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COVID-19 Update 6/23: Cases and Vaccine Updates

COVID-19

In this COVID-19 update, Dr. Bishop discusses the recent surge in COVID cases, the updated recommendations on vaccines for children, vaccines and boosters for adults, and more. Watch the video below and read on for the recap. 

Recent COVID Increase

Over the last few weeks, we've definitely had a surge in Omicron cases across Virginia and most of the U.S.

It looks like things have pretty much peaked or plateaued and are down-trending, at least in Virginia and surrounding areas. Our testing percent positivity has peaked around 17-18% and seems to be drifting back down, which is good.

Related to that, despite the increase in cases that we've seen, hospitalizations have remained pretty stable on the low side. We've got about 544 as a seven-day moving average of hospitalizations in Virginia, which is certainly up from where it was in the spring, but nowhere near where we were back in January. We were sitting over 3,000, almost 4,000 for seven-day running averages for hospitalizations.

Things are certainly better than they were in winter, but not as good as in the spring. I think what you're seeing is those same trends across the board in the United States.

Fatalities have remained stable and low. In Virginia, I think we're averaging a couple a day at most. Across the country, the seven-day moving average appears to be about 300, which is certainly well down from the peaks where we were having 2,000 to 3,000 a day as a seven-day moving average.

Certainly, things are better, and I think that speaks to:

  • More and more people getting vaccinated over time.
  • The newer variants of COVID seem to be milder, Omicron being the current one.
  • And we've got additional treatment options now that we didn't have, say, a year ago.

We've got Paxlovid, which seems to be an excellent treatment option for a lot of people. It's very easy to get for the most part around here, and we've had good success using that. That's FDA approved.

The monoclonal antibodies have been short ever since sotrovimab was taken off the market because it did not work for Omicron. There is an alternate, but it's really only recommended to be used if you can't use one of the other oral treatments that are available, because, again, they're easy to use. They're pretty safe and they are pretty accessible.

So, the virus seems to be milder, more people are getting vaccinated, and we have other treatment options. Overall, we've sort of tamed this, which is good.

I think that the stability you're seeing there is also reflective of the fact that, as many experts have said, we've transitioned into an endemic phase of the virus and it's never going to disappear completely, unfortunately.

Vaccines Approved for Kids

So let's talk about vaccines. I think the big update that everybody probably has seen on the web and in the news media lately is that CDC has approved and the FDA has approved updated vaccine recommendations for kids.

  • For those 6 to 17 years old, Pfizer is the only one approved as a two-dose primary series.
  • For kids five years old, you can either get a primary two-dose series with Pfizer or Moderna.
  • For kids six months to four years old, you can either get a two-dose Moderna primary series, or they recommend a three-dose Pfizer primary series for those kiddos.

There is a lot of data to unpack about vaccinating the kids. I think the best way to summarize this is:

  • I would encourage you to look through the data if you feel that you can do so and that you can digest it. It's certainly worth a look. There are some pretty good PowerPoint presentations that the CDC and FDA staff have put together that are pretty easy to understand. So I would look through some of these - CDC & FDA Presentations.
  • Read that, read the CDC website, and then I would have a really in-depth conversation with your child's physician about whether they should get vaccinated. And, if so, with which vaccine and when.

I think a couple of things to keep in mind are to remember that for children, for the vast majority of children, COVID remains a very minor illness. For those that it was not a minor illness, the majority of them tended to have significant underlying medical problems.

And so, if you have a child in that category, it's likely going to lead you more toward the area of definitely wanting to go ahead and get the vaccine.

If your kid doesn't meet those criteria, then maybe, again, have a more in-depth conversation with your pediatrician about the risks and benefits. Like all treatments, right?

These vaccines do have some risks. There are some potential side effects. In particular, for the younger boys, ages, say, 10 to 15, there is an increased risk of myocarditis with the vaccines.

And that's born out in some of the data that's presented by the FDA and is a well-recognized potential side effect. So just have a very frank conversation with your child's doctor about what the best thing to do for your kid is. Get personalized advice about what to do if you're unsure.

You can always follow the CDC's recommendations. And that is fine in general, but if you have questions, if you're just not sure, that's always the best thing to do. Talk with your child's doctor and get the information from them.

Express any concerns you have and get your questions answered before you move forward if you're just not sure what you want to do.

Again, if your child has an underlying chronic illness, that's probably going to lead you more toward wanting to go ahead and get the vaccination.

Again, lots of data there, lots to unpack. Unfortunately, can't do it all in this session here because there is just so much information. And I would encourage you guys all to look at it and to read the CDC website, their current recommendations, and decide what you want to do about vaccinating your kiddos at home.

Vaccines for Adults

For you adults out there, if any of you have not gotten your initial two vaccines, it's still not too late. Please, do it. Please, do it.

For adults, and especially older adults, say, 50 and up, it absolutely makes sense for you to do so.

Let's talk a little bit about boosters. I think definitely for adults 70 and up, you definitely want to strongly consider getting a booster dose if you haven't gotten one. And if you're eligible for a second booster, probably want to go ahead and do that sometime before the fall if you haven't done that already.

For slightly younger adults, or if you're on the healthier side, again, CDC does recommend up to two additional boosters after your first two doses of vaccine. I think that if you're in that younger category or slightly healthier, again, it's available for you, it's recommended to do.

If you're not sure if you want to do it, just have a one-on-one discussion with your doctor. And your doctor can help you make a personalized decision about timing and whether it's the right thing to do for you right now.

I know a lot of people have questions and they wanted to time their doses around when they're going to be traveling overseas or being in events where they're going to be around a lot of people. And I think that makes a lot of sense.

Again, if you have questions about that, talk with your personal doctor and let them help you make a good decision around the timing of booster doses if you're just not sure what you want to do with that.

Timeline for Decline of Current Cases

"We are plateaued. When will rates start declining again to reflect a low community spread? We are rated high at the moment."

Yeah, it's probably going to be a couple of weeks. That would be my guess. It looks like we have just plateaued and maybe just on the downslope. So my guess would be two to four weeks before we get back down to a lower rating. So a little bit more time on that, probably by end of July we'll be back in a more moderate transmission zone, if you will.

Waiting for Booster

"I am a teacher, so I was going to wait until closer to the start of school to get that second booster."

Yeah, and that strategy makes a lot of sense to me, in general. And that's kind of what a lot of folks that I've talked to, that's been their strategy, is to wait just a smidge.

If they're not super high-risk, or, again, in that 70+ crowd, they're saying, "I'm going to wait just a little bit until I'm a couple of weeks out from being either around lots of people or being in a high-risk situation where I do really want that protection."

Because remember, the boosters do only last a few months. If you can time it that way, that's probably the best thing to do. And, again, if you have particular questions or you're not sure, then just let your doctor know and they can help you figure out the timing on that.

But, in general, knowing nothing about your medical history, that makes a lot of good sense to do that strategy.

When is the next update?

Our next update will be on Wednesday, July 20 at 1:00 p.m.

About Steve E. Bishop, M.D.

As a board-certified internist and concierge doctor in Richmond, VA, Dr. Steven Bishop is passionate about helping his patients improve their lives through better health. He helps healthy adults adjust their lifestyles as they age and helps patients with complex medical diseases manage and improve their health.