The holidays are almost on us, and with it comes tidings of good cheer. We do need to remember that COVID-19 is still here, and along for the ride are new variants, such as the Omicron variant. It’s time to stay healthy over the holidays as Alaina Rajagopal talks about holiday health safety with Victor Cisneros. Victor and Alaina discuss the steps you can take to ensure you and your loved ones enjoy a safe, happy and COVID-free Christmas. Tune in and learn more about health and safety here.
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Staying Safe And Healthy Over The Holidays With Victor Cisneros
Please note that the content of this episode does not constitute medical advice. It is purely for the purpose of education. This episode was supported by the National Geographic Society’s Emergency Fund for Journalists. We are discussing some COVID updates and safety over the holidays. We are joined by Dr. Victor Cisneros who is the host of our new social medicine series. We are very excited about that. Welcome back, Dr. Cisneros.
It’s a pleasure to be back and be part of the team with this new segment. We are going to start on social emergency medicine and talk about the health disparities in medicine in general.
I’m excited for some of the episodes we have talked about and the upcoming, so stay tuned. The holidays are here and there are a lot of information out there about how to stay safe, which can be confusing.
As we can see, this COVID virus is continually mutating and now we have this new Omicron virus, which we don't necessarily know if it's going to be more or less severe, or exactly what type of characteristics we are going to see with each variant. These mutations are going to happen. The only way we can stop mutations is from stopping the spread because as we know, viruses require a host. They can't live on their own. These hosts are your cells.
Why do we care if the virus mutates?
It's super important because we have vaccinations that are proving to be very effective. If we have these mutations on these proteins or in general, these vaccinations become less effective. Eventually, they might not necessarily work. We could see potential spikes and mortality or severity and disease. It's important to prevent the spread by wearing masks, social distancing, and doing all the social normal precautions.
As we are having variants and mutations, let’s talk a little bit about what we know about this new Omicron variant so far. On November 24th, 2021, a new variant of SARS-CoV-2 called B11529 was recorded to the World Health Organization after it was found in both Botswana and South Africa. As of December 14th, Omicron has been found in 35 states and territories in the United States. It will spread quickly. It is believed that at this time, the Omicron spreads more easily than the original COVID virus and everyone can spread Omicron to other people, even if you are vaccinated, boosted or doesn’t have any symptoms. This is pretty similar to other variants we already know about.
At this time, we don't know if the Omicron causes more severity or less than other variants but data aren't showing a surge in deaths, which is promising. With that said, we are seeing the highest rates of transmission we have ever seen in the pandemic, which is concerning, especially with these holidays and people gathering around. Vaccines are expected to protect against severity, hospitalizations, and death with this new variant but we don't know yet. The verdict is not out there. There are still a lot more data. It's important to emphasize to our readers and the general public the importance of vaccinations and boosters.
Vaccines don’t create a force field around you preventing you from getting infected unfortunately but vaccines teach your body how to recognize easily, so you can fight them off before the infection becomes severe. You can still be infected with the virus even if you are vaccinated but after vaccination, you are less likely to have severe illness or death if you get infected. It seems the Omicron variant is transmitted more easily than other variants and is rapidly spreading among United States and the world. Vaccinations and boosters are more important than ever.
The only way we can stop mutations is from stopping the spread because as we know, viruses require a host, it can't live on their own.
What we know is our masks are effective against all variants, no matter what. It's so important to keep that in your mind. If you are going to small enclosed spaces and having that protective barrier, even though it's not 100%, it’s super important. It's better than nothing.
We have seen over time that masks are effective even if they are cotton or surgical masks. N-95 masks are the most effective. Having some barrier protection is important. The holidays are here, how should people safely navigate all of these banned public gatherings that we have been waiting to have for two years?
I hate to sound like a broken record but the number one priority should be getting vaccinated and having a booster vaccine if you have already been vaccinated. A lot of the prelim data from Israel, which is looked at over 800,000 patient population shows that at least having a primary series vaccination is greater than 90% effective against mortality and severe disease.
In addition to when they looked at boostering at least 5 months after the 2nd dose of the Pfizer vaccine, they haven’t looked at the other vaccines yet, they have 90% lower mortality due to COVID. Participants who received the booster at least five months after the second dose of Pfizer had 90% lower mortality due to COVID than participants who did not receive a booster vaccine. In the older age group, the booster vaccine was over 95% effective in preventing severe disease.
