COVID-19 update: coping with increased cases, breakthrough infections, national masking mandates and vaccine requirements

Newswise — LOS ANGELES — COVID-19 continues to keep us on our toes, as the country now faces increased cases and hospitalizations, breakthrough infections, new masking mandates and vaccine requirements. Keck Medicine of USC experts weigh in on the latest developments and how they affect America’s physical health and psyche.

The rise of the delta variant and why it’s so important to get vaccinated

 “People are understandably concerned about the recent rise in COVID-19 cases and hospitalizations, largely due to the more contagious delta variant, which now accounts for most cases in the United States. Research shows that patients with the delta variant carry up to 1,000 times more virus in their nasal passages than patients infected with the original strain.

“Over 99% of people hospitalized or dying from COVID-19 are unvaccinated. This is why it is so important to get vaccinated. While not foolproof, COVID-19 vaccines are highly effective in preventing COVID-19 infection hospitalization and death. Breakthrough infections — when people who are fully vaccinated test positive for the disease — are rare and tend to be moderate with less chance of hospitalization or death. Until more of the country becomes vaccinated, we will continue to see cases and hospitalizations rise.”

 - Edward Jones-Lopez, MD, MS, infectious disease expert with Keck Medicine of USC

The possibility of breakthrough infections leading to long COVID

“COVID-19 affects multiple organs, and some 10 or more percent of those who have had the virus will experience long-term symptoms including fatigue, brain fog, breathlessness, aches, cough, diarrhea, dizziness, anxiety and depression. That is why we developed a Keck Medicine COVID Recovery Clinic that unites a multidisciplinary team of experts, including behavioral health specialists, cardiologists, neurologists, rheumatologists, pulmonologists, pharmacists and occupational therapists. We are also encouraged that long-haulers may have access to disability protection in the future, which will support their long-term recovery.

“Those who have had an extended and severe COVID-19 illness tend to be more at risk for developing long-term symptoms. So far it appears that those who experience a breakthrough COVID-19 infection will avoid this prolonged recovery because breakthrough infections tend to be milder and shorter in duration. It is still possible that some immunized patients could have long-term symptoms, and we will continue to watch for that development.”

- Purush (Adupa) Rao, MD, pulmonologist with Keck Medicine of USC

How to cope with anger related to increased COVID-19 risks and new mask mandates

“Earlier this year, society felt a collective anger when vaccine access was limited because some felt the distribution was unequal or random. By early July, as vaccines became freely available in the United States, anger was replaced with the hope that COVID-19 was moving into the rearview mirror. However, now with the recent rises in cases and hospitalizations, primarily among those who are unvaccinated, some people may be angry at those who are unvaccinated because of the increased risk of catching the virus and the new mask mandates. They may feel that they did everything that was asked of them to protect themselves and those around them, but others didn’t.  

“To cope with anger, it may help to consider that those who are unvaccinated are not guided by malice or disregard for others, but by their belief systems and, in some cases, lack of information or misinformation. We didn’t get to this place overnight, and we won’t get out of it without working together to foster a sense that everyone matters, even when they act in ways that seem to place us in harm’s way."

 - Steven Siegel, MD, PhD, chief mental health and wellness officer and psychiatrist with Keck Medicine of USC and chair of the Department of Psychiatry and the Behavioral Sciences at the Keck School of Medicine of USC

On the trend toward the government requiring employees and health care workers to show proof of vaccination or face frequent testing

 “In California, we have just learned that state and health care employees must get the COVID-19 vaccine or face frequent testing. The state of New York and the U.S. Department of Veterans Affairs are enacting similar vaccine requirements as are many leading health systems across the country. Keck Medicine welcomes this announcement, and it is very much in line with a policy we have in development as we believe vaccination is one of the key tools to keep staff and patients safe. Currently, 84% of Keck Medicine hospital staff and 87% of physicians are vaccinated. With the upcoming state mandate and policy, the health system expects to reach 90%.

“Moving forward, Keck Medicine is considering only allowing approved religious and medical exemptions, eliminating a current blanket declination for personal reasons. The state-level decision will give us and other hospitals more public support to mandate vaccines, allowing us to better protect our patients and communities.”

 - Felipe Osorno, executive administrator, continuum of care operations and value improvement, Keck Medicine of USC

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