General Wellness

STAY HEALTHY! You may not find a doctor or nurse to care for you!

Imagine coming out of a sterile surgical procedure to learn that across the hall, there were emergency patients being treated for various ailments. Some may have an infection, some a kidney stone, some possibly may have Covid. This is not happening in a third world country. This is here in the US. This weekend, during a middle-of-the-night surgery I needed to perform, I was shocked to learn that as many as half of the operating room recovery beds are often filled with overflow emergency room patients. This is not a small rural hospital. It has 30 operating rooms. It has a recently renovated ER with over 75 beds! It has a few hundred in patient beds. And they are often all filled. And they are starting to be filled with Covid patients once again. 

Worldwide, there is a shortage of healthcare workers at all levels. Doctors, nurses, nursing assistants, respiratory therapists not to mention EMS and pharmacy staff. This pre-existed the pandemic, but Covid has accelerated early retirement as well as burnout. This is partly why there has been an explosion of walk-in clinics at pharmacies and urgent care facilities. With the recent announcement by pharmacy giant CVS that they are planning to close over 900 stores in the US, the shortage will continue to worsen. In my area, 2 local hospitals will be closing in the new year, unable to keep up with patient volume, along with reduced reimbursement. Healthcare is just too expensive. Too many sick people. Too much pressure on the healthcare system to see more, document more with less. 

In the world, the US is #1 in 3 particularly important health metrics. Obesity, rates of chronic disease and healthcare costs. We are #1 in a variety of other not-so prestigious things like number of guns, school shootings and per capita incarceration. 75% of Americans are overweight or obese (over half of them), and we know this is the #1 risk factor for contracting and having a severe bout of Covid. 20% of kids are obese. 30% of Americans are diabetic or prediabetic with an estimated 50% more having underlying insulin resistance. 40% of Americans are on a statin essentially because of a poor diet. Only a tiny fraction of them have a true genetic form of elevated cholesterol. It is not a pretty picture.

The bottom line? Get your butt in shape so that you don’t need to go to the doctor or ER. Furthermore, get vaccinated and boosted against this virus and behave in a way which minimizes exposure like wearing a mask and avoiding crowds so you don’t get Covid.

Stay Safe and Be Well

AC

Omicron Update (12/9/21)

As of 2 days ago, 54 countries around the world have documented Omicron cases, 17 of which had cases where there was no identifiable international travel or contacts. In the US, 25 states have confirmed cases. Chances are that it’s everywhere, we just have not tested for it.

We need another 2 weeks or so to be able to make more definitive statements about this variant however, as we continue to gather information from around the globe about Omicron spread, a few things are becoming clearer.

1. Transmissibility. This variant appears to be about 4x more transmissible than Delta, which was already 5x more transmissible than the original version of this virus. In S. Africa, the 2 week total case average increased by 1700%. In adjacent countries, the 2 week case rate went up as much as 6000%. It’s doubling time appears to be about 3-4 days.
   
2. Disease severity. Given the large case clusters we have seen so far, it appears that although this is a much more transmissible disease, the degree of disease severity it causes appears to be more mild. HOWEVER, there are caveats. Those who did have more significant disease were mostly unvaccinated (about 75%), older and had other chronic diseases. Most of the infected are younger adults, but the average age in S. Africa is almost a decade younger than in the US so this fact needs to be taken in context.
   
3. Immune Evasion. There have been a few cases of Omicron infection in vaccinated people who had negligible interaction. It appears that vaccination provides protection against it, but to a lesser degree than it does for Delta or other versions of this virus.

So what do we do? Well, although Omicron is on the rise, Delta is still the dominant strain everywhere. Continue to do what we know works against it.

VACCINATE, and get the BOOSTER. A recent study showed that the risk of death from Covid was lowered by over 90% in boosted people. This is in addition to the over 90% protection vaccination already provided.

MASK, MASK, MASK. Some public places look like there is nothing going on. It is crazy.

DISTANCE and VENTILATE.

HYGIENE.

GET HEALTHY, both physically and mentally.

Stay safe and be well.

AC