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Infectious Diseases

COVID Recommendations are a Moving Target

August 2, 2021 by Inside Press

Editor’s Note: We contacted Northern Westchester Hospital for guidelines on the latest news surrounding COVID, for thoughts on breakthrough infections, vaccinations and mask wear. Here, expert insights and advice from Debra Spicehandler, M.D., Co-Chief, Division of Infectious Diseases, Northern Westchester Hospital

By Debra Spicehandler, M.D.

To mask or not to mask? That is just one of the questions generating confusion as the CDC tries to nail down current COVID recommendations as the very contagious Delta strain gains traction. We continue to learn more, but the Delta variant appears to cause more severe illness and may spread as easily as chicken pox. In addition to a growing number of breakthrough infections among the fully vaccinated, it appears that symptomatic vaccinated people can also spread the Delta variant.

Dr. Debra Spicehandler

During the past few weeks, New York seemed to have pushed COVID back to the point when people felt comfortable eating in restaurants, attending weddings and going back to the office.  Not so fast. Almost overnight, the Delta variant has become the dominant COVID strain, and we are seeing rates of infection rise especially among the unvaccinated.

Here is what we know:

Being vaccinated is key, but vaccine hesitancy persists, and there is discussion about mandating vaccines among certain groups, including healthcare workers.

We are now seeing breakthrough infections even among people who are vaccinated as a result of the now dominant, highly contagious Delta variant. The good news is that breakthrough infections among the vaccinated seem mild, in most cases, and do not require hospitalization. It is unclear whether people with breakthrough COVID cases will have any of the long-term effects we’ve seen that include cardiac issues, long-lasting fatigue, lung problems, joint pain, and brain fog.

Though we have not seen definitive data, federal health officials announced both vaccinated and unvaccinated people who contract the Delta variant of COVD may carry similar levels of viral load and spread the disease even when asymptomatic. A recent New England Journal of Medicine study of 1,497 vaccinated Israeli healthcare workers found 39 breakthrough infections with three quarters of those people showing a high viral load.

This information raises other questions: if we are seeing more breakthrough infections, is it because the Delta variant is more efficient, or does the efficacy of the vaccine wane over a certain period of time? And, if so, how long do vaccines last?

It is beginning to look as though people who have been vaccinated will soon need booster shots.

As COVID rates rise, the CDC recommends that even fully vaccinated people wear masks indoors where transmission of the virus is high, such as New York City and surrounding suburbs, including Westchester. Since the virus is rising in New York, I recommend caution. It is still okay to be outside without a mask if you are vaccinated, but it looks like indoor masking should be reinstituted, and people should follow the most updated guidelines on the CDC website. This is an evolving situation. Even if we know people have been vaccinated, we cannot be sure that someone has not been exposed to the Delta variant.

For the vaccinated, COVID symptoms can be extremely mild. But if you are concerned that you may have COVID–especially if you have other co-morbidities–then get tested.

Patients who test positive and are at high risk for developing a severe infection may be eligible for infusions of monoclonal antibodies. This risk group includes people 65 and older, who have diabetes, high blood pressure, cardiac disease, obesity, asthma or who are immunocompromised.

Because recommendations are changing so quickly as we learn more, check the CDC website for the most current information. And, if you think you may have COVID, check with your physician. For more information, visit Northwell’s Digital Resource Center.

 

 

Filed Under: Surviving COVID-19 Tagged With: Breathrough Infections, COVID, COVID-19, Delta Variant, Infectious Diseases, Mask Wear, Northern Westchester Hospital

Top Five Things You Need to Know About the Measles

April 23, 2019 by Inside Press

Measles outbreaks in surrounding communities, including confirmed cases in Westchester County, have raised concerns for the community, as well as questions about how to protect yourself and those you love.

“Measles is one of the most contagious of all infectious diseases,” says Debra Spicehandler, MD, Co-Chief of Infectious Diseases at Northern Westchester Hospital. “My advice? If you’re not vaccinated, get vaccinated immediately. And, avoid high-risk areas, if possible, especially if you have an unvaccinated baby.”

Debra Spicehandler. M.D.

According to the National Center for Health Research, one person with measles can infect 12 to 18 others, in an unvaccinated population, before they even know they’re sick. Why? It’s airborne. Also, the virus can live for up to two hours in an airspace where an infected person has coughed or sneezed. So, if you’re not vaccinated and breathe contaminated air or touch an infected door, you’re at risk. This is why it’s so important to get vaccinated – wearing a mask will not prevent you from getting sick. Anyone who has not been vaccinated can get the vaccine free through the Westchester County Department of Health. Call 914-995-5800 for an appointment.

Here are Dr. Spicehandler’s tips on the top five things you need to know about measles:

• You may not even know you’re sick:
Here are symptoms to watch out for: The measles virus incubates for the first two weeks after infection, which means you won’t have any signs or symptoms. Even when you begin to have symptoms, you may mistake them for a common cold. A cough, runny nose, sore throat, or conjunctivitis is common during the first stage. When the virus progresses, usually three days after symptoms begin, you may notice a diffused itchy rash that starts on the face and progresses downward toward the hands and feet. Fever is also common during this stage. Accompanying the rash and fever, people often notice bluish-white spots in the mouth. You are contagious four days before the rash starts and up to four days after the rash appears.

• Call your doctor:
If you believe you or a loved one was exposed, or if you have symptoms, call your doctor, but do NOT go into a healthcare facility unannounced. Your doctor’s office, or community hospital, likely has plans in place to treat measles, but there are protocols in place to ensure others don’t get sick. Please call ahead before entering one of these facilities.

• If you were exposed, you have three days to get vaccinated:
After this time period, a vaccine is not effective. Typically, you should avoid all contact with others for 21 days, as it’s still possible for symptoms to develop during this time. Speak to your doctor or local health department to discuss when it is safe to go back to work, school or other public places.

• Revaccination is “a thing” but you probably don’t need it:
If you received two doses of the MMR vaccine or if you were born before 1957, you should be fully protected against the measles. However, it’s not harmful to receive additional doses if you’re unsure of your status. If you’re concerned, ask your doctor for a blood test to check your immunity levels.

• If you’re not vaccinated you’re putting others at risk for serious complications:
For those who are pregnant, immunocompromised, or babies under six months old, the measles can be devastating. The MMR vaccine is a live (weakened) virus vaccine, so these individuals cannot receive it. However, you have other options. Protect yourself (and baby) by making sure everyone who enters your home is vaccinated, get your titers checked (they identify the amount of antibodies in a person’s blood), practice good hand hygiene, and avoid high-risk areas. If you fall into one of these categories and have been exposed to the measles, you may benefit from a temporary vaccine called immunoglobulin. It’s best to speak to your healthcare provider to explore your options.

Info here via a release courtesy of Northern Westchester Hospital

About Northern Westchester Hospital
Northern Westchester Hospital (NWH), a member of Northwell Health, provides quality, patient-centered care that is close to home through a unique combination of medical expertise, leading-edge technology, and a commitment to humanity. Over 650 highly-skilled physicians, state-of-the-art technology and professional staff of caregivers are all in place to ensure that you and your family receive treatment in a caring, respectful and nurturing environment. NWH has established extensive internal quality measurements that surpass the standards defined by the Centers for Medicare & Medicaid Services (CMS) and the Hospital Quality Alliance (HQA) National Hospital Quality Measures. Our high-quality standards help to ensure that the treatment you receive at NWH is among the best in the nation. For more information, please visit www.nwhc.net and connect with us on Facebook

Filed Under: Sponsor News! Tagged With: Infectious Diseases, Measles, Northern Westchester Hospital, Vaccinations

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