COVID-19 July Column

A-   The department of Health in Louisiana warns that COVID-19 cases among unvaccinated people and people in Louisiana are at risk of exposure to the more contagious Delta variant strain. More deaths are seen in the unvaccinated. Guidance’s came out that if you are not yet fully vaccinated, you should wear mask and distance in public. Even if you are fully vaccinated, you may have a very good protection although not absolute. If you are at risk for complications of COVID-19 because of advanced age or underlying medical conditions or even if a member of the household has the disease, you should consider masking yourself even when adventuring outdoors.

B-  In Louisiana, the numbers of patients hospitalized with COVID-19have increased through the states in almost all the regions. It is reported that an increase of 170% of cases in 2 weeks day camps, child day care, religious services, and restaurants. The Delta variant is the most transmissible and encountered among the unvaccinated individuals.

C-The Delta variant known as the B.1.167.2 variant emerged due to a mutation in the virus genetic figure, it is the most contagious form and demonstrated its aggressivity during the spring and summer of 2021 which pose a severe threat to the unvaccinated. Vaccination with any of the vaccines Pfizer, Moderna, or Johnson and Johnson remain the single best way to protecting yourself, your community and your family. Remember that the disease spreads primarily by breathing, coughing, singing or laughing. The virus will spread in indoor setting especially when distancing is impossible The vaccines are free and widely available. They remain highly effective at protecting against the virus. They are also extremely safe while now recommended for anyone older than 12-year-old once recommended by any primary care physician. The CDC is now calling COVID-19. The Pandemic of the unvaccinated.

C-     COVID-19 cases are spiking in communities where vaccinations are low

 The viral load among vaccinated people is so low that the transmission is unlikely. This new variant has made it to more than 100 countries. Four states account for the new cases in the United State included Florida.

The CDC states that the Delta variant is now responsible for almost 60% of all new COVID-19 infections in the USA. Hospitalizations are raising and vaccine hesitancy.  remains a problem even among healthcare professionals while the NIH official keep urging people to get vaccinated with any of the 3 very effective vaccines available.

More than half millions of people in the USA are being vaccinated daily. Down to 3.3 million 3 months ago. Less than half in the US have been vaccinated fully but the CDC claims that 79% of people over 65 which represent the most vulnerable of the population are fully vaccinated. Important to remember that 3 months ago people were rushing to centers to get vaccinated and there were not enough healthcare personnel to administer the vaccines, now it is different…  Centers are sending people out to look for patients to vaccinate.

In Los Angeles County, the face masks become again mandatory in indoor public places. This is directly related to the propagation of the Delta variant. In Austin TX, it is recommended to the partially or unvaccinated people to wear masks indoors while shopping or travelling while vaccinated people do not need to wear masks.

Remember the Boston Red Sox and the New-York Yankees game postponed because of six Yankee players tested positive for COVID-19. These three players were all vaccinated. The same can be noted among hospital workers which are still defying the rule of the vaccinated.

D-   By the beginning of June 2021, one (1) hospital worker in four (4) in direct contact with patients in the United States, have not received the vaccine against COVID-19. This come from data received provides by 2500 hospitals across the nation. A hospital in Florida, Lakeland Regional Medical Center has 64% of its healthcare personnel still unvaccinated. More hospitals are starting to require the shots. Many authorities agree that hospitals should be the safest places in the country and the workforce should be mandated the vaccine. Advent Health in Orlando Florida is a 1300-bed hospital which has more than half of its staff (56%) unvaccinated. There again, it mirrors the rate of unvaccinated in the general population. 24 % of the healthcare workers appear to say that they definitively will not get the vaccine as reported by researchers in New Mexico. While another 12% are willing to take it. Around the world, it is believed that 23% of healthcare workers are reluctant to take the vaccines. 9% of pharmacist, 23% of medical technicians, 12 % of registered nurses and doctors remain unvaccinated and are also reluctant to take the vaccines

E-    Some hospitals are even giving options to take the vaccine or to wear a mask. Many chose to wear one. Although N-95 masks and vaccines are both highly effective in protecting against the virus, the vaccine is by far superior. It is hard to wear a N95 all the a hospital. During a break, or while eating or drinking, you can be exposed because of someone carrying the virus or being infected… In restaurants, in malls or in other public places. Soon people will be asked to take the COVID-19 vaccine or to provide a reason why they should not take it. During the meantime, hospitals are putting patients at risk for having their personnel unvaccinated. A recent hospital in Houston TX, mandated all patients to have their vaccine shots and many who went to court against the ruling,  realized soon that the court sided with the hospital. If you are refusing to take the shot, you may soon be out of work. Advent Health is the 12th largest hospital system in the nation with 49 hospitals and has at least 200 hospitals are in line with a 50% rate of vaccination. Other hospitals rates in the country have already reached an 83% rate.

F-    Healthcare workers carry a heavy load and many works to a point of exhaustion. and even burnout. Often, they are the only contacts between the infected patients and their families communicating by phone or video so the family can communicate with their sick one. We remember well the way many were insufficiently protected during the first waves of attacks because of the shortage of gloves, gowns or other protective gears. More than 3600 healthcare workers have passed since COVID-19 in the United States. Vaccination is certainly important to protect them and to minimize the risks of contacting the disease.

G-   Hesitancy in Healthcare workers is certainly dangerous because this is the same one in the frontline who will carry the virus to others, to a patient with autoimmune disease or an elderly, or a premature child or a kidney transplant recipient with immunosuppression. There are no published statistics to demonstrate the numbers of patients infected this way, by healthcare professionals.

H-   In Presque Ile, Maine, four of the five staff members in a hospital, although not fully vaccinated, were tested positive, contaminating 13 residents and staff with the virus. In Oregon Health and Science University, an outbreak of COVID-19, in a cardiovascular unit was discovered because an infected visitor brought the virus to the campus where he spread it to 14 others.

I-     In Kentucky, an unvaccinated healthcare worker carried the virus to the nursing home. Where he works, infecting 26 patients. 90% of the residents were fully vaccinated. Indeed, vaccines slowed the virus and made infections less severe.

J-     Based on statistic recorded in the United Kingdom. up to 8,700 from a total of more than 32,000 patients who have caught COVID-19, have died and based on this analysis, the vaccination against COVID-19 become mandatory for health care workers. The same certainly will happen in the United States, soon.

K-   Louisiana is one of the less vaccinated states in the United States, where only 36% of all the population is vaccinated. The Delta variant is sweeping the United Sates causing new hospitalizations. With infected children and pregnant women. It is said nowadays in Louisiana that where goes the delta strain, death follows. This strain which originated in India, last spring and may have already caused at least 3 million deaths around the world. This strain is also highly contagious in the United Kingdom. Even the Canadian data have shown similar findings with an increase in hospitalization with the Delta strain. This Delta strain appears to have an enhanced virus which escape antibodies bringing a different mutation away from it binding site (P681R) or form the syncytia which may help the virus hide from our immune system.

L-    It is known that the virus infects the cell and corrupts the cell protein when the cell dies when new copies are released into the plasma outside the cell. Remember well the symptoms related to the Delta variant of COVID-19 because they differ from the original symptoms. Look for especially:

stomach pain, sore throat, headache, stuffy nose, loss of appetite, vomiting, nausea. joint pain and hearing loss.


Maxime Coles MD
Boca Raton FL

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