The Wannabe Mayor And His Spokesperson, Unmasked

Don’t go to the ER for COVID testing — do this instead
Jan. 12, 2022
Mother and daughter getting tested for COVID-19
San Diego emergency rooms are overwhelmed. They are filled with people who have severe illness caused by COVID-19, those experiencing other serious illnesses, individuals who are injured, and people who are simply seeking a COVID-19 test. However, emergency rooms are not meant to serve as COVID testing sites.

According to experts, local hospitals are striving to manage the current surge of COVID-related illness due to the emergence of the highly contagious omicron variant and ongoing delta variant-related illness while also coping with a surge of people seeking COVID tests.

“While we are prepared to care for those with emergency medical needs, we are experiencing some staffing and supply shortages due to the recent surge,” says Josh McCabe, director of emergency services at Sharp Memorial Hospital. “We encourage anyone who is without COVID symptoms or experiencing mild symptoms to look to other testing sources throughout the county, rather than heading to their local ER.”

In doing so, McCabe says, you are likely saving yourself time, preventing your own exposure to illness, freeing up resources for those who are experiencing medical emergencies, and giving local care providers the gift of time and energy they need to care for those most in need.

5 things to consider before heading to an ER:

Due to limited test supplies, local emergency rooms and most urgent care centers can only test people with significant COVID-19 symptoms and those at risk for serious illness, including people with underlying medical conditions (including pregnancy) and those age 65 and older and their caregivers.

While COVID-19 tests are free, you are responsible for the cost of any ER or urgent care visit. County COVID testing sites provide free testing and do not require a visit fee.

If you do not have COVID symptoms, have not had an exposure, or are under age 65 with no underlying health issues, you can visit a County of San Diego testing location or consult other community resources, such as 211sandiego.org, for testing options instead. At-home tests may be available online or in stores. A positive at-home test should be assumed to be accurate and does not need to be confirmed with a test at a medical facility or COVID-19 testing site.

If you need to be tested due to a confirmed exposure, contact your primary care doctor or visit one of the options offered by community and health care partners to be tested sooner. If your primary care provider orders a COVID-19 test, you will receive instructions on where to go. In some cases, you will be instructed to self-test and follow CDC quarantine and isolation guidelines while you wait for — and after receiving — your test results.

Some school districts are offering free COVID-19 testing sites for students, teachers and staff. Check with your district for specific testing site details or learn about testing options for the San Diego Unified School District.
Have symptoms? Assume you have COVID.
If you are between ages 16 to 64 and experiencing mild symptoms, assume you have COVID-19 and take all necessary precautions. You can most likely find relief for your symptoms with the use of over-the-counter pain relievers and fever reducers, along with lots of rest and hydration.

Monitor your symptoms and call your doctor if symptoms worsen. Call 911 or go to the nearest emergency room if you are having trouble breathing or persistent pain or pressure in your chest, are unable to stay awake, have bluish face or lips, or are experiencing confusion.

Myocarditis in children and young adults
Jan. 11, 2022
Man getting COVID-19 vaccine
The Centers for Disease Control and Prevention (CDC) recommends COVID-19 vaccination for everyone age 5 and older to reduce the risk of getting and spreading COVID-19. The vaccines are safe and highly effective at preventing severe illness, hospitalization and death from COVID.

Since April 2021, however, increased cases of myocarditis — an inflammation of the heart muscle — have been reported in the U.S. after people received either the Pfizer or Moderna COVID-19 vaccine, particularly in children and young adults. This leaves many parents wondering how worried they should be about this rare side effect.

What is myocarditis?
Myocarditis is inflammation of the heart muscle responsible for pumping blood in and out of the heart. The inflammation can reduce the heart's ability to pump and cause rapid or abnormal heart rhythms, also known as arrhythmias. Symptoms can include shortness of breath, chest pain, fatigue and a rapid or irregular heartbeat.

Most of the individuals who developed the condition after receiving a COVID-19 vaccine are male adolescents and young adults. The condition often occurs after the second dose and typically appears within a week of vaccination.

“Myocarditis appears to be an extremely rare side effect of the COVID-19 vaccine,” says Dr. Justin Parizo, a cardiologist affiliated with Sharp Memorial Hospital. “When this rare event occurs, the vast majority of people experience mild symptoms, and the disease resolves without treatment.”

What are the risks of myocarditis?
It’s understandable to worry about a side effect that could affect the heart. But before choosing not to vaccinate, it’s important to weigh the risks of myocarditis with the risks of COVID-19, Dr. Parizo says.

