COVID Update April, 2022
Dear ones –
In one sentence, my update on COVID is: For as long as it lasts, let’s enjoy this while we can!
Cases and hospitalizations around New Mexico are a tiny fraction of what we’ve seen. Our
vaccines are holding up extremely well when it comes to severe illness and hospitalization,
and as a community we are approaching numbers that suggest we may have real herd
immunity to help buffer us – come what may. If you get nervous watching trends in cases of
positive COVID infections, try to watch hospitalizations and deaths instead.
Yes, the Omicron BA2 sub-lineage is likely to take over as the dominant strain of the virus that
is circulating. It is more transmissible than the earlier Omicron subtypes, but that does not
mean it is destined to cause more severe illness and death. All of this is very good reason to
feel relief and optimism. Hospitals are no longer packed to overflowing, but our whole health
care community has been badly beat-up by everything that’s happened over the past couple
of years. This is a great time to see your dentist, get a mammogram or go see your PCP for a
checkup, but be patient – wait times for non-emergency care are going to be very long
for a good while yet.
PREVENTING COVID
You know the drill. Get vaccinated, wash your hands, and wear masks when appropriate!
MASKING
Masking continues to be one of our effective pillars of prevention. If you are in an area with
high rates of infection or have a high need for extra protection, I recommend the KF94, KN95
or N95 mask respirators– available at pharmacies and online.
However, I also believe that it is safe for fully vaccinated people to shed their masks in
most public places in New Mexico. I am currently using a benchmark of an expert
infectious diseases epidemiologist that I found helpful. His recommendation was that it
is OK to not mask in indoor public spaces as long as your community rate has a low
amount of circulating Covid – specifically, fewer than 20 cases per 100,000 population,
which you can find reported at either of the following links. (At the time of this writing,
Bernalillo County has 6 cases per 100,000 population)
CDC Prevalence Tracker: https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html
New York Times Tracker: https://www.nytimes.com/interactive/2021/us/covid-cases.html
Outdoor and well-ventilated spaces are still safer than indoor spaces without good
circulation, and masks are still protective, especially if you have a weakened immune system
or are regularly around vulnerable people.
MORE BOOSTERS? HOW TO MAXIMIZE YOUR VACCINATION STATUS
All of you should have completed your original vaccine series (one dose of J&J or two doses of
Pfizer or Moderna) plus at least one additional booster. You should already have an account
on the NM Department of Health website - VaccineNM.ORG.
I recommend that you receive ONE additional booster with either of the mRNA vaccines
(Moderna or Pfizer), regardless of which vaccine you got originally. Side effects from the
booster doses are usually comparable to the side effects of the second dose of your original
series and can be mild or substantial enough to put you in bed for a day or two. Large,
swollen lymph nodes are a very common effect. Second booster shots (for most people, this
is the 4th shot) are a different story.
Fully vaccinated and boosted adults and children are still very well protected from
illness. Please be mindful of medically fragile people and small children in your life that may
be more vulnerable.
We are just now getting news about approval of a second booster, or a 4th shot, for
patients over 50 years old. Saying that a booster is “authorized” is not the same thing
as being “recommended,” and I am still waiting to see what kinds of guidelines follow in
coming weeks. Studies continue to come out showing that fourth doses of vaccines are
not meaningfully helpful for the large majority of the population – unless the patient has
a very abnormal immune system causing them to not respond to the first series.
The CDC will issue a guideline soon that is aimed at two important goals – keeping you
healthy as an individual, and keeping the population as healthy as possible as a
whole. When the guidelines suggest that you should consider getting an updated
booster, you’ll be able to register again through the state’s department of health
website: VaccineNM.ORG.
**** FOR PATIENTS WITH IMPAIRED OR ABNORMAL IMMUNE SYSTEMS
Your vaccination regimen is going to be different that the general public. If you have
moderate to severe immune system compromise, please be in touch with your docs to make
sure that you’re covered as fully as possible.
Moderate and severe immunocompromising conditions and treatments include but are not
limited to:
• Active treatment for solid tumor and hematologic malignancies
• Receipt of solid-organ transplant and taking immunosuppressive therapy
• Receipt of chimeric antigen receptor (CAR)-T-cell therapy or hematopoietic cell transplant
(HCT) (within 2 years of transplantation or taking immunosuppression therapy)
• Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich
syndrome)
• Advanced or untreated HIV infection (people with HIV and CD4 cell counts <200/mm3, history
of an AIDS-defining illness without immune reconstitution, or clinical manifestations of
symptomatic HIV)
• Active treatment with high-dose corticosteroids (i.e., ≥20 mg prednisone or equivalent per day
when administered for ≥2 weeks), alkylating agents, antimetabolites, transplant-related
immunosuppressive drugs, cancer chemotherapeutic agents classified as severely
immunosuppressive, tumor necrosis factor (TNF) blockers, and other biologic agents that
are immunosuppressive or immunomodulatory
IMPORTANT SCAM WARNING
The NM DOH has issued an alert that there is an active scam through which patients are
contacted by text message by agents stating that they will help schedule your 4th
vaccine shot. This text prompts recipients to enter personal information including
social security number into an online form. PLEASE BE VIGILANT. The NMDOH will
NEVER ask for your social security number by text or email.
TESTING
Thankfully the intense Omicron surge has passed, and our resources are back in good
supply. Rapid antigen tests are available over the counter. PCR tests are also widely
available again, with fast results, through the NMDOH
website: https://cv.nmhealth.org/covid-19-testing/ Being able to do a rapid antigen test at
home is going to come in very useful for almost everyone. We know that the Abbot BinaxNOW
tests and the Quidel QuickVue tests seem able to accurately detect the Omicron variant. I
would continue to stick to these two brands for now when you can. (Depending on your
circumstances, you may need to use two home tests, 2-3 days apart in order to be confident
in the results.)
IF YOU CATCH COVID
Effective medications are now widely available and should be used ASAP when an at-risk
person contracts COVID.
Please be in touch with with your physician immediately if you do catch COVID. The new
outpatient treatment options (some are pills and others are IV treatments) are incredibly
powerful and effective, but there is a very short window of time in which they need to be
prescribed. Not everyone qualifies for treatment, but A LOT of people do. Let your PCP know
so they can make sure to do everything they can to help you recover as quickly and safely as
possible.
QUARANTINE AND ISOLATION are still important for exposed or infected patients, so please
be mindful. We have learned a lot about when a COVID infection is contagious, and about the
incubation period, or when an exposure turns into an infection for those unlucky
people. Quarantine is what we do for exposed patients that are not yet infected but are being
observed. Isolation is the process for infected patients. The definitive guide that I use is
here: https://www.cdc.gov/coronavirus/2019-ncov/your-health/quarantine-isolation.html
That’s it for now! If you are tempted to go out into the world, I say GO. Enjoy the
springtime! Your mental health, physical health and preventive care are all important!
Dr. B