EM:RAP 2021 July 26th Breaking News: Delta Variant COVID-19 and Vaccine Effectiveness


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David I. S. -

Mel and Crew
I am a 47 yr old healthy, athletic doc working in Miami, Florida, who somehow managed to avoid Covid infection until now through luck, masking and getting the Phizer vaccine.

As of last week, I am part of the breakthrough infection crowd... I assume it is the delta variant. Please inform your listeners, it has been 8 days of symptoms including 4-5 days of fevers at the start. I have no cough or lung issues but marked fatigue, full sinuses and I am very congested. Been like a bad flu. Another physician in my group had similar but with fevers for 10 days. We also have several nurses out with covid. I would advise great care with masking in the department and also socially as the vaccine will not stop mild cases from coming and taking doctors and nurses off the front lines for 10-14 days.

Thanks as always for your amazing work!
David Sack, MD

Mel H. -

Thanks David, sorry you got sick but good reminder that either way we want to avoid this puppy!!

Rachelle S. -

First off thank you for keeping us up to date. It is hard for the general clinician/Pit doc to keep up.
We are starting to give COVID vaccines in the ED, which I love. Still some logistics to work out, but it is great.
I have a few questions with regard to this. Is there any information as to who we can and can not give this too? For example, can we give it to anyone who is sick? What if they are in the ED for cellulitis or diverticulitis or other non-COVID things? Can they get the vaccine? How about if someone comes in with loss of smell, but otherwise is totally well. Can those people get the vaccine? Is there any guidance for this?
Again, thanks for your help.
Rachelle Soper MD

Mel H. -

The general consensus is if you think someone has or probably has active COVID wait. In general if there is some other significant infectious disease going on, wait. What is significant, if they are septic obvious no, but a little cellulitis, might be ok. https://www.prevention.com/health/a36186576/can-i-get-covid-19-vaccine-when-sick/

Mallory B. -

Along the same lines, what are the recommendations for how long to wait after covid infection to vaccinate? I think originally the recommendation was to wait 3 months. Is that still correct or can we advise to get the vaccination sooner after resolution of symptoms? Thank you

Jennifer L. -

Thanks for these updates! They're super helpful and really boil things down when there's so much information out there to sift through. When you do your next update, could you talk more about boosters? Are they a third dose of the same mRNA vaccines, or do they contain new strains? It seems to me since we have variants that are eluding the original vaccines, getting more of the same wouldn't be as effective as getting inoculated against new variants. And with the flu season approaching, any guidance on combining the seasonal flu shot with a COVID booster? Thanks in advance.

bogdan i. -

Hello, as an EM doc I struggle as to what to offer all these pts I discharge home with Covid . Sometimes if they have Covid pna I may start Zithromax? Literature is not great on any effective outpt treatments for Covid pts. What can we offer these patients when we d/c them? ASA for 14 days? Vit C & D? Zinc? Zithromax? Dexamethasone oral? Not sure if I should be using all or any of these meds? I've seen my ID docs d/c them from inpt on many of these meds including NOAC x 14 days
Please advise or do short EMrap segment on outpt med for covid pts.
Bogdan Irimies DO

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EM:RAP 2021 July 26th Breaking News: Delta Variant and Vaccine Effectiveness Full episode audio for MD edition 8:49 min - 10 MB - M4A