Parents should consider the following:

While it’s true that children and young adults have been less affected by COVID-19, there are many within these age groups who have gotten very sick and even died from COVID-19. In 2020, COVID-19 was a top 10 cause of death for children ages 5 to 11, and thousands of children have been hospitalized from the disease. Additionally, even children with no symptoms from COVID-19 can — and have — developed lasting symptoms or “long-haul COVID” weeks to months later.

Long before the pandemic, thousands of cases of myocarditis were diagnosed in the U.S. and around the world each year, often triggered by typically benign viral infections. SARS-CoV-2, the virus that causes COVID-19, can trigger it as well. Other causes include bacterial infections, autoimmune diseases, and adverse reactions to medications and toxins.

As of Dec. 15, 2021, more than 486 million doses of COVID-19 vaccines have been given in the U.S. And, as of Dec. 17, 2021, 2,168 cases of myocarditis among people age 30 and younger were reported to the Vaccine Adverse Event Reporting System (VAERS). However, identifying the cause of myocarditis can be very difficult and, while temporally associated with receiving a COVID-19 vaccine, further investigation is required to better understand the cause.

If someone gets COVID-19, they are approximately 16 times more likely to develop myocarditis than individuals who don’t get the illness, according to the CDC, while the best data available suggests that people who receive the vaccine are approximately two to three times more likely to develop myocarditis than individuals who don’t receive the vaccine. And the risks to the heart from COVID-19 infection can be more severe.
Dr. Parizo joins other experts in recommending that getting vaccinated is the right health decision for both children and young adults. Individuals who are vaccinated can more safely go to school, play sports and be with their friends and families, he says, all of which are important for health and well-being.

“It’s understandable that some parents fear having their child vaccinated,” says Dr. Parizo. “The potential negative effects of a bad case of COVID-19 are far riskier than the minimal risk of developing myocarditis after vaccination as a result of getting the disease.”

If it’s not COVID, what is it?
Jan. 10, 2022
Sick woman
Whether it was masking or social distancing, closed businesses or virtual education, we were collectively thrilled to see COVID-19 precautions lift in 2021 as vaccinations increased and case numbers dropped.

Unfortunately, the emergence of the omicron variant has led to a new surge of COVID-19 cases, along with the return of some safety measures. And the time in between may have led to a rise in other respiratory illnesses as well.

“We are definitely seeing an increase in upper respiratory illness,” says Dr. Phil Yphantides, medical director for Sharp Rees-Stealy Urgent Care Centers. “While it was expected that we would see an increase in illness when mask use dropped, it is concerning now that many of these respiratory cases are COVID-19, as well as influenza, rhinovirus and respiratory syncytial virus, known as RSV, which can cause severe disease, such as pneumonia, in infants under 1 year of age.”

The rise of flu and RSV
While COVID-19 is the most common viral infection causing illness severe enough to require hospitalization for those who are not vaccinated, Dr. Yphantides says they are seeing a rash of other respiratory illnesses, including the flu, RSV and the common cold, in their offices and urgent care clinics.

According to the Centers for Disease Control and Prevention (CDC), the circulation of respiratory viruses other than COVID-19 drastically slowed, and flu viruses and RSV circulated at historically low levels during the first year of the pandemic. This was largely due to prevention measures, such as masking, social distancing, reduced travel and isolation.

However, in 2021, influenza and other respiratory virus activity increased later in the year at an unusually rapid pace. This rise in flu and RSV cases — both of which can lead to hospitalization for acutely ill young children, people with compromised immune systems and older adults — paired with the latest COVID-19 surge, is leaving some hospitals concerned that ICUs will once again become overwhelmed. Some are calling the possibility a “surge upon surge.”

Isolation’s effect on the immune system
This raises the question of whether our immune systems may have weakened during the several months we isolated and wore face masks while in public. According to Dr. Yphantides, it’s less likely that COVID prevention measures led to later increases in illness, and more likely that our immune systems were negatively affected in other ways.

“There is no evidence to suggest that avoidance of infections negatively affects the immune system's ability to fight off illness,” he says. “The immune system develops rapidly in early childhood and provides remarkable lifelong protection against most infections. Yet there are known psychological risks of isolation that can negatively impact immune function.”

According to Dr. Yphantides, stress and loneliness have been associated with decreased immune function. So, if social distancing produces significant stress or loneliness, this can adversely affect the immune system.

