The following link is a good resource to view a summary of current recommendations by the N.I.H. regarding the medical management and treatment of COVID.
https://www.covid19treatmentguidelines.nih.gov/management/clinical-management/
What do we know?
They prevent severe disease, hospitalizations and death in people infected with COVID and this is what matter most..
They help to some extent in preventing infection with COVID, but with the Omicron variants, less so.
With regard to mRNA vaccines (Pfizer & Moderna), 2 is better than 1 and 3 is better than 2. Will 4 be better than 3? The Israelis are giving a 4th dose to all adults. So far they have seen some increased immunity but not enough to prevent Omicron. Problems with these vaccines are that variants have already evaded the immunity provided and the immunity seems to fade with time.. However, the exact degree and duration of protection offered with the current 3 dose recommendation is not completely known. It seems likely that we will be getting a 4th dose at some time in the future. There is work being done on the development of more effective vaccines but the current vaccines are all that we have now.
The vaccines have been given to so many people over the past two years, that we know from this experience, that they are largely safe in the short and mid-term, comparable to other vaccines that are widely used.
Bottom Line
The current vaccines are very effect in preventing severe disease, hospitalizations and death in people infected with COVID.
Monoclonal Antibodies is a treatment offered to people with mild to moderate disease who are most at risk for progression to severe disease. It consists of a 4 hour intravenous infusion, and is usually given in a hospitals.
Currently there are several products available; Bamlanivimab, Casirivimab (Regeneron), and Sotovovimab (Galaxo product). Only the latter product appears to be effective with Omicron.
Those individual diagnosed with COVID, at risk for severe disease based on vaccination status, age and/or underlying conditions should check with their doctors and local hospitals immediately upon laboratory diagnosis regarding availability and criteria for receiving Monoclonal Antibodies as well as currently available oral antiviral medication. These treatments are effective in reducing the severity of the illness and risk of hospitalization and death and are important measures to control the morbidity and mortality from the virus.
The purpose of this posting is to discuss the acute medical problems that can best be diagnosed and treated via telemedicine.
To do this, it is first important to understand the types of medical problems that usually cannot be properly evaluated with telemedicine.
So what are the medical problems best amenable to telemedicine urgent care?
Problems where the symptoms are generally not associated with serious outcomes and where the history alone can usually make a correct diagnosis. Often these conditions may be recurrent medical conditions that the patient is familiar with, has had before, and knows the diagnosis and treatment.
Examples of some conditions that often can be diagnosed and treated via a telemedicine consult include:
To understand the answer, look at the medical community. After the initial 2-3 months of the pandemic, which consisted of a learning curve and period of preparation, hospitals and physician offices have largely been able to operate without the spread of COVID internally. However, this requires the proper masks, the proper use of masks, adequate hand washing and disinfecting, as well as other social distancing and PPE measures. However, these are not the conditions readily seen or replicable in the outside world. More recently with the spread of Omicron, the number of infections among healthcare workers increased dramatically. However, this may have been due to workers being infected on the outside rather than in the healthcare setting. Because of the increased level of infectivity of the new variants, it is possible that protective measures that were effective for early strains may not be as effective with newer strains. Best bet is to wear an N95 mask when in situations with the highest risk of exposure. These offer the most protection.
A simple study from early in the pandemic did conclude that mask mandates, do in fact, reduce the spread of COVID in the real world. On July 2, 2020, the governor of Kansas issued a mandate to wear facemasks in public places starting the following day. However, individual counties in the state were allowed to opt out of the mandate. This compared the 7 day average of new cases, from June 1, (4 weeks before mandate), until August 23, (7 weeks after mandate), in those counties that observed the mandate (2/3 of the population) and those that didn’t. The counties observing mandate had a 6% decrease in new cases and those that didn’t observe the mandate had a 100% increase in new cases.