COVID-19 Roundup: Experts Urge Vaccinations, Mask Wearing to Slow Surge; Clarifying CDC's Renewed Guidance; and More

Baptist Health Experts: Getting Vaccinated, Mask Wearing are Key to Slowing Surge in Hospitalizations

Undoubtedly, the unvaccinated are driving the current surge in COVID-19 hospitalizations in South Florida, across the state and nationwide, with the more transmissible delta variant playing a dominant role.

Medical experts and leaders from Baptist Health hospitals took part in a Resource LIVE session this week, hosted by Jonathan Fialkow, M.D., deputy medical director and chief of cardiology at Miami Cardiac & Vascular Institute, to shed light on the current situation. The experts warned the people who have not been vaccinated are most vulnerable to the delta variant, which carries greater viral loads when infecting an individual, compared to the original strain of the virus.

“What we’re seeing in the hospital is a sharp increase, an exponential increase, in the number of patients that are coming to our emergency departments and requiring hospitalization with COVID infections,” said Zulma Berrios, M.D., Chief Medical Officer at West Kendall Baptist Hospital. “Most of those presenting are unvaccinated, and are requiring critical care services for the management of their care.”

The panel of experts welcomed breaking news from the U.S. Centers for Disease Control and Prevention (CDC) on reinstating recommendations for vaccinated individuals to wear masks indoors in places with high infection rates.

“We know that that strategy (mask wearing in most indoor settings) works, and at least in the short run, I think it’s something that we probably need to do, because even if everyone who’s unvaccinated made the decision today to go and get vaccinated, it would be five weeks before any of them were fully vaccinated,” Yvonne Johnson, M.D., chief medical officer at South Miami Hospital. “Right now, we are seeing such tremendous increases in our COVID patient populations that we need to do something more immediate to address it.”

But the biggest takeaway from the experts was to get vaccinated as soon as possible. Across the nation, only about half of the eligible population has been fully vaccinated.

As a physician, my role is to educate and inform my patients to help them make the best decision possible for their own health and wellbeing,” said Samer Fahmy, M.D., chief medical officer at Boca Raton Regional Hospital. “At this point, the best decision anybody can make for themselves is getting vaccinated against COVID-19 so they can avoid the complications that come with getting infected with that virus.”

CDC Reinstates Recommendation for Vaccinated People to Wear Masks Indoors in Certain Places

As concerns grow over the dominance of the delta variant of COVID-19 and the resulting surge in hospitalizations among unvaccinated people, the U.S. Centers for Disease Control and Prevention (CDC) recommended this week that fully vaccinated people begin wearing masks indoors again in places with high transmission rates.

The agency’s new guidance is limited to places where COVID-19 transmission is considered “substantial” or “high.” That refers to areas where there are either more than 50 cases per 100,000 people over a seven-day period, or that the COVID-19 test positivity rate is higher than 5 percent.

Public health officials believe that fully vaccinated individuals represent a very small portion of new cases stemming from the delta variant, which is more transmissible that the original strain of COVID-19. But some vaccinated people could be carrying higher levels of the virus than previously thought, and they potentially could transmit it to others while being asymptomatic.

The new guidance is mostly a reversal of the CDC’s recommendation in mid-May when the agency said fully vaccinated people didn’t need to wear masks in most indoor settings. The CDC also recommended indoor masks for all teachers, staff, students and visitors at schools across the nation, regardless of vaccination status.

The updated mask guidance is “supporting what we have been seeing in our communities and that people are not using the mask in many situations,” said Zulma Berrios, chief medical officer, West Kendall Baptist Hospital, part of Baptist Health. “We know that not everyone, probably half of the population, has been vaccinated. So, there’s a lot of people out there that are in a vulnerable situation that are not using the basic measures of protection, like wearing a mask.”

The CDC guidance for those who are unvaccinated hasn’t changed: Continue masking until they are fully vaccinated. Health experts fear the delta variant, already the dominant strain of the coronavirus in the U.S., is overwhelming states with low vaccination rates. Those states are now being forced to reintroduce mask rules, capacity limits at restaurants and other businesses and other public health restrictions that had largely been rolled back in recent months.

“This pandemic continues to pose a serious threat to the health of all Americans,” CDC Director Rochelle Walensky, M.D., told reporters on a media conference call. “Today, we have new science related to the delta variant that requires us to update the guidance regarding what you can do when you are fully vaccinated.”

Study of COVID Long Haulers Cites 203 Different Symptoms

COVID-19 “long haulers” who experienced lingering ailments reported a total of 203 different symptoms in the seven months between Dec. 2019 and May 2020, according to a new study published in the Lancet’s E Clinical Medicine journal.

Based on surveys from nearly 4,000 people from 56 countries, the study found the most frequent symptoms after the sixth month following infection were fatigue, post-exertional malaise (worsening of symptoms following physical or mental effort), and cognitive dysfunction. For the majority of respondents (91 percent), the time to recovery exceeded 35 weeks.

During their illness, participants experienced an average of 60 symptoms, across an average of 9.1 organ systems. Researchers found that cognitive dysfunction or memory issues were common across all age groups.

“Our analyses show that participants experience symptoms that are not commonly mentioned in public discussion of Long COVID and may benefit from further research,” the study states. “These include but are not limited to: anaphylaxis and new allergies, seizures, suicidality, changes in sensitivity to medication, vision loss, hearing loss, and facial paralysis.”

Symptoms varied in their prevalence over time, and in the following “three symptom clusters”:

• 86 percent of participants experienced relapses, primarily triggered by exercise, physical or mental activity, and stress.
• 87 percent of unrecovered respondents were experiencing fatigue at the time of survey, compared to 45 percent of recovered respondents.
• 45 percent required a reduced work schedule compared to pre-illness, and an additional 22 percent were not working at the time of survey due to illness.