse asthma. What we do know is that baseline control of asthma is key in how well you fare during active infection. So if you’re at baseline, a well controlled person with, or person with well controlled asthma and you fare much better than if you are in the 50 % that would be considered uncontrolled asthma. So baseline control is really the key point about who with asthma does better or worse with COVID. Now in my own home I have one daughter who has never had asthma until she experienced COVID and post COVID. She is experiencing more frequent asthma symptoms and we’ve, you know, seen several doctors and specialists and had conversations about what may have happened to her Airways during that first COVID infection, which was way back in late 2019 early 2020 for her that have worked to remodel her Airways. So we are seeing and hearing that more anecdotally from patients. And I do expect that there’ll be more data from across the world. All right, looks like we’ve got time for maybe one or two page more questions, Doctor Parikh. This one says symptoms 14 days after exposure, even with the new easily transmissible variance, is it taking that long to see symptom presentation?
Speaker 1 57:14
Usually the symptoms come on within the first five days and especially within the first three days. But if it’s 14 days later, I would assume that this person may have gotten re-exposed to someone else who might have a variant number. There are a lot of asymptomatic symptoms, as well. So 14 days is a bit long, unless again that initial person continued to be sick or show symptoms. For the 14 days it is possible, but usually it’s like within the first five days. That’s when the viral load is the highest.
Speaker 2 57:51
That’s definitely what we’re seeing as well and yet we know that people can still be shedding. The virus 14 days out, for sure right.
Speaker 2 58:03
Now, this next question comes from Lisa and she says, do you still recommend separating the flu vaccine and the COVID vaccine if one is going in for their fall visit? At this point, would you recommend them getting both flu and COVID at the same time? You can get both at the same time. And in fact, you know, it may be available as a combined vaccine as soon as this fall, as soon as this flu season. So there’s no medical risk to getting them together. Some people may choose to separate them if they tend to get more significant side effects or what we call, you know, the reactogenicity of the expected side effects. That’s completely fine. But the key is to get both, you know, in a timely fashion as soon as possible yeah And of course we’ve got about 70 % school nurses on the line today, Doctor Parikh, and we love these questions from school nurses. And Liza asked here, can you help school nurses offer some guidance on sending symptomatic kids home and when they might be able to return to school?
Speaker 1 59:12
So that’s a great question. So, you know, symptomatic kids should definitely be sent home as soon as possible, obviously, especially in the school population. In terms of vaccination rates are so much lower compared to the adult counterparts. And typically the first five days the child should likely be kept home, especially if they’re symptomatic. And I feel that a negative rapid test is also very helpful to see if a child or adult is still contagious or not. So you know that five day rule quote unquote was given basically to allow healthcare workers, other essential workers to return back to work because they’re not the most contagious at that point, right? But if you know someone is still testing positive and it’s not urgent for them to get back to school or work, I would still recommend you stay home till that rapid test is negative. Now that’s different from the PCR because as we know the PCR can stay positive. Up to 12 weeks, you know, so the child doesn’t have to stay home for multiple months. But that rapid test is a great tool to at least let us know if someone is still contagious or not.
Speaker 2 01:00:21
Yeah, yeah. And that really addresses Gail’s question in our final one of the day here, which if a COVID test is still positive 12 days, you know, after 12 days of active infection, is that person still considered contagious? Could they be spreading the virus?
Speaker 1 01:00:37
Yeah and again, if it’s the rapid test, then yes, I would say that person like still has enough of a virus that they’re testing positive on that antigen test and can pass it on to somebody. If it’s a PCR, then I would say no because PCR is still positive and symptoms are gone. The rapid test is back to negative. Then that person, it’s very unlikely that they’re still highly contagious.
Speaker 2 01:01:03
And I said it was going to be the last question, but I just saw a really thought provoking one around. Have you seen any schools that are making the COVID-19 vaccine mandatory? We’re not hearing that across the country, but wondering if in your experience you’ve seen any schools doing so?
Speaker 1 01:01:22
Right so not schools for younger children, but colleges and universities. Yes, I have seen that as mandatory. And then I’ve heard anecdotally for older children, certain high schools. So, for example, like boarding schools where children may be staying and living at school. But I haven’t heard it yet for elementary schools, middle schools and that age cohort. But remember, even if that does become mandatory, it’s not something very surprising. Because we already have 11 mandatory vaccines to attend school currently yes yeah. Well, we do have a number of questions we were unable to get to today, but we will pull those into our next webinar. And so please do plan to join us as we continue with a wide range of questions around COVID-19 for our next COVID-19 webinar. But also mark your calendars for our Back to School With Asthma webinar. It’s scheduled for Thursday, August 16 at 3PM Eastern and we’ll be joined by Reagan, Lloyd and Sally Schoessler, who are going to look at going back to school with asthma, you can register for that webinar on our homepage at allergyasthmanetwork.org. And again they are on our home page, you can see where you can register and view all of our webinars. I’ll ask once again that you stay online just to complete the quick evaluation as we conclude today. And thank you so much for joining us. I’m Tonya Winders on behalf of the team and the staff at Allergy & Asthma Network as we work together to employ key strategies to manage COVID-19 will certainly be able to breathe Better Together. I also want to thank all of you for the grace and space with the technical issues today and thank Doctor Parikh for jumping off an airplane and on to a webinar again. It was great to be with you all today and we look forward to our next time together. Thank you and have a great day.
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