COVID-19 | R-Health

What We Know About the Delta Variant

July 29, 2021/0 Comments/in Patients /by Randy Robinson

Just as things were starting to open up, a new strain of COVID-19—the Delta variant—is causing concern as cases are once again rising in certain sections of the U.S.

Since we have been receiving a lot of questions about the Delta variant, here’s what we know:

This new Delta variant is highly contagious – about twice as transmissible as the original virus.
Nationally right now, about 97% of patients hospitalized with COVID-19 and 99% of COVID-19 deaths are among the unvaccinated.
While it is true that you can still contract the Delta variant of COVID-19 if you are fully vaccinated, people are typically asymptomatic or experience mild symptoms.
While the Delta variant is the latest, there are more unknown variants that could still make an appearance. To continue getting back to “normal,” we need a much more significant portion of the population vaccinated and we all need to do our part to ensure that happens.

It is also important to remember that all COVID-19 vaccines available in the U.S. have been rigorously tested to ensure safety. Our clinical teams have also spent a significant amount of time evaluating the safety of the vaccines so that we can do our best to help our patients better understand the safety and effectiveness of the vaccines.

If you have questions on COVID-19, any new variants, or the COVID-19 vaccines, please reach out to your R-Health doctor. We are here to help.

CDC GUIDELINES ON FULLY VACCINATED INDIVIDUALS

July 1, 2021/0 Comments/in Patients /by Annie Arbizo

Now that you are fully vaccinated you may be wondering “now what?” The CDC has come out with recommendations that can help when making decisions about daily activities after you are fully vaccinated. Below is a comprehensive breakdown on what fully vaccinated people can start doing and what they should continue to do.

If you’ve been fully vaccinated, 2 weeks after your second dose of COVID-19 vaccine, you can resume activities that you did prior to the pandemic. This means:

Resume activities without wearing a mask or staying 6 feet apart, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance
If you travel in the U.S., you do not need to get tested or self-quarantine
If you’ve been around someone who has COVID-19, you do not need to stay away from others or get tested unless you have symptoms

However, there are still some things that you should continue to do even when fully vaccinated.

You will still need to follow guidance at your workplace and local businesses
You are still required to wear a mask in a healthcare setting
Masks are required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the U.S.
People who have a condition or are taking medications that weaken the immune system, should talk to their healthcare provider to discuss their activities. They may need to keep taking all precautions to prevent COVID-19.

Because things are everchanging, please refer to the CDC website for the most current up-to-date information.

The Different COVID-19 Vaccines

January 19, 2021/0 Comments/in Patients /by Randy Robinson

As of today, January 12, 2021, there are currently two vaccines that have received FDA approval. These are both mRNA vaccines including:

According to the CDC, mRNA vaccines teach our cells how to make a protein – or even just a piece of a protein – that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.

There are also three additional vaccines in Phase 3 of clinical development in the US, including:

AstraZeneca’s COVID-19 vaccine
Janssen’s COVID-19 vaccine
Novavax’s COVID-19 vaccine

COVID-19 VACCINE FACTS & MYTHS

January 19, 2021/0 Comments/in Patients /by Randy Robinson

Will I test positive for the COVID-19 virus if I have had the vaccine?

No, you will test positive for the antibodies, but not for the virus.

Will the vaccine make me sick with COVID-19?

No, none of the approved vaccines contain the live virus, which means that getting vaccinated will not cause you to get sick with COVID-19.

Can I expect any side effects after I get the shot?

Yes, you may experience some minor symptoms. Most likely your arm will be sore for about a day. There may be other flu-like symptoms that will respond to Tylenol or Advil. These manageable symptoms are very limited in duration, a day or so at most.

Is there a chance there may be side effects and adverse effects that we don’t know about for the future?

None of the current science to date points to any actual long term adverse effect that support various hypothetical theories.

If I have a lot of allergic reactions should I get the vaccine?

Yes, but possibly with a little more observation. Discuss with your doctor.

Can I stop worrying about COVID-19 precautions if I get both doses of the vaccine?

Not yet. While you will most likely have protection from becoming ill, you may still be able to transmit the virus to other people who are not protected.

How long do the COVID-19 vaccines last? Do I need one every year like the flu shot?

Unfortunately, we do not know yet. It is anticipated that the immunity will last longer than immunity developed from the infection itself. We have reason to suspect one to two years of protection and reinfection even after antibodies from the vaccine wane will most likely not be as potentially dangerous even after that.

