North Atlanta Primary Care

COVID-19 Update Article

Coronavirus Update #17

Posted on October 28, 2020 by Thomas E. Bat, MD, CEO

NAPC is pleased to continue to share COVID-19 information as knowledge expands about the novel SARS-CoV-2 virus.  After the July spike in cases, we have been fortunate in Georgia as the positivity rate, hospitalizations and COVID deaths have declined in our communities. Unfortunately, the latest data shows Georgia on an upward trajectory in the last two weeks. Experts are projecting increased COVID prevalence, hospitalizations and deaths in the winter months ahead. The staff at NAPC wants to help keep you safe and informed. We remain open at all 12 offices, have ample COVID-19 rt-PCR Abbott ID NOW rapid testing supplies, have developed COVID therapeutic protocols, and are actively engaged with our health systems and GA Department of Public Health to obtain approved therapeutics for our hospitalized patients. NAPC will put your health and safety first both in our offices and provide virtual telehealth visits.

Telehealth Updates:

NAPC has adapted the use of synchronous audio-video technology to connect to our patients in the virtual environment. Our providers want to remind you that virtual visits remain an important adjunctive part of your care strategy. Telehealth visits remain covered by all major insurance companies, are less expensive to provide care to you, and require no cost-sharing or co-pays for most visits. Please consider using your smartphone or computer to connect to us to request refills and evaluate an acute illness that could be COVID or the Flu before presenting to the office. We will safely schedule you to be seen in the office if required. Your insurance provider covers all COVID testing and treatment in the virtual and office setting. As winter approaches and the number of patients with upper respiratory symptoms increases, please let your provider know you want a virtual visit. You may call and schedule or request on the patient portal. Your health is important, and at NAPC, we will be open to providing care every day in a virtual visit.

Influenza Update:

Flu shots are finally in abundant supply in all 12 NAPC locations. Please call, and we will keep your wait times to a minimum. Flu shots are essential, so do not wait any longer. HD (high dose) flu shots are in short supply, and if you are over 65 years of age, you may have to obtain this at the health department or pharmacy. We have only a few HD vaccines available. We suspect that most providers will have exhausted supply by the end of October. A regular strength quadrivalent influenza vaccine is still recommended and nearly as effective as the HD immunization. Bottom line, GET THE FLU SHOT ASAP.

COVID Vaccine Update:

The news media is full of reports of Operation Warp Speed. The FDA is currently working with numerous Pharmaceutical companies to review the data on SARS-CoV-2 vaccine candidates in phase 3 trials. NAPC is in discussions with GA DPH as they determine the logistics of distribution of the vaccines and what groups of individuals will qualify for early vaccinations. We suspect that first responders and healthcare workers will be required to participate in early vaccination programs, followed by the elderly and high- risk patients. We will concurrently review all the safety data released by the FDA/CDC. NAPC will help guide our communities and patients in making the best choices as vaccines become available.

COVID Therapeutics Update:

The mortality rate of hospitalized COVID-19 patients has declined significantly since this pandemic began in March 2020. Our clinicians and scientists have identified therapeutic agents and treatment modalities that have successfully recovered many of our patients. We are grateful for the hard work and successes of dedicated healthcare providers. There is no one perfect magic pill that eliminates the coronavirus once an individual is infected. However, many of the complications from COVID-19 are known, and we can treat and prevent them. Everyone must do their part; limit exposure to the virus and practice good hygiene, practice social distancing, and of course, wear a mask. If you have COVID symptoms meet with us on telehealth, get a rapid PCR test, monitor your oxygen saturation and let us guide you to early treatment for best results. Some of our current therapeutic options are:

  • Oxygen. Use of supplemental O2 for pulmonary congestion. Monitor O2 saturation and if your level decreases below 94% contact NAPC.
  • Remdesivir. First antiviral approved by FDA for COVID. Initially used for Ebola. Required to be administered by IV. Developing an oral formulations for easier administration and increased usage.
  • Convalescent Plasma. Requires COVID positive donors who have recovered to give blood. This requires blood typing and matching. Must be administered by IV.
  • Dexamethasone. This is an inexpensive steroid that decreases the inflammation in severe lung disease common in pneumonia with COVID.
  • Monoclonal Antibodies. Regeneron and others have developed neutralizing antibodies that can be administered by IV. This can impart immediate protection and treatment to decrease viral burden.
  • Interleukin inhibitors. A new class of therapeutics that can decrease the inflammatory over-reaction (cytokine storm) the immune system has with severe COVID.
  • Anticoagulants. Blood thinners that can decrease blood clots that are common with COVID.

