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January 12, 2022

Infection Numbers in Fully Vaccinated vs Unvaccinated

Yesterday the New York Times had graphs for Covid-19 infections in New York City and Seattle, both cities had timely data for the rates of infection.  In NYC the graph shows the number of weekly cases per 100,000 from Nov 6th to Dec. 18th.  Infections in NYC by 12/25 were more than 85% omicron variant. The Y axis on the graph  is 0-3000 cases per 100,000 people.  Vaccination doesn't prevent "infection", but does block severe disease.  and this is also seen in hospitalizations and deaths in the graphs published in the NYT article for each..  The graphs for Seattle are also very similar - telling a consistent story.

The other two graphs for NYC also demonstrate a stark difference between the unvaccinated and fully vaccinated less than 1 month ago.

HOSPITALIZATIONS: Not fully vaccinated - 80 weekly per 100,000 people.  Less than 10 weekly per 100,000 people in the fully vaccinated.  Statistics from other studies show that many of these people (as many as 40%) are hospitalized with other diagnoses, but were positive for Covid-19 when tested.

DEATHS:  Not fully vaccinated - 4 weekly per 100,000 people.  Less than 1 in the fully vaccinated and the graphs show the big difference.  Deaths tend to lag 2-3 weeks after being infected, so the differences are expected to continue to rise. 



January 8, 2022

Isolation vs Quarantine

The CDC has revised guidelines for Isolation and Quarantine in the face of the surge of omicron Covid infections throughout the country.   

You ISOLATE when you are sick and have been infected by the virus.  

You QUARANTINE when you may have been exposed to the virus and may or may not have been infected even if you do not have symptoms.  

CDC Guidelines for ISOLATION:  Stay home and isolate from people for at least 5 days.  The day you developed symptoms is day 0.  Wear a well fitting mask around others at home and in public on days 6-10 if you are afebrile and have decreasing or no symptoms.  You can take a rapid test at that time, but it is not required. In a British study 31% of patients still had a positive test on Day 5, and 1% on Day 10, but rapid tests are not reliable for determining when an individual is no longer contagious.. .

CDC Guidelines for QUARANTINE:

If you come into contact with someone with COVID-19, and you are fully vaccinated AND boosted, you don't have to quarantine. 

If you are vaccinated, but not boosted, or you have not been vaccinated, you should quarantine for 5 days, followed by strict mask use for 5 more days. The incubation period for the virus is usually 3-5 days, but may be as long as 10 days.  See Below  


When I was a child I distinctly remember having measles and chickenpox - one year APART.  My doctor came to our house to make the diagnosis and then put a big sign on our front door that the house was in QUARANTINE - by an old public health definition.  After I was no longer febrile and symptomatic, my mother and I went to the Department of Health and turned in the Quarantine sign.  Both of those highly infectious viruses are now controlled by vaccines that children get early in life.  Please vaccinate your children and grandchildren against COVID-19.  More children are getting Covid and more are hospitalized.  

January 5, 2022

Happy New Year and Covid Updates

Wishing You a Happy and Healthy New Year!  But we are in the middle of a huge surge in Coronavirus Cases and even fully vaccinated and boosted people can develop breakthrough cases.  These people, however are reporting mild symptoms, i.e. like a bad cold, and are rarely being hospitalized with severe disease.  Most of the hospitalized patients are unvaccinated.  Today one of my favorite epidemiologists said that neither cloth nor surgical masks are sufficient to block exposure to the omicron virus and recommended N95 or KN95 masks from this point on. 

I follow the daily infection rates for NY State, City, and Manhattan and we are in the middle of a surge that is worse than any other time during the pandemic.  On Nov 1st the Washington Post Covid Tracker said that NY State had 20 Covid Cases/100,000 people.  The infection rate was 0.7% in Manhattan, 1.0% in NYC, and 2.4% in NY State.  On January 1 the Covid Tracker showed 318 Cases/100,000 population, and the infection rates were 18.6% in Manhattan, 22.7% in NYC, and 23.4% in NY State.  When I take my early morning walk lines are very long for testing at multiple sites in my area.  For high risk patients with omicron infection there is only one monoclonal antibody treatment that is effective and that is in very short supply.  Neither of the recently approved drugs against the virus are available in any quantity - and the preference is for Paxlovid by Pfizer - based on efficacy and safety.  See Below 


Vaccinations are making a huge difference and this week the CDC will approve booster shots for 12-15 year old children 5 months after their 2nd vaccine dose.  Hospitalizations and severe infections in children have increased and there are many children who should still be vaccinated and if fully vaccinated should be boosted based on the CDC recommendations.  On Saturday I'll review "Isolation" and "Quarantine" recommendations that are changing in order to safely shorten time out of work for essential workers. 

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