How will I know when it is my turn to get a COVID-19 vaccine?

Unfortunately, the criteria are different at every state and even at the county-level. Check your state’s Department of Health website or with your R-Health physician to keep you updated with this information.

Do I really need to get both shots?

Yes, you do. The longer lasting immunity is based on the multiple exposures to the vaccine. There are vaccines in very late-stage development which are a single shot, however there is nothing to support single shot vaccination with the two mRNA vaccines that are currently available.

Can’t I just let the COVID-19 virus run its course and get natural immunity?

No, this is a myth. Strong immunity from a vaccination is better than natural immunity. Even if you have had the virus, you should still get vaccinated to protect yourself and those around you.

Weren’t these vaccines rushed in their development?

No. The safety and approval process for the COVID-19 vaccines is the same as any other new immunization or medication. Normally it does take years to develop and test a new vaccine, but in this case the pharmaceutical companies had a head start because scientists have been working on coronavirus vaccines for years for other variations of the coronavirus including SARS and MERS. It is also important to note that no clinical steps were skipped but there were modifications to the process including overlapping phases of the clinical trials and moving into production while the companies were awaiting final approval.

Is it true that the mRNA vaccines can change my DNA?

No, this is not true. The messenger RNA, or mRNA, does not affect your DNA. It instructs your body to build the coronavirus’ spike protein, which then teaches your body to produce antibodies to combat the coronavirus when it encounters it later.

Will it be my choice about which vaccine to take? How is one to know which of the vaccines available that they should take?

At this point in time, there is no way to declare a preference as to which vaccine to get. More importantly, there is no known reason to choose one vaccine over another.

Is the vaccine safe for everyone? Are there some people who shouldn’t get it?

The vaccine is recommended for the frail elderly, immunocompromised, pregnant and nursing women, and people who are recovered from COVID-19. If you have an allergy to current vaccines, the CDC recommends that you stay for 30 minutes of observation after your vaccination. Currently, the only group recommended to not take the vaccine are persons with known allergy to one of the components in the vaccine.
Currently, the vaccine from Pfizer is recommended for children 16 years and older while the Moderna vaccine is recommended for people who are 18 years and older. This has more to do with how the vaccines were studied rather than any inherent difference in how the vaccines would work.

Can I get other vaccines at the same time as getting the COVID-19 vaccine?

Just to be cautious, it is recommended that you leave two weeks on either side of the COVID-19 vaccination. But, if you require a tetanus shot or are part of a measles or hepatitis outbreak, co-administering the vaccines is expected and appropriate.

What happens if a lot of people opt out of taking the vaccine?

COVID-19 will continue to overburden our healthcare system and take much longer to end the pandemic. In addition, many needless deaths and illness will occur.

Why should I wait to schedule a screening mammography after the second dose?

The COVID-19 vaccine may cause normal and temporary lymph node enlargement in the axilla (armpit), causing difficult interpretation in mammogram imaging. If you are due for a screening mammography, the Society of Breast Imaging has issued guidelines recommending scheduling 6 weeks after the second COVID-19 dose.

Do I have to quarantine after traveling if I’ve been fully vaccinated?

In accordance with the CDC guidelines, it is recommended that if a person has waited 2 weeks until after their vaccination has completed AND begun travel after that time, no quarantine is needed. However, please inquire with your employers as they may make other recommendations with regards to travel. Please note that state requirements may vary.

Last updated 2/19/21.

COVID-19 TESTING—WHAT KIND OF TEST MAY BE RIGHT FOR YOU?

December 9, 2020/0 Comments/in Patients /by Randy Robinson

Since March 2020, COVID-19 testing has been evolving. Many people still have questions on tests, including what kind of test may be right for you?

Currently there are two kinds of diagnostic tests for COVID-19: PCR and antigen (rapid). The ideal time for any COVID-19 diagnostic test is 5-7 days after possible exposure, or shortly after symptoms develop. There is also one that looks for a past infection called an antibody test.

PCR test

The PCR test is often considered the “gold standard” test.

PCR tests use a nasopharyngeal swab goes deep into your nose or to the back of your throat. Results may take 2 to 3 days or longer to come back.
Sometimes it is too sensitive. If you are asymptomatic and you test positive with a PCR test, it may represent an infection that you had even as far back as two months ago. However, we need to act on it as if you were currently infected.

