Happy August 2021
We hope this newsletter finds you and yours doing superbly! We want to deliver the most relevant, up to date, important information to our friends and community. Please enjoy the topics below. We welcome your feedback and/or requests
OFF TO COLLEGE
Our telehealth platform has allowed us to
care for patients in 34 states and 3 continents! Many college students leave us each fall and move to exciting campuses across state lines and away from the comfort, safety and convenience of home. We have a robust, leading-edge program to care for and support our collegians. Campuses have a range of health services, and we feel honored to stay connected with and care for these amazing young adults. Parents tell us it’s a peace of mind knowing 24-7, they have a team ready to help.
Congratulations to our graduates and collegians - You are always close to our hearts
Fall Asthma/”Peak Week” Asthma exacerbations requiring hospital visits or ER tend to spike in early-to-mid September. Why does it happen? How to be proactive and preventive to avoid a flare? Allergy and Asthma Network has been helping patients, families and practitioners alike to prepare and prevent these issues. They hosted a recent webinar to discuss new ideas for this topic: https://allergyasthmanetwork.org/webinars-updates/september-asthma-peak-webinar/
Wildfires in the West Our skies are filled with smoke, ash and particles. The Caldor, Dixie and other fires have been wreaking havoc on AQI’s in most of Northern California. This jeopardizes all health, but especially that of our younger patients and those with chronic respiratory issues. In this review, highlighted in AAN’s news, there’s even evidence that fires and COVID19 don’t get along.
Does exposure to wildfire smoke put you at higher risk of getting COVID-19? The combination of the COVID-19 virus and wildfire smoke are a potentially dangerous combination. A Harvard University study published in August 2021 has found evidence that exposure to high levels of fine particle pollution in wildfire smoke can put you at risk for COVID-19. It also could put you at higher risk for hospitalization and death from COVID-19. Scientists say it’s possible that wildfire smoke particles can carry the virus. When there are more particles in the air, there is a greater chance the virus can get deep into your airways and lungs. In addition, people may spend more time indoors during wildfires, potentially increasing exposure to the virus in indoor environments. On its website, CDC says wildfire smoke can harm the lungs and make you more prone to lung infections, including COVID-19. Read more @ Allergy & Asthma Network https://allergyasthmanetwork.org/news/how-wildfire-smoke-can-worsen-your-asthma/
AIR PURIFIERS A common question we get this time of year: “Is there an air purifier (HEPA) Dr. Miller recommends”? We went with the Blue Aire Model 203, 3+ years ago around the same time as the Paradise Fire. Our AQI’s were north of 300 and we were having detectible smoke in our building. We’ve been very pleased with the reliability, endurance, ease and performance of this product. There have been continuous upgrades and there is a range of CADR (how much square footage the product will process per minute/or hour). Changing filters on a regular basis is also highly recommended. https://www.consumerreports.org/air-purifiers/best-air-purifiers-of-the-year-a1197763201/ https://www.cbc.ca/news/business/portable-air-purifier-tests-marketplace-1.5900782?fbclid=IwAR3MEM4ZgrTBzG0yuteZWe9t3NbI1eWia7UHQjDK-lrFXL9qLFOnsdudixQ
HEPA filters don’t replace a good relationship with your health care team and appropriate asthma/COPD action plan. But this gives some background for sensible choices, as it looks like air quality isn’t getting better any time soon.
COVID19 – Testing and Vaccines Testing – With guidelines changing and new rules for school and work, we have been able to move back towards a renewed sense of normalcy. The Delta variant has also put significant strain regionally on healthcare infrastructures. As such, testing early for SARS COV2 must be one of the strategies to protect health care systems. The availability of rapid home-based testing has changed the paradigm for how we can help patients and families, while minimizing exposures and further spread of COVID19. This gives us another tool to be able to manage and mitigate. There is a difference between antigen and PCR tests, so read the information and let us know if you need help with results. https://www.nbcnews.com/shopping/wellness/best-home-covid-tests-n1275687 (We personally have used BINAX-Now test kit, and it was easy-to-use, quick and helpful).
As the confluence of Fall Allergies, smoke exposures and COVID/coronavirus/Delta makes for an overlapping group of symptoms, it will be even more important to triage and help navigate these busy times.
VACCINE – The FDA gave full approval of Pfizer/ BioNTech COVID-19 Vaccine on Monday August 23rd. The vaccine was given a trade name, Comirnaty. If you want some levity, watch ZDoggMD’s Podcast #203 where he questions the methods of naming. https://zdoggmd.com/comirnaty/
Warning – content is mature in nature. (ZDoggMD, aka Zubin Damania and/or DocVader, is one of the brightest, most honest & balanced medical spokespersons, who cuts right to the chase and says it like it is. His perspective is both refreshing and non-partisan. I value his opinion and wisdom).
The studies supporting the FDA’s approval of Comirnaty followed over 44,000 patients, half who received 2 doses of the vaccine, and half placebo. This was a rigorous safety and efficacy evaluation.
Bottom line - the vaccine was 91% effective at reducing severe outcomes from coronavirus infection. Of note, the pericarditis and myocarditis warning will remain in the label, and was elevated for patients who are male, especially those 12-17 yo. The indication for use in patients 12-15 years old is still under the EUA, as Comirnaty is approved from 16 years and older. Booster Vaccine (Dose # 3) have also been the talk of the scientific community. As of today (Aug 26th), the CDC recommends boosters for patients with moderate to severe immune compromise. That would include: patients undergoing cancer treatment, organ transplant recipients, stem cell transplant recipients, primary immune deficiency patients, HIV/AIDS, and those who take steroids to treat underlying chronic conditions.
I WILL TAKE A MINUTE TO NOTE – Those patients are community members in our practice! Please respect our requests to wear masks and follow health and safety protocols. We work VERY HARD to support these patients, and they deserve the same opportunities as the rest of us. Thank you.
The ACIP (of CDC, committee who recommends vaccine decisions) is scheduled to meet August 30th. It is expected that they will vote on whether to recommend the COVID vaccine boosters for 2 other at-risk groups of patients: nursing home residents and patients 65+ years old who do not have immune compromise. We will follow this information, but the news cycle literally changes by the hour. You will likely hear from mainstream media channels when these decisions are made. We will do the best we can to keep up with current, accurate information and guidelines. A final note – Most of you know – I’m a firm believer in common sense and strong values. One of my greatest heroes is John Wooden, the legendary basketball coach of UCLA’s 10-time NCAA Championship team. They called him the Wizard of Westwood. But the real reason I love Coach is – he treated everyone with respect. He earned their trust. He listened. He was fair, but firm. And above all, he was decent.
So many of these values seem missing from today’s conversations. The Pyramid of Success hasn’t lost its usefulness in these conversations. In fact, it may even be more important today than it ever has been. Maybe let’s focus on a few: team spirit, self-control, adaptability, patience and cooperation.
We can this. We must do this. It won’t be easy. But we really have no other choice.
Thank you! As always, I wish you the best of health. Travis