We are aware that many of you are concerned about the latest surge of COVID cases here and around the country. Cathy and I share your concern and are tracking the incidence of disease in our area very closely. We may well increase the proportion of video visits for our patients if the situation requires a reduction in face-to-face visits, especially for those with high-risk conditions and those whose efforts at self-isolation do not meet our requirements. At this time, we feel confident that our office safety protocols are adequate to protect you (and us), and we will continue to see our patients in the office. Office visits, blood draws, exams, and other testing remain the best way to provide the level of care you deserve. As long as we can do these visits safely, we plan to continue.
Our office is conducting approximately 30-40 drive up COVID PCR tests per month for patients, and thankfully we have had relatively few positive cases. This is largely due to your diligence at mask wearing and social distancing – so keep up the good work. As you know, the PCR test is sent to a laboratory and the results generally return within 3-5 days. Recently we added the ability to conduct 15-minute antigen testing to our in-house laboratory with a Quidel Sofia2 machine. This test is indicated for symptomatic patients and is highly accurate (sensitive and specific). We were fortunate, with the help of Specialdocs, to obtain this machine, as it is the best quick test available on the market and in high demand.
We will use this test for our patients who are symptomatic and who would benefit from knowing a result quickly. The cassettes used by the machine test for both flu and COVID at the same time which allows us to treat people for the specific illness affecting them. As you know, they are treatments for influenza which shorten the duration of illness and decrease the spread to others. You may also know that there are new treatments for COVID which may be available to those with high-risk conditions. Knowing a diagnosis quickly allows us to make the appropriate medical decisions on a case-by-case basis. Keep in mind that early diagnosis, treatment, and isolation are important to prevent the spread of both influenza and COVID. Please note that we are not yet sure about insurance coverage with every plan, so there may be a charge for the test if it is not covered.
Testing with the Quidel machine is not indicated for asymptomatic individuals as the accuracy is significantly lower. This is likely because the viral load is lower in patients without symptoms. The PCR test remains the gold standard for testing patients with significant exposure to a COVID positive person. While there may be certain circumstances where we will perform the quick test in asymptomatic individuals, these will be very limited. Testing for travel and visiting with relatives is not an appropriate use for this test as the supply chain for the cassettes is a challenge for the foreseeable future. We recommend staying safe, avoiding travel, and not getting together with people outside of your current (hopefully small) bubble.
Kudos go out to the scientists and doctors involved in the development of these vaccines in record time. The vaccines that have completed late phase trials are effective, and the independent committees evaluating both the Pfizer and Moderna vaccines have deemed them safe enough for emergency authorization and deployment. Cathy and I expect to receive our first personal doses in the next few weeks after local hospital personnel receive theirs. In our area, INOVA Health System hospitals, Virginia Hospital Center, and Reston Hospital will be the vaccination centers for the community. Exact plans for the vaccination sites for the non-medical community and the phased administration based on medical priority are being determined. The plans are completely dependent upon the actual volume of doses received by these institutions and, supplies will be limited for several months at least. We will keep you informed – this is our highest priority.
Keep in mind that both the Pfizer and Moderna vaccines require two doses separated by several weeks. You must get both doses to have full protection, and the vaccine distribution site will do its best to ensure that the second dose will be available to you at the appropriate interval.
Our hope is that the Moderna vaccine will be distributed to both these large institutions and to individual doctor’s offices so that we can provide the vaccine in the safest possible setting. We cannot store the Pfizer vaccine in our office due to its need for super cold storage, but the Moderna vaccine can be stored in a normal freezer. We hope that the Virginia Department of Health recognizes that patient acceptance is enhanced by delivery at a trusted doctor’s office. We will be lobbying the VDH on behalf of primary care offices in our state.
A word on safety. Vaccinations have known side effects, and the COVID vaccine is similar in that respect. Soreness, fatigue, and lost time from work are possible. The second dose may cause more side effects than the initial shot. You cannot get COVID disease from the vaccine, and the vaccine does not alter the DNA of a recipient.
There are multiple reports of more severe reactions, mostly of an allergic nature, prompting warnings to those people who have experienced serious (anaphylactic) allergic reactions in the past. People with certain medical conditions – such as autoimmune disorders, taking immunosuppressants, HIV, pregnancy, and severe allergies – should consult with their specialists for recommendations about the vaccine. There have been 7 cases of Bell’s Palsy (facial nerve paralysis) in the vaccine trials, most of which occurred in the vaccinated group (1 in the placebo group). The incidence is not higher than the incidence of Bell’s Palsy that occur naturally, but the predominance of cases in those receiving the vaccine has raised concern and will be analyzed.
Overall, the benefit from the vaccine in the serious COVID pandemic outweighs the risk of the vaccine as determined by the FDA and CDC committees, and we encourage all of you to take the vaccine when it becomes available. If a large percentage of people get vaccinated, the pandemic will slowly come under control. We are looking forward to better circumstances this summer.
Family Healthcare of Fairfax