By Richard Sternberg, M.D.
The son of two former members of my religious congregation died of complications of COVID over this past weekend. He was 38 years old. Of course, his parents are devastated. He was an adamant anti-vaxxer.
Currently, in the intensive care unit at Bassett Hospital, which, by the way, is full, there is a 30-something female who has complications of COVID. I’m told that she had been vaccinated, but I don’t know her booster status or whether she was eligible.
New York ordered every hospital in the state’s Mohawk Valley, Central New York, and Finger Lakes regions to its list of “impacted facilities” to stop non-essential, non-urgent elective surgeries “due to the increasing COVID-19 cases and hospitalizations” in those regions. That includes the whole of the Bassett Healthcare System with the exception of O’Connor Hospital in Delhi.
Greetings, Friends! The time is nigh To bid this Covid Year good-bye. We’ve had enough, we’ve played our parts Stayed home alone filling Amazon carts. And cleaning our closets and working online Making do with our WiFi that’s not always fine. We’ve said goodbye to some friends, to some relatives too Our families we’ve not seen, travel’s been so taboo. Goodbye ’21, au revoir, off you go Adios and kwaheri, arrivederci, adjo. Go away ’21! But wait! Not before TFJ has its way with some thank-yous galore.
By Richard Sternberg M.D.
Checking the Otsego County Department of Health dashboard on December 20 showed a distinct uptick in a number of cases of COVID in recent days. Most of these still are probably from Delta, but also are beginning to reflect the Omicron variant. The website did not identify the specific variant of those cases.
Dr. Fauci says the number of cases of the Omicron across the United States doubles every two to three days. That in itself is very disturbing. The good news is that those who have been fully vaccinated and, where indicated, have received booster shots, generally show mild symptoms. The number of patients in intensive care units over the total number of people who tested positive shows a decline from those of a year ago. Additionally, the Paxlovid antiviral medication, when available and when properly indicated, seems to decrease the risk of serious complications by up to 90 percent.
Cooperstown Board of Trustees member Dr. Richard Sternberg this week announced his plan to run for another term of office when the village votes on March 15, 2022.
Hope for the best, prepare for the worst
In 24 months, we have learned many things about responding to a pandemic of a dangerous disease.
Don’t ignore it.
Take reasonable precautions to prevent the spread.
1918 is still relevant.
Work on treatments and immunizations and use them when available.
And more: Lessen our travel. Wear a mask if it’s transmitted by air. Avoid any behavior that promotes spread.
Saturday, November 27, 2021. 1:00 PM
Yesterday morning we had not heard of SARS-CoV-2 variant B.1.1.529. The New York Times did not mention it and The Economist had no information in their morning news feed. It was then one of many variants of the virus that causes COVID. Then the World Health Organization named it Omicron. WHO reserves Greek letter names for variants of particular concern. Omicron is one of them.
The global stock markets plunged with U.S. major indices losing more than 2% in a half day of trading. Lockouts have been instituted and announced. Governor Hochul has declared a state of emergency. Doctor Fauci is making the rounds of all the major media news organizations. How severe Omicron will be and whether the current vaccines will be effective, and if so, to what extent is unknown.
Below is a compilation of what is known and unknown as of the time this article is being written. Most of it is open to revision.
By Richard Sternberg M.D.
The amount of information regarding COVID in children and the risks and benefits of vaccination is overwhelming and as reported even varies from country to country.
There is no clear-cut consensus on anything in the younger age groups other than that the risk of developing a case requiring treatment, hospitalization, or leading to death is lower if the patient is younger. Still, the risks of vaccine complications in the very young have so far been trivial, with no deaths or hospitalizations in pre-clinical studies reported in the United States.
Last week a friend told me a story that should have surprised me, but unfortunately I was inured to. In fact, you could say I had been immunized to the situation.
Her friend who she had worked with frequently over the past few months, came up to her smiling and announced that he had finally “bit the bullet” and had gotten vaccinated against COVID. He had refused up to that point because of concerns he heard about, mostly from the internet. My friend was a bit shocked because the other person had previously told her that he was immunized when they first started working on a project together several months previously.