“Even if isolating from others, it is important to maintain a healthy diet and healthy routines, such as exercising and connecting with others,” he says. “In this digital age, this is fairly easy to do online or in outdoor settings with appropriate distancing.”

Steps to take to prevent illness
Common sense tells us that being among more people in public spaces will lead to increased exposure to germs. To avoid becoming sick with any of the currently spreading viruses, the CDC recommends:

Washing hands often with soap and water or using a hand sanitizer that contains at least 60% alcohol
Avoiding touching the eyes, nose and mouth with unwashed hands
Staying away from people who are sick
Disinfecting frequently touched surfaces, including toys and doorknobs
To avoid catching the flu and COVID-19, Dr. Yphantides reports that current efforts to reduce the spread, especially vaccination, are working. “The best way to prevent influenza and COVID-19 is to get your annual flu shot, a COVID-19 vaccine and your COVID-19 vaccine booster shot when eligible,” he says.

He also encourages everyone — whether vaccinated or unvaccinated — to follow California’s requirement to wear a face mask in indoor public spaces. People should also avoid large crowds, both in indoor and outdoor locations.

How to respond to respiratory illness
So, what should people do if they begin to experience respiratory symptoms, but are unsure whether it’s a common cold, COVID-19 or something in between? Dr. Yphantides recommends they start by reaching out to their doctor.

“With the rapid increase of new COVID-19 cases in San Diego, it is a good idea to contact your physician and get tested for COVID if you develop cold or flu symptoms,” he says. “If you test positive, you should isolate at home to stop the further spread of the virus.”

Dr. Yphantides also advises people to seek immediate medical care if they develop any of the following symptoms after a positive COVID-19 test result:

Trouble breathing
Persistent pain or pressure in the chest
Confusion or altered mental state
Inability to wake up or stay awake
Pale, gray or blue-colored skin, lips or nail beds
Doctors may also test for other illnesses, such as strep throat and the flu, and will treat patients accordingly if their results are positive. If you are diagnosed with any of these illnesses, the CDC recommends you take any prescribed medications and stay home while you have symptoms — and at least 24 hours after your fever is gone — except to get medical care. Your fever is only considered truly gone if it goes down without the use of fever-reducing medication.

If you test negative for COVID-19 or other illnesses and don't require further medical care, you can likely treat any symptoms causing you discomfort at home.

“Rest, stay hydrated, eat a healthy diet with plenty of vegetables and fruit, and give it time,” Dr. Yphantides says. “Most colds run their course within a few days to a couple of weeks. If needed, you may take over-the-counter medications to ease fever, aches, cough or congestion.”

5 steps to take if you think you have COVID-19
Dec. 21, 2021
Woman getting tested for COVID-19
With COVID-19 case numbers once again increasing across the country due to the spread of the delta and omicron variants, you might be wondering if you can continue to avoid infection, especially if you have not yet received a COVID-19 vaccine. Even if you are vaccinated, you may have similar fears.

Whether you are vaccinated or not, there is risk of infection. However, for those who are fully vaccinated and have received a vaccine booster dose, the risk of infection is minimal compared to those who are unvaccinated or not fully vaccinated.

COVID-19 vaccines are effective at preventing severe illness and death, and the addition of a booster dose makes them highly effective at reducing the risk of infection. Additionally, people who experience a breakthrough case of COVID-19 after vaccination are likely to have no or very mild symptoms.

For those who are unvaccinated, the risk of infection, severe illness and death is much higher. In fact, the majority of people who have been hospitalized with COVID-19 or who have died due to complications of COVID-19 were unvaccinated.

Exposed, aka in ‘close contact’
Regardless of whether you are vaccinated or not, what should you do if you are exposed to someone with — or experience symptoms that could be — COVID-19? First, it’s important to understand what it means to be exposed to someone who has COVID-19, and what symptoms to watch for — whether you know you've been exposed or not.

According to the Centers for Disease Control and Prevention (CDC), you are considered to have been exposed to — or in close contact with — someone with COVID-19 if you were within 6 feet of the infected person for a total of 15 minutes or more over a 24-hour period.

This 24-hour period starts 2 days before the infected person's illness began, or if they are without symptoms (asymptomatic), 2 days before they tested positive for COVID-19. The period goes until approximately 10 days after their symptoms first appeared or they are released from isolation.

