• Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

    COVID Update February 27, 2022: How to Unmask

    By Dr. Arthur Lavin

    Glossary

    • Virus– a type of germ that consists solely of a bit of genetic material (DNA or RNA) wrapped in a protein coat.  The coat gets the genes into the target cell where the genes force the cell to make zillions of new viruses (genes and protein coat), and on it goes.
    • Variant- also known as a mutation, a variant strain of a virus is the same species of virus but with a change in the genetic code.  The change is minor if it has no impact on contagious the new variant is, or how deadly it is, or if it allows the virus to neutralize our vaccines. Variants that substantially increase harm are now listed by Greek letters, the most troublesome one now is Omicron.
    • Coronavirus– a species name of a number of different viruses.  Called corona because its protein coat is studded with spike shapes that form a crown, halo, or corona of spikes
    • SARS-CoV-2– the specific name of the new coronavirus
    • COVID-19-the name of the illness that the new coronavirus is causing
    • Endemic– an illness always present in a region.  One could say strep throat is endemic in the US
    • Epidemic– a sudden burst of an illness that comes and goes over a limited time
    • Pandemic– an epidemic that bursts across the world not just one region
    • Spreadability– how contagious is the disease, how many people will end up infected
    • Symptoms- the experience of being ill, for example- fever, cough, headaches, loss of smell etc.
    • Asymptomatic– literally means “without symptoms”.  For COVID-19 it refers a person infected with the virus but has no and will have not symptoms
    • Presymptomatic– This is a person who was infected with SARS-CoV-2, and will feel sick, but hasn’t yet
    • Severity– what harm does the disease cause, in terms of  how sick you get and how many it will kill
    • Mask- a mask is a loose-fitting cloth or textile that covers the mouth and nose loosely.  A surgical mask is a mask used in surgery
    • Respirator-  for the purposes of the COVID-19 pandemic and other respiratory illnesses, a respirator is a mask that fits very snugly or tightly to the user’s face.  An N95 mask is a respirator.
    • PCR Test–  swabs the nose to detect the genes of the COVID virus.  The genes if detected are almost certainly there, but they can persist long after contagion ends.  Very few false positives, positives can be trusted.
    • Antigen Test (the home kit)- swabs the nose to detect the proteins on the coating of the COVID virus, the spike proteins.  If it does not detect those proteins, you are almost certainly not infected, negatives can be trusted.  These proteins are also on the coating of many common cold viruses, so one positive test may indicate you have a cold rather than COVID.  Two positive home tests though reliably indicate you have COVID.
    • Vaccine Terms
    • Vaccine or Immunization– a dose of a substance that activates your immune system, as if you have the actual infection you are hoping to prevent, leaving you in fact protected from having that infection.
    • Efficacy– the percentage of people immunized with a particular vaccine who will not get infected if exposed to the target infection.  For example, a COVID-19 vaccine will be said to be 95% effective if 95% of people immunized with that particular COVID-19 vaccine will not get COVID-19 if exposed to COVID-19
    • mRNA– DNA works by dictating exactly which proteins your cell will make.  The message on how to construct each protein is delivered to the cell machinery that makes proteins by a piece of genetic material called messenger RNA, or mRNA
    • mRNA vaccine– an mRNA vaccine places a small bit of mRNA code that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected
    • Viral vector vaccine– a viral vector vaccine takes a harmless virus that is known to infect people reliably and places that weakened virus in a person where that virus will in fact infect the person.  The virus is not only weakened, but also attached to a set of genes  that makes your cells make a protein that is the protein from a virus that alerts your immune system and activates it to make protections against you being infected.

    How to Unmask

    As readers of Real Answers will recall, the COVID Pandemic is in dramatic retreat across the world, with the tragic exception of parts of Asia, including Hong Kong, which is suffering grievously right now.

    Specifically, COVID transmission is quite low in Cuyahoga County, we are today officially at the Medium, or Yellow level of risk of spread.  We see this in our office in real time, we have had no positive COVID tests done in over a week or two.  We have not had a single week with no positive tests since our last lull, in May and June of 2021.

    The goal with COVID will always remain the same.  We should all do what we can to keep people of any age dying from COVID which means preventing spread and getting immunized, period.

    As transmission draws close to zero, steps we need to take to block transmission begin to disappear.  If no virus is spreading, then keeping distant or not, wearing a mask or not, does not really make any difference.

    We are not quite at zero transmission.  But the CDC has issued new guidelines recognizing that about 70% of the nation is at low or medium levels of transmission.

    Here are the new guidelines: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

    And here is site that tells how every region of the nation is doing today- hi, medium, or low risk:

    https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

    You will note that Cuyahoga County is at Medium risk of transmission and harm, based not on our incredibly low new case per day rate, but our hospitalization rate which remains a bit higher from cases caught a few weeks ago.

    The Current Recommendations from the CDC for Mask Wearing

    What Prevention Steps Should You Take Based on Your COVID-19 Community Level?

    Community Burden Levels
    Low Medium High
    ·  Stay up to date with COVID-19 vaccines

    ·  Get tested if you have symptoms

    ·  If you are at high risk for severe illness, talk to your healthcare provider about whether you need to wear a mask and take other precautions

    ·  Stay up to date with COVID-19 vaccines

    ·  Get tested if you have symptoms

    ·  Wear a mask indoors in public

    ·  Stay up to date with COVID-19 vaccines

    ·  Get tested if you have symptoms

    ·  Additional precautions may be needed for people at high risk for severe illness

    People may choose to mask at any time. People with symptoms, a positive test, or exposure to someone with COVID-19 should wear a mask.

    If you are immunocompromised, learn more about how to protect yourself.

    Note the following points:

    1. We are in a medium risk county
    2. For us, if you are not at high risk for harm from COVID, you no longer need to wear a mask.  You may continue too, but it is no longer recommended as necessary.
    3. Everyone, at any risk level, is urged to be fully vaccinated
    4. Everyone, at any risk level, if they have cold symptoms should be tested for COVID

    We would add the following points:

    1. We all know too well that COVID transmission rates go up and down.  When they are way, way down, masks can come off
    2. You can continue to wear a mask to avoid colds which continue to spread well now.
    3. Unimmunized people who are healthy, including young children, can take their masks off indoor and out now, as long as we remain in the green or yellow, low or medium risk of spread zone.
    4. Some parents may wish to continue masking their unimmunized children (all kids <5 years old for now).  COVID transmission has not ceased, just low enough that catching it in Cuyahoga County is fairly unlikely.

    Bottom Lines:

    1. Our goal remains true and steady:  We should all we can reasonably do to protect those we love from catching COVID, to prevent as many COVID deaths as possible.
    2. THE #1 ONE ACTION THAT CAN GET THIS GOAL DONE IS TO GET FULLY VACCINATED
    3. COVID spread goes up and down. When up mask, when down you can still mask to avoid colds, or drop risk of COVID even closer to zero, but you can also stop masking.
    4. Right now, and for now, Cuyahoga County is at medium risk of COVID spread, so healthy, not hi-risk people can take their masks off. That includes all the healthy not hi-risk unimmunized at any age.

    My One Takeaway Sentence:
    We applaud these new guidelines and are very comfortable with masks coming off those not at hi-risk, but this is totally conditional on spread rates remaining low, and the URGENCY OF 100% VACCINATION OF OUR COMMUNITY REMAINS TOP PRIORITY

    To your health,
    Dr. Arthur Lavin

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