Antigen or rapid test

While this test may take only 10 to 20 minutes to analyze, due to backlogs and testing delays, it may take up to a day to come back.
This test is less sensitive than a PCR test which means if the probability is high that you have COVID-19 but test negative with an antigen test, you may be recommended to follow up with a PCR test anyway.
One benefit of an antigen test is that if you are positive with an antigen test, you are most likely currently infectious.
The main drawback of the antigen test is that if you test a little too early or a little too late, you may miss an active infection.

Antibody tests

Antibody tests are blood tests that look for past infection and present antibodies conferring protection against repeated exposure to COVID-19. It is best to wait several weeks after an infection before testing for antibodies. However, antibody tests are not routinely recommended at this time since:

Having antibodies does not necessarily mean that a person is immune. For example, a person may have been exposed to seasonal varieties of coronavirus (which circulate yearly in the United States and cause mild cold symptoms) which could possibly cause a false positive COVID-19 antibody test.
Antibodies are sometimes not at a level high enough to be detected on the blood test, even when you have had COVID-19.

If you still have questions on COVID-19 testing, do not hesitate to reach out to us.

A GUIDE TO ENJOYING SUMMER ‘SAFELY’

July 7, 2020/0 Comments/in Patients, R-Health /by Morgan Feeley

As we begin to slowly open and some restrictions start to lift, it is hard to know what ‘safe’ vs ‘unsafe’ encounters look like. While prevalence continues to play an important role in our local communities, it’s hard to quantify what that translates to as most want to do the small things like hug family and friends, get our haircut, have a pool party, visit the nail salon, or gather at local bars and restaurants.

We know the urge to get out and enjoy summer is real. That’s why social distancing is more important than ever to keeping you and the ones around you safe.

What is considered ‘safe’?

Backyard gatherings. With a small group, getting together outside in a spacious area isn’t too risky depending on who you invite and their status or symptoms. To lower your risk, avoid sharing food, drinks, plates or utensils.
Spending the day at the beach or pool. Watch how close you are to others. As long as you can stay 6 feet apart and gather in a small group, this could be a pretty safe activity.
Hugging family and friends. You have to use your best judgment—there isn’t a one-size-fits-all. Before you give a hug, know how the other person has been following the social distancing rules. To be extra cautious, avoid the long, lingering hug and the kiss on the cheek or lips.
Using a public restroom. This could be a pretty scary thought, but most restrooms were designed to avoid the spread of germs. Be sure to avoid waiting in a line to use the bathroom and wash your hands after.
Going to a vacation house with another family. Again, you will need to use your best judgement here. If both families have been quarantining and limiting their exposure to others, your risk of getting infected is limited. Don’t be afraid to ask.

What is considered ‘unsafe’?

Eating indoors at a restaurant. Because people tend to linger more, you’re in the restaurant longer and the risk of being exposed to the virus is greater. Especially since you don’t know who you’re dinning next to you and their symptoms. If you do go to a restaurant, look for outdoor seating.
Attending a place of worship indoors. Worship services tend to bring together those from different households, which could increase the risk of people becoming infected in a short amount of time.
Getting a haircut or nails done. These are some of the highest risk scenarios as there’s no way to keep 6 feet from the person performing the service and breathing on one another is extended for several minutes.
Gathering at a bar or nightclub. When most drink, they become less likely to follow the social distancing rules. While there, you are then exposed to crowds, singing, sweating and the risk of sharing drinkware with others who may be infected.

The key to enjoying your summer while minimizing your risk of getting sick is remembering to social distance, wear a face covering, and wash your hands. When possible, always opt for outdoor activities over indoor ones. We hope that knowing what the risks are for specific activities helps you to make the right individual decisions you need to in order to have peace of mind as well as stay safe summer.

ADDRESSING MISCONCEPTIONS ABOUT COVID-19

April 7, 2020/0 Comments/in R-Health /by Morgan Feeley

Q: Can people of any race or ethnicity get sick from coronavirus disease 2019 (COVID-19)?
Yes. COVID-19 cases have now been recorded in over 170 countries^1,2.

Q: Are older adults and those with underlying medical conditions or a suppressed immune system the only ones at risk of contracting COVID-19?

No. Older adults and individuals who are immunocompromised and/or have underlying medical conditions are at higher risk for more serious complications from COVID-19 infection, however, it is possible for people of any age group or health status to become infected with the virus. Although it is far rarer, there have been confirmed reports of healthy teenagers and young adults who have died from COVID-19, and several cases of infants who have been infected^3,4. So the danger is that a young person can become infected and either have no symptoms or only mild symptoms and then pass the virus on to someone in a higher risk category. This is why it is so vital that everyone practice social distancing and proper hand hygiene, not only those who are at high risk or who have symptoms.

