Wednesday, February 16, 2022

Covid Prevention Two Years Into the Pandemic

Two years after we first heard about a new coronavirus which was referred to as Covid-19, we are still seeing around 30,000 official deaths a month in the United States. We may never even know the number of unofficial deaths which occurred in people who died prematurely because Covid hastened their death from a chronic health condition. Personally, I know my father, two neighbors, and several friends, all of whom either died from Covid alone, or had their deaths hastened by it. 

Despite these dire numbers, we have made substantial progress in the past two years in our fight against Covid.  Scientists have learned more about the virus, and they have developed vaccines which reduce our risk of hospitalization and death. We have also learned which activities increase or decrease our risk.  Finally, researchers have discovered antiviral and anti-inflammatory treatments which can make a big difference in our outcome, if we do contract Covid. 

Below is a rundown of where things stand, who is most in danger of dying from Covid, how to lower your risk, and what to do if you think you might have it.

What is Your Risk of Dying from Covid?

By early April, 2022, nearly 1,000,000 people had officially died of Covid in the United States, and over 90% of those deaths were in people over the age of 50.  In the 31 days between January 16 and February 16, 2022, there were 75,000 Covid related deaths in the United States, with over 65,000 of those deaths occurring in people over age 50.  In March, the numbers had dipped to "only" 30,000 deaths for the month.  However, that is the equivalent of a commercial jet crashing every day, and is nearly quadruple the 8,000 cases a month we saw in August of 2021.

In the cases of people who died before age 50, many of them had pre-existing conditions, although those conditions could have been as mild as simply being obese, or as serious as having poorly treated diabetes or heart disease.  However, we do not always know why Covid hits some people so much harder than others.

The actual death toll caused by Covid may be higher than we realize, because in some parts of the United States families have been allowed to ask that Covid be removed from the death certificate, especially if the person had any other illness which was the primary cause of death, with Covid acting as the "final straw" in hastening their death.  We also know that in the early days of the pandemic, in places such as New York City, the National Guard was sent to pick up the bodies of people who had died at home or in nursing facilities, and many of those bodies were not tested and not included in the official count.  

The fact is that if you have any chronic health problems, including being overweight, you have an increased risk of dying if you get Covid. If you have a serious health problem and you are over the age of 65 when you contract Covid, your risk is extremely high. Sadly, in some cases, a number of perfectly healthy children and young adults have also died.

What are the Best Ways to Reduce Your Covid Risk?

Over the past two years, we have learned that there are several actions you can take on your own to dramatically reduce your risk of dying.  These are:

Get vaccinated and, when eligible, get booster shots.  As of late March, 2022, the CDC has recommended that people over the age of 50 get TWO booster shots, if it has been at least four months since they had their last shot.  The nation of Israel discovered that people who had two booster shots had a significantly lower rate of death and complications if they contracted Covid, than people with only one booster shot.  In addition, people who had one booster shot had a lower rate of death and complications than people who had only had the original two doses of Covid. 

Lose weight, eat a healthy diet (Ad) and treat your other medical conditions..

Wash your hands frequently, and use hand sanitizer when you cannot wash them.

Maintain healthy levels of Vitamin D, (Ad) either by spending time daily outdoors in the sunshine or taking supplements.  People with low levels of Vitamin D in their bodies tend to have worse outcomes when they contract Covid-19, compared to those with adequate levels.

Wear a facemask when around others, especially unvaccinated people and strangers.  In particular, you should wear an N95 mask that is made in America if you are especially vulnerable.  If you have trouble finding them, a good second choice is a KN95 mask, or surgical masks.  (Ads)  All of these masks provide a high degree of protection, as long as they fit well and do not have gaps around the edges.  I keep some of each type of mask on-hand, and choose my mask depending on what I am doing that day.  If you want to wear a fun sequined or decorative mask, wear a surgical mask underneath it. Fabric masks alone are not very effective at protecting you. The good news is that facemasks will also reduce your risk of catching the flu, bronchitis, and other respiratory illnesses, including the common cold.

Stay home as much as possible if you have a serious, chronic health condition, or if you are getting treated for cancer, or had recent surgery.  Avoid house guests and mingling with others in either your home or theirs. If possible, do as much of your shopping from home as possible.  Check out this recent article on how to order your groceries online from Amazon Fresh. 