When questioned about that, he said that he was sure that she would insist on wearing masks and even working remotely from each other if he told her that he weren’t vaccinated against COVID-19. He really hated wearing a mask and wanted to work together. He was immunized, just not against COVID. He had, after all, been immunized as a child against measles, mumps, chicken pox, diphtheria, pertussis, and tetanus. He finally acknowledged that he knew he was misleading but insisted he had made a true statement.
Six weeks ago, I wrote about a new drug called malnupiravir from Merck that was a game changer in the treatment of COVID-19. When taken in the first few days of infection it was 50% effective in the prevention of hospitalization and death. While not as good as monoclonal antibodies this was considered an amazing result and the study was terminated early in order to immediately ask for emergency approval. It was recently approved in Great Britain and large supplies were purchased by Britain, the United States, and other wealthy countries.
By KEVIN LIMITI • Special to www.AllOTSEGO.com
COOPERSTOWN — The Board of Trustees voted to consider a cannabis opt-out law on December 6 at 6:30 p.m.
MacGuire Benton was the dissenting vote. Hanna Bergene and Joe Membrino were absent.
Mayor Ellen Tillapaugh has been in favor of an opt-out law, arguing for drafting a law which would then become open to public comment. “The only option for getting public comment is holding a hearing and that can only be done by drafting a law,” Mayor Tillapaugh said.
On the one hand the media is reporting the number of cases of COVID-19 is receding in the United States. The Wall Street Journal reports that the Delta variant wave of the pandemic has passed its peak. On the other hand, it states that that the approaching winter season and holidays present another opportunity for cases to increase.
I read a report on October 28 that “Delaware, Otsego, Schoharie see virus deaths.” It pointed out that the unvaccinated were more likely to require hospitalization and spread the infection. In the prior week there had been 5 deaths across the three counties. There were several hundred active cases. Of course, this cannot begin to find those people who have active COVID but were minimally or not at all symptomatic but can still spread the disease. Statewide the day before there were 35 deaths and 4,284 new cases. Granted, compared to what we experienced before, this is a major improvement but I think our perspectives are warped by how horrific things had been previously, especially at the beginning of the pandemic, in the United States. Nevertheless, it is 35 mostly unnecessary deaths and 4,200 people who are at risk of developing Long COVID symptoms.
The concept of Long COVID has become a hot topic, especially since people are finally becoming aware that having COVID–19 is not just an acute respiratory syndrome that may or may not lead up to death but a very complicated potentially lifelong debilitating disease process. While there is a general agreement on what Long COVID is, there is no uniform definition internationally and it is not clear that some long-term post COVID complications such as Multisystem Inflammatory Syndrome in Children (MIS-C) should be classed as Long COVID or in a separate category. At this time, it is really a matter of semantics. The term Long COVID is probably a patient created term first cited in May 2020. Other names for this syndrome include post-COVID-19 syndrome, post-acute sequelae of COVID-19 (PASC), and chronic COVID syndrome.
It appears the summer surge of COVID-19 in the United States is abating.
Numbers are going down except in the hardest hit states. The average number of deaths last week was approximately 1,800 per day and the number of daily infections is about 100,000. These seem to be trending down but if they flare up again and represent averages over the long-term we are talking about 675,000 deaths per year. By comparison, in the United States, the flu kills somewhere between 10,000 and 50,000 people a year. If the flu pandemic of 1918 is any guideline, we should expect further surges with the number and severity of the surges dying out eventually.
Last week, Merck and Company announced that an experimental pill they are working on to treat COVID-19 early in the course of the disease to keep patients from becoming seriously ill or dying is proving safe and effective. After discussion with the FDA, it and Merck felt the results were so good they decided to close additional enrollment to the trial. They will finish out the study in approximately November and then present the results and ask for approval for emergency authorization. Production of the pills has already started so as to be ready for rapid distribution when approved.
This is the first easy-to-use treatment specifically for COVID. It is a pill that when taken as prescribed early in the course of symptoms will decrease the risk of hospitalization and death by about 50%.
The drug is called malnupiravir. It is in oral form and easily taken at home. It must be started within five days of the onset of symptoms. This makes it important for people who have symptoms consistent with COVID-19 to get tested immediately (there is now a national backlog of testing, slowing down availability of results) and see their doctor at the onset. Treatment is eight pills daily for five days. This is very much like oral medication people use at early onset of influenza.