Q: Is there a proven cure for COVID-19?
No. There are currently no medications that have been proven effective against COVID-19. There is currently a clinical trial in progress and several others that are planning to begin enrolling soon to evaluate whether an antimalarial medication called hydroxychloroquine may be effective in treating the virus⁵.

Q: Are there any home remedies to prevent or treat COVID-19 infection?
No. There are currently no proven home remedies to prevent or treat COVID-19. Although vitamin C, vitamin D, and zinc, among other nutritional supplements, may help to support your immune system, there is no evidence showing that they protect you against COVID-19. Chemical cleaning products are effective at killing the virus on surfaces. However, ingesting or applying cleaning products to the body does not kill the virus and is extremely dangerous/deadly⁶.

Q: If someone has been infected with COVID-19 and fully recovers, are they immune to the disease or is it possible to be re-infected?
According to Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, although we don’t know with 100% certainty that you will be immune to COVID-19 after recovering from the infection, it is highly likely this is the case, given that this is how all other viruses which have been studied are known to work⁷.

Q: Should I wear a mask and gloves in public and disinfect any packages/mail I receive or items I buy from the store?
The best way to protect yourself from COVID-19 is to wash your hands (for 20 seconds) frequently, avoid shaking hands with others, maintain a 6-foot distance from all others, and avoid touching your face. Medical masks cannot prevent COVID-19 when used alone or improperly⁸. They must be combined with proper hand hygiene. Please check out the video (cited below) for further details. Regarding packages and mail, although the virus may be able to survive for a short period of time on these surfaces, that is not the main method of transmission⁷. The most important way to prevent infection is to continue practicing proper hand hygiene and social distancing.

References:

TIPS ON PREVENTING COVID-19

April 6, 2020/0 Comments/in R-Health /by Annie Arbizo

There is currently no vaccine or medicine to prevent or treat Coronavirus (COVID-19.) While there are some trials underway, the best way to prevent illness and the spread of the virus is to avoid being exposed to the virus. First, it is important to understand how the virus spreads. It is spread mainly from person-to-person contact meaning, close contact with an infected person (about 6 feet) and through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly inhaled into the lungs. The virus can also land and live on surfaces, which can be passed on by if you touch your face after touching the infected surface. Below are guidelines recommended by the CDC on the best ways to prevent the virus.

Wash Your Hands Often

Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing
If soap and water are not readily available, use hand sanitizer that contains at least 60% of alcohol
Avoid touching your eyes, nose, and mouth with unwashed hands

Avoid Close Contact

Avoid close contact with people who are sick
Put distance between yourself and other people if COVD-19 is spreading in your community (at least 6 feet)

Stay Home if You’re Sick

Stay home if you are sick, except to get medical care and please call your healthcare provider first before going to the office

Cover Coughs and Sneezes

Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow and throw the used tissue in the trash
Immediately wash your hands with soap and water for 20 seconds after

Clean and Disinfect

Clean and disinfected frequently touch surfaces daily, like tables, doorknobs, light switches, faucets, toilets, phones, and keyboards

DIY Hand Sanitizer

Can’t find any hand sanitizer at the store? Here is a simple DIY hand sanitizer with only 2 ingredients.

Ingredients:

Isopropyl alcohol
Aloe Vera gel

Ratios:

For 99-91% Isopropyl, use 2 parts Isopropyl to 1 part Aloe Vera
For 70% Isopropyl, use 8.5 parts to 1.5 parts Aloe Vera

MENTAL HEALTH & COVID-19

April 6, 2020/0 Comments/in R-Health /by Annie Arbizo

As news about the COVID-19 outbreak continues to dominate almost every aspect of our lives, it is essential that we pay attention to our mental health just as we do our physical health.

There are many reasons that people may be feeling stressed and anxious whether it be due to loss of a loved one, fear of getting sick, loss of income/fear of loss of job, social distance and self-isolation, or a combination of all of these. The COVID-19 pandemic is a stressful situation, especially for those who are already living with a behavioral health issues. Below are some tips to help cope with stress and anxiety during these challenging times.

Limit news consumption and social media intake

24-hour news and constant social media updates can induce stress, anxiety, and feelings of worry. Try to limit yourself to 10 minutes a day to stay informed, and try to check only reliable resources, like the Center for Disease Control and Prevention (CDC), the World Health Organization (WHO), and your local/state government websites.

