Personal Physicians Newsletter Archive

David Katzman, MD & Jennifer DeLaney, MD Internal Medicine Specialists

COVID Update

Jennifer DeLaney, MD

Since the beginning of COVID, we have been in the unfortunate position of telling patients infected with COVID that they have to miss weddings, funerals, significant birthdays, family vacations, and surgeries. Our goal is to keep you from getting COVID, so you can experience these important events in your life.

This is why you should care as much as we do on this topic:

Cases are as high as ever and still causing significant illness even in the vaccinated.
The current variant, BA5, is rising and has escaped immunity from both previous infection and the vaccines.
We are seeing increasing numbers of patients affected by long COVID who have not recovered their quality-of-life months after what was a mild illness.
Each time you are infected with COVID your risk for severe complications goes up substantially as does the risk of permanent symptoms like stroke, heart problems, or dementia. Forty-five percent of people who have been infected 3 or more times end up with long COVID.
Get your booster now! (There has been some government chatter about opening up second boosters to those adults 18 and older. We will keep you posted as we learn more.)
Your risk of long COVID goes down with each vaccine: 1 shot reduces your risk 18%, 2 shots 45% and 3 shots 85%.

So how do you reconcile COVID risk with doing the things that you want to do?

Wear a good mask when indoors - it is not that hard, we do it 8-10 hours a day! N95s are widely available and are much more protective than surgical masks.
Have an air-purifier in shared spaces in your home and work. This reduces risk by 50%!
Eat outdoors whenever possible.
Wear an N95 on planes, in the car when with non-household members, on trains, and buses.

Hopefully following these suggestions will help keep COVID away while balancing doing the things you enjoy.

Reminder on Quarantine and Isolation Protocols

If you were exposed but have no symptoms

Regardless of your vaccination status:

Get tested 3-5 days from last exposure.
Wear a mask around others for 10 days, even at home.
If test result is positive, isolate.

If you had COVID-19 within the last 90 days:

You don’t need to test unless symptoms start.
If symptoms start, isolate and get tested.

Learn more in What to Do if You Are Exposed from CDPH.

If you test positive or have symptoms

Regardless of your vaccination status or infection history:

Isolate for at least 5 days:

Sleep and stay in a separate room from those not infected.
Use a separate bathroom if you can.
Wear a mask around others, even at home.

Get tested (antigen preferred, such as a home test) on Day 5:
End isolation on Day 6 if:

You test negative, AND
Have no fever for 24 hours without taking fever-reducing medication, AND
Your other symptoms are gone or going away.

End isolation on Day 10 if:

You still tested positive on Day 5 or decided not to test, AND
You have no fever for 24 hours without taking fever-reducing medication.

If you still have a fever, continue to isolate until it’s been gone for 24 hours.
After you recover, wear a mask around others for 10 full days after start of symptoms or your positive test.

For children who test positive:

Children under 2 can end isolation on Day 6 without a negative test.
Children 2 years and older should follow the steps above for ending isolation.

Learn more in What to Do if You Test Positive from CDPH

Daily Use of Marijuana Not a Good Idea

Marijuana’s legalization for medical use has led many of our patients to explore THC for chronic pain issues, anxiety and sleep disorders. A very elegant multi-decade study was just published that showed daily use is associated with dementia. This risk was much higher than with occasional use of marijuana or with daily alcohol use. Therefore, we do not recommend daily use of marijuana, except in unusual circumstances when traditional approaches to a difficult problem fails to provide relief.

Hepatitis B Vaccine

The CDC recently recommended Hepatitis B immunization for adults under aged 60 years who have not already received it. Hepatitis B is a virus that causes chronic liver infection and can lead to cirrhosis. Routine vaccination of children began in 1991 in the US and anyone who works in the health care field has likely already received it. Hepatitis B is typically spread by sexual transmission, blood transfusions, and injections with unclean needles. We recommend this vaccine for anyone in our practice who travels to low-income and middle-income countries, works in healthcare or who may have new sexual partners in the future. We do not currently carry this vaccine in our office, but we will be sending out a survey to see if there are enough patients needing this to go ahead and order a supply.

Medication Timing Assistance

Need help remembering when you last took your medicine? Wondering when you last gave your loved one that prescription pain medicine? There is now a gadget that can help! Caps with built-in timers are available to keep track of when you last opened the medicine bottle. Here are a couple of the retailers that sell timer caps:

Texting the Office May Cause Delay

Recently, we have had a few patients texting our main office number, 314-993-1200, possibly unintentionally. Please be aware that this may result in a delay in our response to your message, and therefore, is not an ideal way to communicate with our office. These texts do not go straight to a phone or to your doctor so are not received right away. Texting is also a less secure method of communication. The best ways to reach us are by calling or emailing. Thank you!

New Insurance, Address or Email?

Please let us know at your next point of care if your insurance, address, email, or any other demographics have changed. It's important to keep your chart up to date as we utilize this information for office tasks such as placing outside orders/labs and making referrals. Thank you!

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