Curious about COVID-19 numbers after holiday travel and as we move into the new year? University of Virginia immunologist and COVID-19 researcher Dr. William Petri continues to answer reader questions about COVID-19. Send your questions to Lynne Anderson at email@example.com, and she will forward them to Dr. Petri.
What is going on locally with COVID-19?
We remain at low transmission for COVID-19 in Charlottesville and Albemarle. However, COVID-19 is continuing to take a toll on our seniors and immunocompromised individuals: we have 38 members of our community hospitalized this week at UVa, with four in the ICU. This is improved compared to over 100 patients a year ago at the height of the omicron wave, but we are not out of the woods.
So my advice is to continue to get tested if you feel ill so that you don’t expose anyone else; consider wearing a mask if you are a senior or have serious underlying medical conditions; and stay up-to-date on your COVID vaccines. The latest data is that people who have received the new bivalent booster have a 40-70% reduction in severe COVID-19 compared to those who only received the original vaccine.
The latest on variants is that the BQ variant predominates in Virginia, with the XBB variant predominating in the Northeastern US.
With the new BQ and XBB variants, I understand that previous drugs developed to treat COVID-19 are not effective. What do I do then if I get COVID-19? How do I treat myself?
Paxlovid and molnupiravir remain effective as treatments; it is only the monoclonal antibody treatments that are no longer effective. Paxlovid is the go-to therapy for COVID-19 and should be given within the first four days of symptoms to anyone who by age, immunocompromise or underlying serious medical conditions is at greater risk of severe COVID-19.
Real-world data (after emergency use approval of the drug) showed in 5,000 patients that Paxlovid was 80% effective at preventing death. A rebound in COVID-19 appears to be as common in those who do as in those who do not take Paxlovid, about one in 50.
Where are we with all the other viruses?
Norovirus infections (aptly named winter vomiting disease!) are unfortunately very common right now, while influenza and respiratory syncytial virus (RSV) infections are dropping below epidemic levels. There is, however, still enough influenza around that it is worthwhile to get the flu vaccine. Next year we should have an RSV vaccine — wonderful news!
MPox (formerly known as monkeypox) peaked in August at around 500 cases per day and is currently at 2-5 per day. This decline is likely a result of safer sexual behavior by men who have sex with men and to the use of an effective vaccine, the small stocks of which were stretched by giving one fifth of the recommended dose, which proved to work quite well.
The state of emergency for polio in New York was lifted in December. The measles outbreak in Central Ohio was at its worst at Thanksgiving. Before it ended, 85 children were infected, with 29 children hospitalized. Unlike the other viruses mentioned here, measles outbreaks are entirely due to a lack of vaccination, as the combined measles mumps and rubella vaccine (MMR) offers 97% protection against measles, with the first dose at a year of age and the second between ages 4-6 years).
One of my colleagues at work just let me know that he has COVID-19. We were in a meeting together for about an hour that day. What do I need to do – should I quarantine myself?
While you do not need to quarantine at home, you should wear a mask around other people for the next 10 days and get tested in a week’s time. Of course if you develop symptoms that could be COVID-19, do get tested and stay away from other people until you know you are not infected. Symptoms of COVID-19 include fever or chills, cough, shortness of breath, fatigue, muscle aches, headache, loss of sense of taste or smell, runny nose, sore throat, diarrhea, nausea or vomiting.
We are having a family reunion to celebrate my 90-year-old aunt’s birthday next week. Am I being unreasonable to ask that everyone who attends the celebration be tested for the day prior to the event?
I am totally on board with your recommendation, for two reasons. First that your aunt by virtue of her age is at high risk of severe COVID-19 should she become infected. Second because we all can infect others with COVID-19 even if we feel perfectly well, since so many infections are with no or minimal symptoms. We are so fortunate to have readily available home tests for COVID-19, that allow us to celebrate such a meaningful milestone safely!
I saw that there were more environmental isolates of polio this month in NYC. As a long-time resident of the City I am curious if you have any thoughts on why we see this in NYC as opposed to anywhere else.
You live in likely the most cosmopolitan city in the world, a mixing bowl in all caps. At any one time in your city there are a fair number of people who are chronically excreting vaccine-derived polio virus, from having been immunized with the live polio vaccine that remains in use outside of the U.S. There were 12 isolates of polio virus found in the last week in NYC. Since the vaccine virus is excreted in stool, it is not surprising to me to see the presence of the virus when sewage lines draining from hundreds of thousands of homes and apartments are tested. Fortunately the inactivated polio vaccine that we use in the U.S. provides life-long protection from paralytic polio, so if you are exposed to the polio vaccine virus in NYC, you will be protected.
Since the inactive polio vaccine does not protect from infection (only from paralysis) there is a huge reservoir of potentially susceptible people for the vaccine-derived polio virus to be introduced into. The one case of paralytic polio last fall in NYC in an unvaccinated adult fortunately was a wake-up call for immunizations, with tens of thousands receiving the inactivated polio vaccine this fall.
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