Doctors’ advice for navigating the COVID-19 pandemic – NBC Los Angeles

Navigating an unprecedented virus pandemic has never been easy.

But in the early days of the COVID-19 pandemic, when scientists and doctors were still learning about SARS-COV-2, the advice was the same for everyone: stay home or mask up and keep your distances if you have to leave. out.

More than two years later, we are in a different place from those early days of quarantine, with vaccines and treatments available in the United States and guidance geared towards living with the virus.

But in some ways it can make it more confusing to calculate your own risk and make the safest decision for you or your loved ones.

NBCLA spoke with two Southern California physicians who have spent the past two years counseling their patients about COVID-19 and treating patients who have caught the virus. Here’s the advice they have at this point in the pandemic.

What can I do to protect myself from COVID-19?

For those who have already been vaccinated, who have maximized the number of boosters they can receive, and who are always careful and cautious about wearing masks indoors and in crowds, they have done almost everything they could to protect themselves.

After that, just keep track of the little things and be “careful about getting together with other people in small gatherings,” said Dr. Douglas Chiriboga, a family physician at Pomona Valley Hospital Medical Center. .

It’s when you’re indoors eating without a mask, and you may not know the vaccination status of the people you’re with, that the risk of getting sick increases again, he said. declared.

According to Dr. Nicole J. Van Groningen of Cedars-Sinai Medical Center, if you’ve already taken all of these steps, taking care of the rest of your health may be the best thing you can do.

“General health is important, like staying healthy,” Van Groningen said. “We know that people who get enough sleep and those who exercise have stronger immune systems and are better able to fight off viruses at all levels.”

A healthy diet can also help, although she added that these factors are more of an “extra layer of protection” than a guarantee.

And after two years, she says, it’s important to include your mental health in the risk equation.

“Even though I’m a doctor, mental health is important,” she said.

Your personal risk assessment may mean avoiding high-risk, poorly ventilated restaurants or crowded concerts, but that’s different than constantly isolating yourself inside the house when it negatively impacts mental health. and that’s what can be tricky. If you can find a way to join the gatherings at this point, that’s something to consider.

“You don’t want to miss weddings and birthdays,” she said. “I don’t think that’s healthy.”

And if you’re not sure what risks make sense to you or what additional steps you should take to protect yourself, now is a great time to contact your doctor.

“It’s difficult, because we no longer receive general advice from any public health agency,” she said. With that in mind, reviewing the risks versus the benefits “is a great use of your primary care physician!”

For people who have relaxed their precautions – maybe they are less strict about hiding indoors, or haven’t had time to get a boost yet – get these boosters should be a high priority.

“If you haven’t gotten your first reminder, that’s the first thing on my to-do list,” Van Groningen said.

“We’re dealing with a variant that didn’t exist when the original vaccine trials were done” with just one Johnson & Johnson vaccine and two Pfizer or Moderna vaccines, she said. The boost a booster shot gives your immune system will make a real difference.

“Because people aren’t very diligent with masking and these booster shots, COVID-19 becomes a smart virus, it mutates,” Chiriboga said. “He becomes very adept at fighting the powers of the vaccine”

“My take home message is, please get vaccinated” with the full suite of vaccines available, to give you the best chance, he said. “Take care of yourself and others, take care of your loved ones.”

What if I don’t want to get vaccinated or can’t?

Vaccines remain the most recommended way to protect against COVID-19.

“I would encourage people who don’t want to get vaccinated, don’t wear a mask, to realize that we have to take the political discussion out of the picture,” Chiriboga said.

He said he has seen unvaccinated patients end up hospitalized in intensive care and regret their decision not to get vaccinated.

“We want to prevent that from happening,” he said.

Given the health risks of choosing not to get vaccinated, Van Groningen said, it’s difficult to give medical advice that rules out highly protective vaccines. But avoiding high-risk activities, wearing a mask, and continuing to sleep, diet, and exercise can help provide some protection.