In this day and age, it is reasonable to ask your guest to be vaccinated to attend the gathering. You may even want to have some of the approved instant tests on hand and test the guests as soon as they arrive. Self-test can be used at home or anywhere, and you can get a result in a minute. If your self-test has a positive result, you need to stay at home, isolate for ten days, wear a mask if you have any contact with other people, and call your healthcare provider.
If everyone has tested negative, we have the instant self-test. It’s most likely safe to gather without masks. However, there’s always a change for false negatives. It’s important to keep in mind that no strategy is 100% effective. By false negative, the test shows a negative result when the person is positive for COVID. The rates of false positives and negatives vary from test to test type. PCR tests are most reliable but it can go out longer to get results. It’s all about weighing the risks and benefits.
You touched an important base on self-testing. If people aren't vaccinated, immunocompromised, or at high risk of severe disease, it's more important to have these tests available and wear masks because the severity of the disease is greater. Especially in certain areas in the Eastern hemisphere where it's getting very cold, there are going to be higher incidents of gatherings inside in close proximity.
If you have anyone whose high risk coming to your gathering with elderly individuals, pregnant or immunocompromised people, you want to be on the safe side and consider wearing masks. If you are gathering outdoors, it’s safer to go without a mask than if you are gathering inside but it’s also important to consider how crowded the gathering is. If people are outside but seem shoulder to shoulder, it’s probably not safe to go without a mask.
If you're going to have many connecting flights and have layovers, you'll need to eat at some point. So make sure when you remove your mask to eat or drink that you're far away from others as possible.
It's important to remember that a lot of people are going to be traveling for the holidays. This is putting people in close quarters, tight planes, trains, and other forms of public transportation. It's important to socially distance to try to stay 6 feet away apart from each other. Always wear your mask when traveling. If you are going to have many connecting flights and layovers, you will need to eat at some point, so make sure when you remove your mask to eat or drink, you are far away from others as possible.
When trying to navigate these situations, it may be helpful to consider what would happen if you or someone at your potential gathering were to get sick. For example, if everyone in your gathering is vaccinated, boosted, and reasonably healthy, the consequences would most likely be minimal if somebody got COVID. You just have to isolate and quarantine for ten days or until your doctor gives a go-ahead.
The situation changes a bit if you are having a family gathering but having the immunocompromised family member who is on chemotherapy or if your sister is not vaccinated may be difficult and it’s important to discuss the vaccination and testing expectations with the whole family in advance. This is because if your aunt who got COVID or any other family member who is also immunocompromised is at risk of severe illness or death even if they are vaccinated.
These immunocompromised conditions don't always make vaccinations as effective. It's important to have these conversations with your family members and reemphasize the wearing of this additional protective barrier, such as masks, which can be helpful in saving your family member who's potentially immunocompromised, and the vaccine might not work as effectively.
It also might be helpful to do some on-site testing. You use some of those instant testings that we talked about, especially if you have some family members who are not vaccinated or have immunocompromised conditions. It can be tough to have those conversations. It may even come down to having two separate events to keep more vulnerable people safe. Ultimately, it’s important to minimize the spread and keep your family, friends, and neighbors as safe as possible.
The holidays are about giving but COVID-19 is a gift that you don't want to be responsible for giving another person. Stay healthy and safe. Happy holidays.
That’s it for this episode. This episode was supported by the National Geographic Society’s Emergency Fund for Journalists. If you liked what you read, please give us a five-star rating, subscribe or send this episode to someone you know who might enjoy it. You are free to connect with us on our website, TheEmergencyDocs.com or Instagram @EmergencyDocs. Until next time.
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About Dr. Victor Cisneros
Dr. Victor Cisneros was born in Guadalajara, Jalisco, Mexico but was raised in Anaheim, California. He received his Bachelor's Degree in Biotechnology and a Minor in Chemistry and his Medical Degree (MD), Masters of Public Health (MPH), and Board Certification in Public Health (CPH) at the University of California Irvine School of Medicine. He was part of the Program In Medical Education for the Latino Community (PRIME-LC) which is a dual degree program that focuses on increasing physician-leaders who are culturally sensitive and linguistically competent to address the specific needs of California’s Latinx population.
After medical school, he completed his emergency medicine residency training at UC Irvine Medical Center, where he was one of the chief residents. During residency, he served as At-Large Director and Board member for AAEM and liaison to the Diversity and Inclusion Committee and International Subcommittee. He has also served as the vice-chair for the social emergency medicine ACEP-EMRA committee.
He completed a research fellowship in Population Health and Social Emergency Medicine and Currently, he serves as attending physician and Graduate Medical Education (GME) Director of Diversity, Equity, and Inclusion at Eisenhower Health.