Bolsonaro and Lula are heading to second round in Brazil election     Zelensky hails advances as open recriminations intensify in Russian media      Ukraine live briefing: U.S., U.K. say Russia’s retreat from Lyman ‘significant,’ hurts its ability to resupply troops     Bolsonaro and Lula are heading to second round in Brazil election     Zelensky hails advances as open recriminations intensify in Russian media      Ukraine live briefing: U.S., U.K. say Russia’s retreat from Lyman ‘significant,’ hurts its ability to resupply troops     Iran’s release of Iranian-American not conditioned on asset unfreezing, U.S. says.      Tear gas use by Indonesian police questioned in wake of mass fatality soccer tragedy     What’s behind the protests in Iran?     Bolsonaro and Lula are heading to second round in Brazil election     Zelensky hails advances as open recriminations intensify in Russian media      Ukraine live briefing: U.S., U.K. say Russia’s retreat from Lyman ‘significant,’ hurts its ability to resupply troops     Bolsonaro and Lula are heading to second round in Brazil election     Zelensky hails advances as open recriminations intensify in Russian media      Ukraine live briefing: U.S., U.K. say Russia’s retreat from Lyman ‘significant,’ hurts its ability to resupply troops     Iran’s release of Iranian-American not conditioned on asset unfreezing, U.S. says.      Tear gas use by Indonesian police questioned in wake of mass fatality soccer tragedy     What’s behind the protests in Iran?     
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News of Otsego County

vaccination

Weekly Medical Briefsl 09-29-22

Weekly Medical Briefs

September 29, 2022

Multiple Shots in One Arm?
Picking whether to give both shots in the same arm or separate arms seems to be a matter of debate and speculation rather than hard science when giving more than one vaccine at the same time. Some, including the White House, advocate giving both shots in one arm spaced at least one inch apart while others advocate using different arms for each.
Many pediatricians, who often have to administer four or five shots to a baby at once, are habitual splitters. “If there’s more than one vaccine syringe to give to a baby, generally, two legs are used,” “If there’s a local reaction to the vaccine, you can identify which vaccine it was if you separate them by space.” (The author of the article had a more painful reaction in her left arm, where she received the COVID shot. Others have reported the same disparity.)

The Atlantic

Weekly Medical Briefs: 09-22-22

Weekly Medical Briefs

September 22, 2022

U.S. Embarks on Latest COVID-19 Vaccination Campaign as New Bivalent Boosters Roll Out
“With a jumble of confusion, eagerness and vaccine fatigue, America embarked in earnest last week on a sprawling new campaign to get Omicron-specific boosters into the arms of a pandemic-weary country.” Millions of doses of bivalent boosters “arrived with little ceremony at pharmacies, nursing homes and clinics across the country, ready to be administered in what health officials now expect to become a yearly inoculation ritual akin to a flu shot.” Early data “from states and several cities showed what health officials described as a robust early response in a moment when vaccine rates have stagnated.”

The New York Times 9/18

COVID-19 Linked to Increased Alzheimer’s Risk
COVID-19 has been linked to a significantly increased risk for new-onset Alzheimer’s disease (AD) a new study suggests.
The study of more than 6 million people aged 65 years or older found a 50% – 80% risk for AD in the year after COVID-19. The risk was especially high for women older than 85 years.
However, the investigators were quick to point out that the observational retrospective study offers no evidence that COVID-19 causes AD. There could be a viral etiology at play, or the connection could be related to inflammation in neural tissue from the SARS-CoV-2 infection. Or it could simply be that exposure to the healthcare system for COVID increased the odds of detection of existing undiagnosed AD.

Journal of Alzheimer’s Disease 9/13

STERNBERG: Polio, Part II
Column by Dr. Richard Sternberg

Polio, Part II

Three weeks ago, this column covered the topic of polio, its cause, symptoms, complications, treatment, and prevention. Polio continues to be in the news, especially in New York, because there are indications that it is spreading geographically. Polio virus has been found in wastewater in Nassau County, Long Island.

Last Friday, Governor Kathy Hochul declared a state of emergency because of the increasing number of positive tests and the apparent spread outward from the initial location. The order is to better enable health care providers to fight the disease and prevent further outbreaks of paralysis.

Among other things it will require providers to send vaccination data to the state Department of Health to better track the total numbers around the state in order to direct the greatest efforts in those areas. The order also allows expanded authorization of who can administer the vaccine. During the emergency, midwives, pharmacists, and other licensed paraprofessionals can vaccinate.