On the other hand, “for people who really cannot get vaccinated, for a legitimate medical reason, if they really have an allergic reaction to one of the vaccines”, there is a monoclonal antibody treatment that can help produce an immune response, she said. .

The two doctors also stressed the importance of staying home if you feel sick and of taking a home test before big events where you could transmit COVID to others, regardless of vaccination status and the level of comfort.

How many boosters will we receive and why should I continue to receive them?

For those frustrated with the growing number of recommended boosters, it can help to think of boosters like system maintenance on a car, Dr. Chiriboga said.

“Just because you bought a new car doesn’t mean you’ll never need an oil change,” he explained.

The initial two-round vaccine “activates your antibodies, but it’s not a long life,” so you need to top things off, he said. Boosters help remind your immune system of what the fight against COVID is like as that defense system fades and the virus mutates.

He recommends following the recommended schedule for vaccinations and boosters.

For Van Groningen, “the most complicated question is, in the current environment, when should I get my booster?”

For her, the first booster dose is “a ‘do yesterday’ kind of thing,” she said.

But his advice on when to get the second booster dose, for those who are eligible, depends on the individual. It may be able to wait until there are higher case loads, to provide maximum protection when there is more risk, if it is a particularly healthy person more 50 years old.

In the future, we’ll likely see more boosters recommended for everyone, including expanded recommendations for that second dose, the two doctors predicted.

This may take the form of a second booster dose recommended for everyone regardless of age, a future “pan-coronavirus” vaccine that protects against the flu and adds to your COVID protection, or a seasonal COVID vaccine as we receive seasonal flu vaccines now.

When can my child under 5 be safely vaccinated?

The FDA has set dates in June to meet about approving vaccines created by Pfizer and Moderna for very young children.

After these meetings, if the FDA approves the vaccines and the CDC approves this decision, young children between the ages of 6 months and 5 years old will be able to get vaccinated.

Both doctors — along with others NBC4 spoke to — agreed that, if and when the vaccines are approved, they will be safe for young children.

“I would put a lot of faith in the FDA seal of approval,” Van Groningen said. “The FDA reviews trials in children very rigorously,” and if it had children that age, it would have no problem getting them vaccinated.

“The risks are far outweighed by the benefits,” she said.

“These vaccines for young children are only a small fraction of the regular dose we use for adults,” Chiriboga said. “You are protecting the child.”

Does wearing a mask help even if no one around me is wearing one?

Wearing a mask is better than not wearing one, even if no one else does, according to Van Groningen.

“What we’ve really found in studies of mask use is that it provides at least some level of personal protection,” she said. “So yeah, it’s very important to wear.”

And unless you test yourself for COVID every time you go out in public, you may be carrying the virus without realizing it, and masks help prevent this virus from spreading to others through the air. .

“You may be a carrier,” Chiriboga said. “If you’re not wearing the mask, it’s easy to pass it on to someone else.”

Are there still treatments for COVID?

If you get sick with COVID, but your case is mild, “the general approach is to treat it like any other flu,” Van Groningen said. Take Tylenol for body aches or fever, and take a decongestant or cough suppressant if you’re congested or coughing.

“Stay really hydrated,” she said, and “try to be a little mobile,” rather than lying in bed all day. “Bring in some light, if you can, even if it’s just around your house or bedroom, so your blood keeps flowing and your lungs actually work.”

Paxlovid is probably the best-known antiviral drug available to treat COVID-19 if you get sick, but there are other options as well, she said.

Your primary care physician can guide you through the different options, Chiriboga said. For UCI Health, where he works, there are telehealth options, or, “if you need to come in, we can see you, we’re just getting dressed.”

And if you suffer from shortness of breath, chest pain, severe diarrhea, abdominal pain, or if you get out of breath when walking a short distance, such as across the street, you should “absolutely go to the emergencies,” he said.

“If you’re feeling really short of breath, I think chest pain and shortness of breath are two key symptoms that we say ‘don’t mess, go to the hospital,'” Van Groningen said.

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