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Covid - What's New?

I thought I'd do a Covid update before I get on a plane headed for a medical mission in Rwanda. Yes, my first trip since the pandemic started is a working trip to Africa. I'm going with a wonderful organization called WorldWide Healing Hands and a small team of doctors and volunteers who will be working with the local medical professionals primarily teaching cervical cancer screening and treatment in women. I should have lots to write about when I return in June.

So now for our favorite subject of 2020-21 - Covid.

Our hospital in San Francisco has had zero Covid patients admitted for the last two days. After over a year of a never-ending surge of sick patients and deaths, this is truly wonderful. This reflects that San Franciscans' vaccination rate is 54% and growing. Covid is not gone, but it is under control and vaccinated people are getting their lives back.

There is new information, however, about people who are immune suppressed and Covid. These are people who take prednisone (corticosteroids), have cancer, auto-immune conditions like rheumatoid arthritis or Crohn disease, have had an organ transplant, people with HIV and a number of other conditions.

There is diminished response to the vaccine in people who are immunocompromised which affects over 10 million Americans. Not all of these people will develop antibodies after receiving the vaccine. Up to 75% of patients who had a kidney transplant at New York Presbyterian Hospital- Columbia University did not develop antibodies after receiving the vaccine. But we don't know if showing antibodies is the entire story. There may be other protective responses of T and B cells that vaccine confers and in time we will have that information. We know people can get Covid but the chance of severe infection is diminished. At one transplant center only 5 fully vaccinated patients developed Covid and none of them were severe. That's encouraging news.

We are advising patients who are immune compromised to get the vaccine but still take precautions. Wear a mask inside crowded settings. The fact that there is less Covid in the community (almost herd immunity) means patients who are at more risk are not exposed. This is yet another reason to encourage everyone to get the vaccine.

We aren't out of the woods yet. We need to think of others as we get our lives and activities back. Getting vaccinated isn't just good for YOU. Its also good for your neighbor, mother, friend, stranger.

See you in a few weeks after I return.


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