STERNBERG: New COVID Vaccine Offers Broader Protection
Column by Dr. Richard Sternberg

New COVID Vaccine
Offers Broader Protection

On Wednesday August 31 the FDA authorized, for emergency use, two new, bivalent, COVID vaccines. Bivalent means that each shot contains two variants of the vaccine. The following day the CDC Advisory Committee on Immunization Practices’ (ACIP) recommended the use of those vaccines and the same day, CDC Director Rochelle P. Walensky, M.D., M.P.H., endorsed the committee’s recommendations for use of updated COVID-19 boosters from Pfizer-BioNTech for people ages 12 years and older, and from Moderna for people ages 18 years and older. Updated COVID-19 boosters add Omicron BA.4 and BA.5 spike protein components to the current vaccine composition, helping to restore protection that has waned since previous vaccination by targeting variants that are more transmissible and able to avoid immune responses.

Currently about 89% of circulating virus in the United States is Omicron BA.5 and almost all the rest is BA.4 and BA.4.6. Both vaccines are RNA types, that is it gets the body’s cells to manufacture antibodies to the COVID virus spike protein but do not affect the body’s cell’s DNA. The virus itself does not make up these vaccines unlike the case with polio, which is either dead virus or live-attenuated virus (see this column’s article of September 24.)

Weekly Medical News: 09-08-22

Weekly Medical News

September 8, 2022

General

The CDC reminds us that, a Newsroutine annual influenza vaccination is recommended for all persons aged 6 months and older who do not have contraindications. For each recipient, a licensed and age-appropriate vaccine should be used. With the exception of vaccination for adults aged 65 years and older, Advisory Committee on Immunization Practices (ACIP) makes no preferential recommendation for a specific vaccine when more than one licensed, recommended, and age-appropriate vaccine is available. All seasonal influenza vaccines expected to be available in the United States for the 2022–23 season are quadrivalent, that is contain vaccine for four different strains of flu. COVID and flu vaccines can be delivered concurrently

—Morbidity and Mortality Weekly Report of the CDC

Sternberg: New COVID Recommendations from CDC
Column by Dr. Richard Sternberg

New COVID Recommendations from CDC

Vaccines and infection induced immunity and the availability of effective treatment and prevention methods have decreased the risk of symptomatic COVID infection, hospitalizations, and deaths. Therefore, On August 11 the Center for Disease Control issued a new set of guidelines for minimizing the impact of COVID on people, communities, and health care providers. This takes into account the psychological and economic effects of the various actions. It allows considerably more freedom than the previous guidelines.

Below is a summarization of the recommendations but I strongly recommend reviewing the original article in MMWR, Morbidity and Mortality Weekly Review, which is published weekly by the CDC, online. The August 11, 2020 edition has the article. You can go to www.cdc.gov/mmwr to find it. The article besides containing the information in more detail contains a table that lists actions to minimize impact based on effects on different persons, communities, and health care system and a figure which lists recommendation for isolation, masking, testing, and other precautions for people who are ill with COVID symptoms and/or have tested positive. I think the figure and article may be easier to understand then in narrative form.

STERNBERG: Monkeypox Vaccines

Column by Dr. Richard Sternberg

Monkeypox Vaccines

There are several things to remember about the current monkeypox outbreak for those of us in Otsego County.

According to the county health department website on Monday, there are no cases identified locally. Vaccine for monkeypox is not available locally. After checking the New York State Department of Health website (www.health.ny.gov) it appears that the closest location for vaccine is Albany County. I would suggest if you qualify for the vaccine and want to receive it, you or your health care provider can contact the Albany County Department of Health or the state. You can find criteria for eligibility at www.cdc.gov.

STERNBERG: COVID – Here we go again

Column by Richard Sternberg, M.D.

COVID: Here we go again

There are 3006 counties, 14 boroughs, 11 census areas, 64 parishes, and multiple independent cities in the United States. The good news is that The Center for Disease Control reports that only 79 of these have a high incidence of COVID transmission.

The bad news is that of the 79, 36 or almost half are in or surround Central New York. Risk in Otsego County is only moderate, but it is contiguous to high-risk areas.

On Friday of last week, Otsego County reported 47 new COVID cases. This represents approximately a four-to-five-fold increase from one month ago. Testing positivity is up to 8.8%. What are we doing wrong?

On the relatively good side, there have been only 16 deaths year-to-date in Otsego County attributed to COVID. Case rate is increasing, but it does not appear that the death rate is increasing, at least not significantly.

In the past week alone, the person whom I went to visit on Saturday wouldn’t let me in his house because his wife tested positive that morning. The visit devolved into a shouting conversation from about 60 feet apart.

Fully vaccinated Governor Hochul tests positive for Covid-19

Fully vaccinated Governor
Hochul tests positive for Covid-19

After testing positive for Covid, Governor Hochul issued the following statement over the weekend: “Today I tested positive for COVID-19. Thankfully, I’m vaccinated and boosted, and I’m asymptomatic. I’ll be isolating and working remotely this week. A reminder to all New Yorkers: get vaccinated and boosted, get tested, and stay home if you don’t feel well.”