What to do if you are exposed to COVID-19
If you have been exposed to COVID-19 and are unvaccinated, you should isolate yourself and be tested. If your test result is negative, stay home for 10 days after your last contact with the person who has COVID-19, monitor your symptoms, and try to stay away from people you live with, especially people who are at higher risk for getting very sick from COVID-19. If your test result is positive, isolate yourself for 10 days after your first day of symptoms or 10 days after receiving your positive test result if you do not have any symptoms. After isolation, follow strict masking guidelines.

If you are fully vaccinated — meaning 2 weeks have passed since your second dose of either the Pfizer or Moderna vaccine or single dose of the Johnson & Johnson vaccine — you should get tested 5 to 7 days after your exposure, even if you don't have symptoms. Wear a mask when around others for 14 days following exposure — in California, all people must wear a mask in public indoor locations — and monitor yourself for any symptoms. The same guidance applies if you are fully vaccinated and have received a booster shot.

Feeling COVID-19 symptoms
Even if you haven’t knowingly experienced an exposure to COVID-19, you might still have picked it up when you were around others in public or with a loved one who is unaware they’re infected. While people — vaccinated or unvaccinated — are able to transmit the virus by the third day after exposure, they may not begin to experience symptoms until day 10 or later.

If you experience any of the following common COVID-19 symptoms, you might be among the millions who have been infected in the U.S.:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
Talk with your doctor about getting tested or go to a nearby COVID-19 testing site. Home self-test kits are considered to be as accurate as antigen rapid tests and can be purchased at some pharmacies. They are easy to use and provide results in approximately 15 minutes. However, PCR tests — provided at most COVID-19 testing sites — are considered the most accurate test to determine an active infection.

5 steps to take if you have COVID-19
If you have received a positive COVID-19 test result or have been exposed to COVID-19 and are experiencing symptoms, the CDC says to take these five steps:

Keep in contact with your doctor. Most people with COVID-19 have mild symptoms. Your doctor can help you decide if you can care for yourself at home or need additional treatment. Always call before you go in person to get care for COVID-19, so that your health care provider can be prepared to protect staff and other patients from potential infection.

Stay home. Stop the spread by isolating yourself and avoiding public areas (unless you’re seeking medical care) for 10 days after first experiencing symptoms or receiving a positive COVID-19 test. Isolate yourself as much as possible from the people and pets in your home and use a separate bathroom, if possible. Wear a face mask if you must be in the same room with others — even pets — and when leaving your home for COVID-19 testing and care.

Take care of yourself. If you are experiencing mild symptoms, you can most likely find relief with the use of over-the-counter pain relievers and fever reducers, along with lots of rest and hydration. Monitor your symptoms and call your doctor if symptoms worsen. Call 911 or go to the nearest emergency room if you are having trouble breathing or persistent pain or pressure in your chest, are unable to stay awake, have bluish face or lips, or are experiencing confusion.

Talk to your own close contacts. It’s important that you reach out to anyone you may have exposed to COVID-19. Think back to all the places you’ve gone and people you’ve seen starting 2 days before your symptoms began or you tested positive. You might receive a call from public health contact tracers in your area; it is important that you cooperate with their efforts.

Keep things clean. Wash your hands often with soap and water for at least 20 seconds or clean them using hand sanitizer with at least 60% alcohol. Make sure to wash dishes, glasses, cups, utensils, towels and bedding after use, and avoid sharing them with others in your household. Use effective household cleaners and disinfectants on all surfaces and regularly touched areas, such as TV remotes and handrails.
The best way to avoid getting COVID-19 is to follow the recommendations of public health agencies: Get vaccinated and receive a booster shot when eligible, wear a mask in indoor public locations, avoid crowds, stay away from people who are sick, and wash your hands often.

What to do if the flu gets you
Dec. 21, 2021
Woman sick at home
If there’s one good thing we can say about the COVID-19 pandemic, it is that COVID preventive measures led to very low numbers of influenza (flu) cases during the 2020-21 flu season. In fact, there were only 848 cases of the flu in San Diego County throughout the entire season, whereas the average number of cases in prior seasons, before the pandemic, was more than 11,000.

Unfortunately, as some spread-prevention measures have been lifted and more people return to pre-pandemic activities — travel, dining out, gatherings, and in-person work and school — it looks as if flu activity across the country will be higher than last year.

So, what should you do if the flu gets you? According to Dr. Jyotu Sandhu, a family medicine doctor with Sharp Rees-Stealy Medical Group, the better question to ask is how can you best protect yourself from the flu before that happens?