Newer therapeutics are under study, and scientists worldwide will have even more useful medications in 2021. This has been a long and challenging year, and the pandemic has resulted in many individuals’ unfortunate tragic loss. Please do not succumb to the misinformation and depression rampant amongst so many of our friends and families. If anyone is having difficulty dealing with COVID stress and anxiety, please call us at 770-442-1911 or contact us privately on the patient portal. NAPC can provide mental health resources as we all endure during this pandemic

Post COVID Syndrome Update:

Many survivors of acute bouts of COVID-19 experience a wide range of persistent medical issues lasting weeks to months. This is commonly referred to as “Long Haulers Syndrome.” We know that many viral syndromes have long term ongoing health consequences (like measles, hepatitis, HIV, etc.). It may take many years before we know all of the consequences of how COVID-19 affects our bodies. This can make it hard for individuals to return to their previous level of health. There is evidence that COVID-19 can potentially cause long-lasting, or even permanent, damage to the heart, lungs, kidneys and even brain.

Patients describe symptoms including exhaustion, trouble thinking and remembering, muscle pain, headaches, shortness of breath and even chest pain. Dr. Fauci, the top infectious disease expert, refers to these symptoms as “myalgic encephalomyelitis”, the disabling illness commonly known as chronic fatigue syndrome. The cardinal symptom is not fatigue per se, but a prolonged relapse of exhaustion, cognitive dysfunction, and other symptoms after a minimal amount of activity.

The truth is we do not know the long-term prognosis as well as the timeline for those with residual symptoms after initial infection with coronavirus. The reality is that we are learning that many patients who “recover” after their initial infection continue to experience prolonged symptoms. Early studies suggest that the majority of recovered patients continue to have at least one persistent symptom. We will continue to research post-COVID viral syndrome at NAPC and will help our patients with the difficult task of regaining their health.

What is Herd Immunity?

The term “Herd Immunity” was initially introduced more than a century ago. Herd immunity, also known as community protection, refers to protecting susceptible individuals against infection when a sufficiently large proportion of immune individuals exist in a population. In other words, herd immunity is the inability of infected individuals to propagate an epidemic outbreak due to a lack of contact with sufficient numbers of susceptible individuals. This individual protection can come from natural infection or vaccination. In the latter half of the 20th century, herd immunity achieved through vaccination programs has accomplished near disease eradication in the developed world. Successful examples include the eradication of smallpox, Haemophilus influenza type B, pneumococcal disease and measles.

Herd immunity threshold is defined as the proportion of individuals in a population who have acquired immunity can no longer participate in the transmission chain. However, the duration of protection for both naturally acquired and vaccine-induced immunity is a critical factor in determining population-level protection and sustaining herd immunity. With seasonal coronaviruses, durable immunity has not been observed, so we must continue to study COVID-19.

So despite the fact that there is much discussion about herd immunity in the media, we must all continue to mitigate our risk of exposure to COVID. So when COVID vaccines become available, they must not only be effective, they must be widely adopted to lower transmission and infectivity so society may once again resume normalcy.

Final Thoughts:

NAPC is grateful for the successes of our health systems over the last nine months of SARS-CoV-2 infections. We are proud of our ability to keep our staff and patients out of the emergency rooms and recovering at home. We continue to learn best practices every day. We continue to grow our testing and treatment abilities. We continue to strive to communicate with our patients. We continue to process the COVID pandemic’s stress with each other, our families and our patients. Our patients are vital to our practice, our careers and our profession. At NAPC, we exist for our patients and continue to strive to improve. Please let us know how best to serve your needs. Please stay safe and practice the 3 Ws: WEAR a mask, WASH your hands and WATCH your social distance. We are all in this together, and we will succeed with your help. #NAPCSTRONG

 

Respectfully,

Thomas E. Bat, MD

North Atlanta Primary Care

Alpharetta: 3400-C Old Milton Parkway, Suite 270, Alpharetta, GA 30005
Braselton: 1255 Friendship Road, Suite 130, Braselton, GA 30517
Cumming: 1800 Northside Forsyth Drive, Suite 450, Cumming, GA 30041
East Cobb: 1121 Johnson Ferry Road, Suite 450, Marietta, GA 30068
Johns Creek: 4235 Johns Creek Parkway, Suite A, Suwanee, GA 30024
Sandy Springs: 1150 Hammond Dr., Building E, Suite 310, Atlanta, GA 30328
Sugar Hill: 4700 Nelson Brogdon Blvd., Suite 250, Buford, GA 30518
West Paces: 3200 Downwood Circle NW, Suite 200, Atlanta, GA 30327
Woodstock: 250 Parkbrooke Place, Suite 300, Woodstock, GA 30189

All locations: 770-442-1911