Avoid crowded spaces, especially indoors, where you do not know the vaccination status of the people around you.  Research indicates that you only have about 10 percent of the risk of catching Covid if you are outdoors, because the aerosolized virus gets disbursed more quickly in a well-ventilated area. That is one reason why it appears to be a seasonal virus, with fewer cases in the summer months, when more people socialize outdoors. Of course, if you are standing next to an infected person who is close enough to spray your face with their germs as they speak, being outside will not provide any protection. Keep your distance from others and wear a facemask in those situations!

Do NOT expect government mandates to protect you.  Look around.  Most Covid mandates have expired.  Even where a few Covid mandates are still in effect, they are widely ignored.  YOU are responsible for your own health, and you are the person who has to make sure you are protected. You are the person who will pay the price if you develop a bad case of Covid.  Never be embarrassed to take care of yourself.

What If You Think You Have Covid, or You Were Exposed?

If you develop the symptoms of Covid, especially a fever and a bad cough, sore throat, or other cold symptoms, get tested.  If you think you have been exposed, but are not showing any symptoms, or you tested negative on a home test, wait a couple of days and then get tested, again.  It can take two or three days after you show symptoms before a home test may be able to identify the virus. 

If you go to a testing center, they will give you a PCR test.  It will take a couple of days to get the results, but this is the most accurate type of test.

You can use an at-home Covid test (Ad) and get results in 15 minutes, but it may not be as accurate as the PCR tests.  The at-home tests initially miss as many as 30 to 60 percent of Covid cases, often because they are taken too soon after exposure, before the virus has had a chance to replicate in your body. When ordering a test, choose one that has a high approval rating.

Here's a basic rule of thumb with the at-home tests:  If you test positive, you have CovidIf you test negative, you might still have Covid, especially if you have symptoms, such as a fever, cough, sore throat, and loss of taste or smell.  Wait a day or two and test again.  If your symptoms are getting worse, call your doctor and go to a testing center for a PCR test.  The advantage of at-home tests is that they are quick, easy to use, and the government has required that your medical insurance carrier reimburse you for up to eight at-home tests a month!  The disadvantage of at-home tests is that you might have to repeat them several times.

New Treatments for Covid

Do not assume that Covid is "just like the flu" and decide to self-treat it solely with rest and plenty of fluids.  See your doctor to get the latest treatment protocol. Over the past two years we have had about 10 to 15 times as many deaths from Covid as we ever have during a bad season of the flu.  A Covid diagnosis is much more serious and is much more likely to kill you.  

Contact your doctor or healthcare provider as soon as possible.  They have new antiviral and anti-inflammatory drugs which help keep the virus from replicating in your body, or causing an extreme inflammatory response.  Some of the drugs which are getting the best results are the new antiviral drugs molnupiravir and Paxlovid (which contains Nirmatrelvir).  Doctors have also had some success with the cholesterol drug fenofibrate and the antidepressant fluvoxamine, which reduces inflammation.  All of these drugs can be given by pill and taken at home.  New drugs are constantly being discovered, but with all of them it is important to take them as soon as possible after a diagnosis of Covid.  

Monoclonal antibodies are also effective, but they are in short supply and have to be given by an IV.  They have also been less effective with the Omicron variant than they were with the Delta variant.  

Watch for Signs of Long-Covid

Many viral and bacterial diseases remain in our body for decades and can continue to cause health problems in the future.  Examples of these are chicken pox, polio, herpes, and Lyme Disease.  Currently, about 37 percent of people who have survived Covid have developed long Covid symptoms which include lung damage, cognitive impairment, muscle pain, weakness, heart disease, fatigue, severe headaches and depression.  Even people who have had a mild case of Covid have an increased risk of a heart attack during the following year.  No one knows what the impact of Covid could be decades from now.

Vaccinated people have a lower risk of long-Covid, but some of them still develop it.  It is smart for everyone to avoid exposure as much as possible, and to get treated quickly if you get it despite your best efforts.

Check with your doctor if you suspect you may have long Covid.  Many of the health issues can be treated.  In other cases, it may turn out that you do not have long Covid but another health issue which has not been diagnosed.  Do not ignore the problems and assume they will eventually go away. 

