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When to test, why you should upgrade from a cloth mask and other COVID questions answered

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The following quotes are from medical professionals and state health officials in briefings they attended this week. If you have COVID or other health questions, email catherine@stateimpactoklahoma.org.

If you know you’ve been exposed to COVID, what is the best timeline to get tested?

Dr. Gita Pai, chief medical officer for the State Department of Health: It’s recommended to test maybe a couple of days — one to two days — after your exposure and then about five to seven days after.

When we wear masks, are cloth ones good enough?

Dr. Dale Bratzler, chief COVID officer for OU Health: Any mask is better than no mask because cloth masks will stop droplets. This particular virus, the Omicron variant, is present in super high concentration. So in the health centers, we’ve now switched back to using only medical-grade masks. So I think during this, Omicron varient, we’re strongly pushing surgical-type masks or N95-type now.

What are some tips on gauging your own risk level? How do you know when it’s time for you to cut back on eating in restaurants, going to gatherings and other group activities?

Interim Commissioner of Health Keith Reed says there are several things to consider, especially your own vaccination status and whether you’ve been boosted.

Reed: We’ve taken a kind of a deep dive into some of these large (case count) days that we’ve reported — the cases. And digging into that, we’re seeing about a 30 percent breakthrough — to where about 30 percent of those cases are what we would consider fully vaccinated. But now here’s the important part I would want to share with that. Of those breakthrough cases, about 80 percent of them were eligible for a booster shot and had not received it. We really need to keep in mind the booster is an important part of that self-evaluation of your particular risk to COVID.

Our recommendation is really — has always been — layer the protection on. Get fully vaccinated; get your booster shot. If you’re in a group where you don’t know the vaccination status of others, or you’re in a small environment, small room, you don’t have a lot of ventilation — you’ll wear that mask on top of it. For Omicron, it’s been recommended the N95 or KN95 mask may afford an additional level of protection than just a cloth mask. So that may be something you can also take in as a precautionary method. But again, it really comes down to understanding the risk and what’s out there and realizing that there are multiple measures that you can take to protect yourself.

We’re hearing that Omicron isn’t as likely to cause severe sickness in people who are vaccinated. But what about people who aren’t vaccinated?

Dr. Aaron Wendelboe, former state epidemiologist and current associate professor at the OU College of Public Health: It does look like if you’re completely unvaccinated, never been infected, that Omnicom can still cause severe disease. And one thing that we’ve learned from both the UK and South Africa is that, you know, these variants are mutating to find a population that’s more susceptible. And unfortunately, there are, you know, our children (who are too young to be vaccinated) are of that susceptible group. We are seeing, actually, a higher proportion of unvaccinated kids getting hospitalized with Omicron.

Note: There are more than 1,000 Oklahomans currently hospitalized for COVID-19, according to the State Department of Health’s daily situation report. Several medical professionals said during this week’s briefings that at least 90 percent of those patients are unvaccinated.

Is there a way to document that you’ve had the coronavirus? In case you need proof in your medical records down the road.

Commissioner Reed noted that anyone who gets their diagnosis from a county health department PCR test is entered into the state’s COVID database. Another route would be informing your own primary care physician.

Reed: I think it’s always good to keep your provider informed of your medical condition, anything that happens in between visits and such. It’s always good to keep your provider knowledgeable of what’s happened so that they can help understand, as they continue your care — what impacts may be important for them.

Are hospitals denying monoclonal antibody treatment to COVID patients because of their vaccination status?

Bratzler said there are a few reasons someone might not get monoclonal antibody treatments, mostly because older treatments don’t work against Omicron, and the one that does is in short supply. But vaccinated patients are less likely to get the treatment.

Bratzler: (Bamlanivimab and etesevimab or) BAM, as we call it, and Regeneron’s product — those two older monoclonal antibodies are unlikely to be helpful (against the new Omicron strain). So your provider may not give those, even though they may have them available in their facility, because they won’t help you. Sotrovimab, which is a newer and a monoclonal antibody, is still effective against Omicron. In fact, it’s effective against all of the current variants that have been circulating. The problem is it’s in substantial short supply. So even if your provider wanted to give it to you – because they have a good sense that most of our cases in Oklahoma are Omicron – they may not be able to because they may not have it.

Not only do we have a shortage of some of these treatments, but we’re also very explicitly told by the (National Institutes of Health) to prioritize certain patients for treatments who are at greater risk of complications. So, people who should be prioritized for getting monoclonal antibodies are the immunocompromised. Those people have a high risk of complications of COVID-19, and they should receive the monoclonal antibodies. Also, people who are unvaccinated are at high risk for severe disease. So, when one of the things I hear is, “They won’t give me the monoclonal antibodies because I’m vaccinated.” And yes, unless you’re immunocompromised or in one of those high-risk categories, and you’re vaccinated, at least by the NIH recommendations, we currently don’t recommend that you receive the monoclonal antibodies because your risk of severe complications goes down.

The State Department of Health offers its own press briefing weekly. The other doctors in this article are members of the Healthier Oklahoma Coalition, a joint effort organized by several of the state’s medical trade organizations. Members hold a weekly press briefing on Tuesdays. Quotes are condensed.

Catherine Sweeney reports for StateImpact Oklahoma, focusing on health.
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