Dr. Held: Yes. The big difference is the spread. This variant increases the amount of virus shed by someone infected. Therefore they’re more likely to spread it and at a faster rate.

Dr. Powell: Yes, it spreads the same way as other variants. Mostly by breathing in these small air droplets. 

Dr. Held: If you think about how a virus evolves, its goal is to reproduce as much as possible. This variant really just makes more virus, so that it’s transmitted easier in the droplets. Those droplets have more particles and make it easier to get infected.

Dr. Held: Absolutely. We all believe we should continue these safety practices well into this year. Even if you’re vaccinated, we don’t know enough about the vaccine yet to know if it will reduce the spread, so mask-wearing, avoiding crowds and washing hands will still be important.

Dr. Powell: It’s still a respiratory virus, so mask-wearing is still the most important thing you can do.

Dr. Powell: We’re following the CDC and Pennsylvania Department of Health (DOH) guidelines, which is a tiered approach. Currently, we’re in the 1A category, which is health care workers and residents of long term care facilities. After that, we’re going to go to the essential workers and those over 75 (1B). Then tier 1C will be those over 65 and those between 16 and 65 with chronic medical conditions. We’re trying to target the most vulnerable first so it won’t be open to the general public for probably several weeks to months.

Dr. Held: To vaccinate the entire country is a herculean task, but we’re up to it. Everyone who wants the vaccine will have an opportunity to get it in time, it’s just a matter of when.

Dr. Powell: We prefer a system where people have an appointment and it’s controlled. We want to avoid a scenario where people are waiting for hours in really long lines to get vaccinated.

Dr. Held: It’s key that we have a process that is controlled. This will allow us to maximize our opportunity to vaccinate people.

Dr. Powell: We’re still working out a system, but my vision is that we would reach out to you and let you know when you will have the opportunity to schedule an appointment. It will likely be at a centralized location rather than at your doctor’s office.

Dr. Held: Centralized locations will be necessary early on because of storage. As the supply becomes more robust we could start to expand to other locations, but that will require a lot of collaboration with county, state and national leaders. As the vaccine is produced, patience will be very important.

Dr. Powell: We’re calling that post-acute Covid-19 syndrome. Studies have shown about 25 to 35 percent of people who contract Covid-19 have prolonged effects on their lungs, heart, or nervous system. I am not aware of a large population in Berks County but it’s something that we will continue to monitor. Anyone experiencing prolonged effects should reach out to their primary care provider.

Dr. Powell: Persistent shortness of breath, fatigue and brain fog are a few examples. Some patients have developed a heart condition called cardiomyopathy.

Dr. Powell: We always encourage people not to delay care, so if you are having any medical concerns, even minor ones, you should reach out to their primary care provider and let others around you know how you’re feeling. Staying connected to friends and family and letting them know how you feel is very important. Also, we all have to remember to get exercise, spend some time outdoors and try to do something that you love to do every day while we get through this.

Dr. Held: Take advantage of the support structures to have, whether that is phoning a friend or family member or using mental health hotlines. Developing a routine of going outside and enjoy the sunlight for those who’re stuck at home all day is one way to help get your mind off the crisis.

Dr. Held: Patients over the age of 65 are in the high-risk range. There is nothing specific to military service that I’m aware of but based on your age and comorbidities you would be higher up on the tier list.

Dr. Held: St. Joseph’s Medical Center will be ramping up the process of reaching out to community providers next week. This is a new process and we’re learning as we go, but you should expect us to reach out to everyone in the first phase groups, which includes dental hygienists, within the next week or two about how you can get your vaccination.

Dr. Powell: Similarly, Tower Health will be targeting the 1A group very soon, probably beginning early next week.

Dr. Held: We’re doing weekly calls with leadership at Tower Health and St. Joseph’s. We haven’t yet collaborated directly but that is something we can work on moving forward. 

Dr. Powell: Dr. Held and I have worked with the County Commissioners and emergency first responders to make sure EMS personnel get vaccinated. There has been some level of coordinating but we could probably do more.

Dr. Powell: Try to spend time outdoors, just make sure you bundle up and stay warm. I would limit interaction with children that you don’t know to minimize the risk of picking up the virus. There are other indoor activates like puzzles and arts and crafts that you can try that may also be helpful. 

Dr. Held: I agree, try to take advantage of the outdoors, just make sure you’re wearing the right clothing and staying warm.

Dr. Powell: Yes, you can be infected more than once, but it’s unlikely you will contract it again within the first three months of your first infection.

Dr. Powell: We do not know yet if the vaccine will be life-long, booster shots may be needed going forward, but I would encourage everyone to get the vaccine once it’s available.

Dr. Powell: It has changed since the beginning. Originally, we were using hydroxychloroquine, but that was proven to be ineffective and can cause heart arrhythmia. We stopped using that in the early months. We have been using steroids and Remdesivir primarily to treat Covid-19. We also use prone positioning, like laying people on their back for part of the day, ventilators and oxygen as treatments. There is still so much we need to learn about this virus and what works and doesn’t work.

Dr. Powell: Children do very well fighting off this virus. They produce a multi-system inflammatory response and most kids have much milder systems and very few side effects.

Dr. Powell: Symptoms children show can be treated with normal medicine. So if they have a fever, you would give them fever-reducing medication like Tylenol and Advil. For a cough, a suppressant is appropriate depending on their age group. Basically, take supportive care measures for kids.   

Dr. Powell: Yes. It’s recommended that pregnant women get vaccinated because they have a higher chance of having a bad reaction to the virus.

Dr. Powell: Yes, breastfeeding is fine. There is no indication that the vaccine presents a health risk to a breastfed child.

Dr. Powell: At home, it’s supportive care, so again, you’re going to treat the fever or cough. Get a lot of rest and try to ride it out. If symptoms get more severe or you begin to feel shortness of breath that is uncomfortable, you should get evaluated at an urgent care center or hospital.

Dr. Held: Keep in touch with your primary care provider. Let them know about your symptoms as you go along. If you will feel a difference don’t be afraid to reach out to either your health care provider or go to the emergency room if you’re concerned. That’s one of the key things that we want to avoid is people not coming when they need treatment out of fear. Never feel like you’re bothering your doctor; that’s what we’re here for.

Dr. Powell: Telehealth visits are also an option, so you don’t necessarily need to come into the office if that is a concern.

 Dr. Powell: Tower Health is not registering people right now but I would say the keep an ear out because we will be notifying you soon when those appointments are open. Keep in touch with your primary care provider because they will be keeping track of what is happening in your area.

Dr. Held: We will leverage the primary care network in our community to reach as many people as we can. We will make sure that, as we start to expand vaccinations, that we have ways to reach people in the high-risk categories.

Dr. Powell: I would speak with your allergists or primary care provider to make sure you aren’t allergic to any of the vaccine’s ingredients. So far, there have been very few anaphylactic reactions. Nationwide, we’ve vaccine 1.9 million people and there have been 21 total anaphylactic reactions we’re aware of.

Dr. Held: The vaccine itself is free. Depending on where you go to receive the vaccine, there could be an administration fee. At this time Penn St. Joseph’s is not charging for administration.