Happy New Year Friends!
It’s been a while since I’ve communicated- early in the pandemic information was hard to come by, but now it’s coming at an overwhelming pace. Some of you have reached out and asked me to communicate more often and so a sort of resolution- to send these letters with more regularity. Much to discuss. I’ll start with a few observations and updates about the Covid pandemic as we enter its 3rd year.
Omicron is now the dominant variant in Oregon and across the country. It is incredibly contagious as you’ve heard, tailor made for “super-spreader events” like 20-50 people gathering in a room unmasked. It appears a good N95 or equivalent mask is necessary to provide SOME protection in crowds. Ventilation is very helpful if it’s available. Most of all knowing something about your guests, their habits and protocols and contacts is very helpful.
The new variant at least appears to cause less serious illness overall, especially in vaccinated populations. An initial vaccine plus booster still seems to provide 80-90% protection against hospitalization- this is our goal! If you have not received your booster, please go get one asap, and if you have not been vaccinated it’s as important as ever and will provide you with significant protection going forward. Feel free to call and talk to me about your concerns!
Actual treatments are here or coming, but they are still frustratingly difficult to access. Two of the widely distributed monoclonal antibodies (including Regeneron) appear to work POORLY against the Omicron variant. The newer product SOTROVIMAB is working well against it but is in very short supply. Some of it (about 300 doses total) has been distributed across Oregon in the past week, but is still being limited to the sickest, most at risk patients. The new oral pill PAXLOVID by Pfizer is showing exciting effectiveness but is not yet available in Oregon Pharmacies as far as I can tell, and the rollout will take a while. There are many other treatments approved by FDA for use in hospitalized patients. Some of you have asked about the hydroxychloroquine, Ivermectin, and Zithromax for treatment- I have been following developments and study in these and others and am not persuaded at this time that they are effective for treatment of Covid.
Testing is uneven as well- as many of you have found for $200-300 you can get a rapid PCR test from one of the drive-through or urgent care sites when needed (within 48 or 72 hours) for travel. We can send PCR testing through our office to St Vincent or Quest labs but can’t guarantee they will be back in 2-3 days. We also have rapid antigen testing in the office, though we’ve been told early on that the Omicron variant is more likely to produce a FALSE NEGATIVE test with the antigen test (including the home ABBOTT test kits). Many test sites are listed on the Oregon Health Authority website.
A few notes about the office. We have a new medical assistant, Nicole. She joined us about 3 months ago, after Patty left. Say hello when you are in. Kazumi continues in her role as lead medical assistant, and Tinh An will be slowly transitioning to more of an office management position, as my daughter Carolyn moves in other directions. Julia has returned to her full previous role after maternity leave. Other changes are anticipated for the coming year. We are adding patients SLOWLY, about 1 or 2 per week at most. I continue to have my eyes open for a physician partner and am testing a few for fit by asking them to provide coverage/backup when I am away. Let me know if you know someone who’d be a great fit! I am interested in improving our Covid testing capability though some of the tests do not make a lot of sense in a small office. I will likely begin administering at least the Moderna vaccine through our office in the next few months. We are considering obtaining a physician “pharmacy license” which would allow me to distribute commonly used as needed drugs like antibiotics, and to give ALL Medicare Part D immunizations (such as shingles vaccine and Tetanus which now must be given in the pharmacy). We likely will add another medical assistant in the second quarter of 2022 as we’ve determined that our patients need more help then ever before navigating other office’s scheduling gymnastics and help with getting radiology and other testing done. More on all this in the coming month.
That’s quite enough for this letter. I’ll close by wishing you all health in the coming year, and if you’re not healthy, that we can be a partner that you can count on. The past two years have been tough in so many ways- let’s all gather as a community and support each other.
Peace,
Jim Biemer and all of the office staff
