Winter 2023 Gave Us Less COVID-19..BUT Illness Still Lurks
Fortunately, our country did not experience the surges of COVID-19 illness during this past January that we had seen the two previous years. The peak daily average hospitalizations were 48,240 on January 6, 2023, vs peaks of 137,000 on January 14, 2021, and 159,510 on January 20, 2022. The community level of COVID-19 remains LOW in all counties abutting and including our Hamilton County except Dearborn County, IN. which is at a MEDIUM level. The absence of a winter surge in probably another indication that this SARS-CoV-2 virus is here to stay and is becoming endemic. This word means that the occurrence of the disease will be a regular feature in our communities. The WHO (World Health Organization) has professed that this virus will be a “permanently established pathogen”. The researchers who brought us the vaccines which prevented so many people from dying due to this novel virus, are using the technology and knowledge to develop the future vaccines that will likely be recommended on a yearly basis.
We are in a better place as it pertains to COVID-19 because of vaccines and the fact that so many people have been infected. The protection (immunity) resulting from a person getting a vaccination after having a COVID-19 infection is called “hybrid immunity”. A systematic review of multiple studies published in a United Kingdom medical journal called Lancet, reveals that hybrid immunity provided 97% protection, at twelve months, against hospital admission or severe disease as opposed to 75% after infection alone. Reinfection rates were 42% and 25% respectively in the two groups, respectively at twelve months.
Vaccination remains a critical piece of our ongoing fight against COVID-19. It’s easy to be confused about the “who and when” of vaccination, considering that vaccination availabilities, varieties, and authorizations have evolved over the last two plus years. In capsule, the current recommendation is that all age groups keep up to date with the appropriate vaccines. The updated (bivalent) booster is recommended for all people 5 years and older two months after they have completed the primary series. The bivalent booster is also recommended for children ages 6 months to 4 years who have completed the Moderna primary series, at least two months previously. There is currently no recommendation for boosting this age group if the primary series was the Pfizer vaccine. Specific recommendations can be obtained at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html.
The US government declared a national emergency because of this virus in March 2020 and a public health emergency in April 2020. President Biden has announced that both of these emergency declarations will end on May 11, 2023. Most of us are behaving as though the emergencies are over. There will be profound differences when May 11 rolls around. The widespread FREE COVID-19 tests, and treatments will no longer be universally available. The out-of-pocket-cost of these services will vary according to insurance coverage and on a state-to-state basis. Medicaid rolls are likely to shrink because the pandemic related additional Medicaid funding has already been eliminated beginning this past December. Vaccines are likely to be covered irrespective of the insurance plan but those Americans without ANY insurance will have new costs. Antiviral pills, like Paxlovid, may no longer be covered. Lastly, hospitals will no longer receive increased Medicare reimbursement for providing care for people stricken with COVID-19.
We are still experiencing five hundred deaths a day due to COVID-19. Some of these people might have been saved if Paxlovid had been used. Remember that this drug is to be taken orally by individuals, 12 years of age or older and weighing at least 88 lbs., “who have tested positive, have mild-to-moderate disease, and are at high risk for progression to severe COVID-19, including hospitalization or death”. The change in reimbursement for Paxlovid will likely be a significant impediment to its use, but currently physicians are just not prescribing the medication. White House data from the first two weeks of January, 2023 reveals that doctors only prescribed it in 45% of the recorded COVID-19 cases. This represents an under-estimate since many more cases are diagnosed by a self-test. Armed with knowledge of Paxlovid, a symptomatic person should contact their physician for this prescription which can save their life.