Out of My Shell

Column by Dr. Richard Sternberg

Out of My Shell

Last week, I took a major step for myself and poked my head out of my shell. I decided that the situation with COVID is really not going to get much better. It is going to be endemic like the flu or the common cold and we’re going to have to deal with it. It’s time to get life back to as normal as possible.

I decided to take a trip to New York City, specifically Manhattan. There were several things that I wanted to do, and I haven’t been able to do for over two years. My personal schedule gave me a small window of opportunity to make the trip. I was also interested to see the response in the city to the continued presence of COVID and increase in lab-positive cases.

I went to a museum and I went to a Broadway show off Times Square. I also had a report from a friend of the crowd reaction at New York Rangers hockey game.

One day I went to the Metropolitan Museum of Art specifically to see a special event, a major retrospective of the works of Winslow Homer. By the way, if you have any interest in American art, you must get down to see this exhibit. It is worth the trip. These major retrospectives of Homer occur only approximately once every 25 years. This one is every bit as spectacular as the last one was in the mid-90s.

Film Days to go virtual again

Film Days to go virtual again

STAFF REPORT • Special to www.AllOTSEGO.com

Glimmerglass Film Days, a program of Otsego 2000, will present a virtual film festival, plus five in-person events Nov. 4 to 11.

Curated by Artistic Director Margaret Parsons and Programmer Joey Katz, the slate of independent documentaries and narrative features and shorts reflects the theme “Rise.”

Rise” is a word of elastic meanings, and we were first inspired by the term at the start of 2021, hearing Amanda Gorman’s use of it in her poem, ‘The Hill We Climb,’” said Parsons. “The films in this year’s program all reflect some note of ‘rising up,’ but these notes also are beautifully whimsical.”

Based on a survey, Otsego 2000 decided to hold the full festival online for the second year in a row. However, there will be five films shown at the Grandstand Theater at the National Baseball Hall of Fame and at Templeton Hall in Cooperstown. The five films also will be online.

The theme ‘Rise’ captures this duality, as it serves as a beacon of hope and new beginnings but also a word of warning in terms of sea levels and global temperatures,” said Ellen Pope, executive director of Otsego 2000. The films include selections from 15 different countries as well as works by indigenous filmmakers.

A Glimmerglass Pass costs $75 and provides online access to 26 feature-length films and two shorts programs, plus online filmmaker talks. All films will be able to be viewed beginning at 7 p.m., Nov. 4. Tickets to individual online films are $5. Both the Glimmerglass Pass and online film tickets are good for a household.

Tickets to the in-person screenings are $10 per person and not included with the Glimmerglass Pass. To attend in-person events, proof of vaccination (NY Excelsior Pass or CDC vaccination card) and photo ID are required. Face masks will be required while watching films.

Passes, tickets, descriptions of each film, and trailers are available at glimmerglassfilmdays.org.

Opinion by Richard Sternberg M.D.: There is good news to report on COVID prevention

Opinion by Richard Sternberg M.D.
There is good news to report on COVID prevention

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.

RUDY: State should mndate vaccinations for its employees

LETTER from JOHN A. RUDY

State should mandate
vaccinations for its employees

The unions representing New York state troopers and public school teachers oppose a mandatory vaccination requirement for their members. At the same time, more and more private employers are requiring vaccination by their employees as a condition of continued employment.

Conservatives regularly argue that government should emulate the private sector in its employment practices. A vaccination mandate is a good place to start.

For those state troopers and teachers who choose not to be vaccinated and thereby to ignore the risk they pose to us taxpayers and children with whom they come in contact, I suggest that they have at least two other choices:

1) find another line of work;

2) move to Florida or Texas.

John A. Rudy
Cooperstown

STERNBERG: Here we go again with the coronavirus pandemic

Life in the Time of Covid-19

Here we go again with
the coronavirus pandemic

erna
Richard Sternberg, retired Bassett Hospital orthopedic surgeon, is providing his professional perspective weekly during the COVID-19
threat. A village trustee,
he resides in Cooperstown.

Several months ago, I stopped writing my weekly column on life in the time of Covid-19. The rollout of the vaccinations was going well locally, the numbers of people hospitalized locally were low, and organizations were opening up. The Rotary Club that I belong to in Cooperstown was making plans to go back to meetings in person.

I was also recovering from major surgery and it was difficult physically to put together the columns.

I thought for the most part my job was done. Now, here we go again.

In many places in the United States the numbers of the sick and dying from Covid-19 are rapidly increasing in areas where there is a low percentage of vaccinated individuals. It also correlates with places that opened in an unrestricted fashion. Many first-line healthcare workers are completely burned out and can’t begin to understand how people who could have avoided this very deadly and debilitating disease refused to do so and even refused to acknowledge that in many cases it was real. What is particularly disturbing is seeing patients begging to be vaccinated as they are being rolled into intensive care units.

Yes, there is a risk of complications from vaccination. There is a risk of complications from everything we do or food we eat or medicine we take. Riding in a car is a risk.

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