Create and follow a daily routine

Sticking to a routine can help bring a sense of normalcy back into your life. Try waking up and going to bed at the same time every day, having regularly scheduled meals, getting dressed for the day, and stick to your regular working hours if possible. Also try adding something new into your routine, like a daily workout or calling a friend.

Stay virtually connected with others

Video calls with friends and family can help beat isolation. Set up a scheduled time to have a virtual coffee or lunch date with a friend, start a book club and discuss weekly over video calls, call a friend or family member you haven’t talked to in a while and reconnect. There are many ways to stay connected to your loved ones even when you can’t see them physically.

Maintain a healthy lifestyle

Try to eat healthy, well-balanced meals, drink plenty of water, exercise at least 30 minutes a day, and take a walk outside. It is mood-boosting to be in nature and get some sunshine, but please remember to try and keep at least 6 feet apart when enjoying the spring weather.

Communicate feelings of stress, anxiety, and worry

This is a difficult time for everyone and sharing how you are feeling with family and friends may help you and them cope by talking about fears, worries, etc. and the ways you are trying to deal with your emotions. If you have children, be sure to communicate with them as well. Be as open and honest as possible in an age-appropriate way and give them the space to process feelings, especially if they have fears or anxiety.

Meditation and Yoga can help keep your stress levels down. Here are some resources if you are new and looking for a place to start:

- Yoga
  - Cosmic Kids Yoga (yoga for you and your kids)
    - Teaches mindfulness, yoga and relaxation in a fun way
    - https://www.youtube.com/user/CosmicKidsYoga
  - Yoga with Adriene on You Tube
    - https://www.youtube.com/user/yogawithadriene
- Meditation (Guided or Self)
  - InSight Timer
    - Guided meditation
    - Free app that can help with sleep, anxiety and stress
    - Also with a section for Kids
    - https://insighttimer.com/

MAINTAINING PHYSICAL HEALTH DURING COVID-19

April 6, 2020/0 Comments/in R-Health /by Annie Arbizo

Our physical health has a great affect on how we feel mentally. Even though social distancing guidelines are making daily life complicated, the good news is that there are plenty of ways to maintain good physical health and staying active while we are adjusting to this new way of life for the time being. If exercise and healthy eating wasn’t part your previous daily routine, now is a great time to start. Here are some tips on how to stay healthy while practicing social distancing during the COVID-19 outbreak.

Nutrition

It’s essential to maintain a healthy and balanced diet of fruits, vegetables, whole grains, and lean proteins all the time, but especially during the COVID-19 outbreak. Eating well is just as important for your physical and mental health as exercising and getting good sleep.

While it is good to have a robust supply of dry and canned goods, now is a great time to buy fresh produce too. You can cut up and freeze what you aren’t using and keep in the freezer for a few months. You can also do the same with fresh proteins as well and freeze immediately if not using that day.

Physical Activity

You may not be able to go to the gym, but there are plenty of options to stay active. It’s okay to walk, run, or bike outside as long as you are keeping a safe distance – ideally at least six feet- from other people. You can even play in your yard with your family to incorporate more physical activity in their daily routines as well.

If you don’t have great access to the outdoors, at-home workout options are great. If you already belong to a gym or attend fitness classes, check to see if they are providing any virtual classes or online workouts. There are a lot of great free resources available for home exercise programs like Daily Burn, Obe Fitness, and The Body Project that have different types of workouts you can choose from and do from home. Youtube also has many free videos that fit any type of at home workout, whether you are a beginner, interested in dance classes, body weight fitness, or workouts that require no equipment.

Sleep

Getting enough sleep is crucial for just about every aspect of your health, and understandably it might be harder to fall and stay asleep these days if you are experiencing stress and anxiety. Getting quality rest every night will help you feel energized and keep stress levels down during the day.

If you are experience sleep issues, yoga and meditation are great tools for managing stress and helping you calm down. Try InSight Timer, it is a free guided meditation app that can help with sleep, anxiety, and stress. Try to keep the blue light from phone and computer screens at a minimum and not use directly before you sleep.

Health Care

To limit exposure to the coronavirus, try to postpone or hold off on scheduling non-essential medical appointments, such as annual physicals and dental cleanings, and using telemedicine for pre-scheduled appointments that need to happen, other illnesses like the flu or strep throat, and for managing chronic conditions. If you have a pressing medical need, you can and should seek care, but please call your doctor’s office or hospital first before arriving, as they may have containment procedures in place now.

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