Why vaccination is vital
“We recommend that everybody age 6 months and older gets their flu shot,” Dr. Sandhu says. “It’s definitely not too late to receive the influenza vaccine. With the flu season underway, and typically getting worse around January and February, now is the time.”

Dr. Sandhu reports that experts throughout the country are expecting a worse-than-normal flu season this year.

“Typically, we have about 200,000 hospitalizations and approximately 40,000 to 50,000 deaths in the U.S. during the flu season,” he says. “But this year, given we’re in the midst of the COVID pandemic as well, we’re expecting about 600,000 hospitalizations. We need 75% to 80% of the population vaccinated to bring that number down.”

Additionally, the Centers for Disease Control and Prevention (CDC) recommends that you take other general preventive steps to avoid flu infection, such as:


Avoid close contact with people who are sick
Wash your hands often with soap and water or use hand sanitizer with at least 60% alcohol
Avoid touching your eyes, nose and mouth
Clean and disinfect frequently touched surfaces and objects
What to do if you get the flu
However, because some will choose to forgo vaccination and others may experience mild breakthrough cases of the flu, Dr. Sandhu offers recommendations about what to do if you think you may have the flu.

If you experience flu-like symptoms — including fever, chills, headache, sore throat, congestion, body aches and fatigue — he recommends you:


Isolate yourself from others
Rest
Maintain good nutrition and hydration
Monitor your temperature for fever
Take over-the-counter fever- and pain-relief medication as needed
“You should also seek medical advice,” he says. “Contact your doctor and get tested for both flu and COVID-19, as both can exhibit similar symptoms. Antiviral treatments for flu, which may be prescribed, are effective if taken within 48 hours of symptom onset.”

If you are diagnosed with the flu, the CDC recommends you stay home for at least 24 hours after your fever is gone (except to get medical care or other necessities). Your fever is only considered truly gone if it goes down without the use of fever-reducing medication.

6 things to know about California’s indoor mask mandate
Dec. 15, 2021
Coffee shop employee wearing mask
As COVID-19 cases rose and holiday gatherings gained momentum, the California Department of Public Health ordered a mask mandate for all indoor public spaces. However, vaccination and booster numbers have been increasing while COVID-19 case numbers have been decreasing. This has led to the removal of the face mask mandate for all those who are fully vaccinated.

Here are six things to know about the California mask mandate as it now stands:

It’s temporary.
The mask mandate will be revisited in late February, when California officials say they plan to reevaluate it and move forward with plans to pivot to an endemic response.

It’s required only for people who are unvaccinated and in various settings.
If you’ve received your COVID-19 vaccine and booster, you are no longer required to wear a face mask in public indoor spaces. However, everyone — regardless of vaccination status — must continue masking while using public transport and in schools, childcare settings, jails and prisons, health care settings and long-term care settings.

It doesn’t apply to private gatherings.
The mask mandate for people who are unvaccinated applies to indoor public spaces only. However, the Centers for Disease Control and Prevention (CDC) maintains its recommendations for private indoor gatherings — which include masking for those who are unvaccinated as well as staying home if you are sick and considering a COVID-19 test prior to getting together for everyone.

It’s effective.
Masking requirements for those who are unvaccinated have proven to decrease the rate of COVID-19 infections, in addition to slowing the community spread. Health officials credit masking, in addition to a number of other precautions, with allowing the state to successfully keep schools open. California accounts for 12% of all students in the U.S. but only 1% of COVID-related school closures.

It has exceptions.
The mask mandate applies to everyone who is unvaccinated. However, individuals are exempt if they are fully vaccinated, age 2 or younger, have certain medical conditions, are hearing impaired or have a job that mask wearing would pose a risk. Those who are exempt should still follow standard precautions, such as maintaining a 6-foot distance when possible, avoiding crowded spaces, frequently washing hands and staying home when they are sick.

It’s only one layer in protecting ourselves against COVID-19.
While masking in indoor public settings can help slow the spread of COVID-19, getting vaccinated is still the most effective way to protect yourself and others. The County of San Diego is currently vaccinating individuals age 5 and older and offering boosters for those age 12 and older.
The updated mask mandate will mark a welcome lifestyle change here in San Diego for those who are vaccinated. Vaccination is not only a way to be permitted to move about in public settings without wearing a face mask, it is vital to keeping ourselves and our community safe — and forging a way through the pandemic together.