What Else Can You Do to Protect Yourself?

Most of us are "tired of Covid" and want to just get past it.  However, it is risky to pretend that Covid is over.  With 30,000 to 75,000 additional people dying of Covid every month, none of us can afford to ignore it.  If you have done well so far, don't let your guard down, now.  

Be particularly careful during the winter. Remember, Covid appears to be seasonal.  Although cases will probably drop in the spring and summer, cases are likely to continue to spike during the winter months, at least until we have better vaccines, higher vaccine compliance, and better access to medications which treat it.  Meanwhile, it is wise to plan large family events such as weddings and reunions for the summer months, hold them outdoors, and encourage everyone to be vaccinated and boosted.

Continue to get booster shots whenever your healthcare provider recommends them, especially as scientists develop new and better vaccines.

Get a flu shot to protect yourself from other respiratory diseases which could make you more vulnerable to Covid.  Some people have been getting Flurona, which is a combination of the flu and Covid at the same time.  When this happens, they have DOUBLE the death rate of people who just get Covid. 

Keep wearing a facemask indoors around other people, particularly unvaccinated people or strangers. We need to practice feeling normal whenever we wear a mask in a store or while traveling.

Avoid crowds, especially indoors in poorly ventilated spaces.

Continue washing your hands often, and avoid touching your face.  Although rare, it is possible to get Covid on your skin and transmit it to your mouth or nose by touching these areas.

Do NOT rely on a previous Covid infection to protect you.  Many people have been infected by Covid more than once.  Some people have had their symptoms reappear only a few weeks or months after recovering from a previous infection. You should continue to take reasonable precautions, even if you have been vaccinated or had an infection.

Maintain your overall health, to make yourself less vulnerable.  Follow your doctor's instructions about the medications you should be on, including supplements which could support your immunity.  Get plenty of sleep, exercise, and eat a healthy diet with plenty of fruits and vegetables.

Get tested if you develop Covid symptoms or believe you have been exposed to Covid, and contact your doctor quickly if you test positive.  You can purchase at-home Covid tests online (Ad) and have them delivered within a day or two.  Your medical insurance company should reimburse you for the purchase of up to eight tests per month. Medicare began reimbursing its beneficiaries in the spring of 2022. 

Fill any prescriptions for antiviral or other medications quickly.  The sooner you start taking them, the better they work.  Do NOT experiment with unproven treatments when there are proven medications which could be safer and more effective.

Be thoughtful and protect others. You may have a strong immune system, but what about your elderly relatives, or the friend who is recovering from cancer, surgery or a heart attack?  Stay home until you test negative and, in particular, avoid exposing anyone who is likely to get a serious case of Covid if they are exposed.

What If You Do Not Succeed in Preventing Covid?

The truth is that many people will be on their own if they are not successful at protecting themselves from Covid.  Some of the serious consequences are:

Increased death rate: If you do not get vaccinated, you are approximately 97 TIMES as likely to die if you get Covid as your vaccinated peers, according to the CDC.

Financial problems: If you survive Covid, but have a lengthy hospitalization, you could end up losing your job and, depending on your health insurance, have high co-pays and deductibles.  On average, hospitalized patients with private insurance have paid an average of about $4,000 out-of-pocket for their care.  However, some people are underinsured and there have been patients who were forced into bankruptcy because of high medical bills.  In early 2022, about 12,000 people a day are being hospitalized for Covid-19.  Can you afford to be in the hospital for weeks, followed by another few months in a skilled nursing home?

Serious health effects: If you survive Covid, you also have about a 1 in 3 risk of developing Long Covid, with chronic health problems you did not have before.  This can include new heart problems, diabetes, respiratory failure, blood clots, decreased mobility, memory problems and other symptoms of cognitive decline. Long Covid sometimes begins to show up just a few weeks after recovering from a case of Covid, even a mild case of it.  No one knows what health consequences there could be in future years for people who survived Covid, since we have only been aware of the virus for the past two years.

Fortunately, if you take the precautions mentioned above, you have a much better chance of staying healthy and reducing your personal risk, as well as the risk to others.  Then, you can enjoy your life with one less thing to worry about! 

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