On August 3, 2022

Local doctors explain the current risks of Covid, monkeypox for Vermonters

By Curt Peterson

Local residents are worried about endless variants of Covid-19, and the new Monkeypox. As usual, these important topics are clouded by unanswered questions and misinformation.

Both Dr. Rick Hildebrant, Rutland Regional Medical Center’s chief information officer and department chair of medicine, and Dr. John Perras, Mt. Ascutney Hospital and Health Center’s CEO, cited the Center for Disease Control for official national and county statistics.

There have been 90,895,306 Covid cases since its first identification. Deaths to date total 1,024,611, and there are 36,996 hospitalized Covid patients in the U.S. right now.

Rated according to community level, based on the numbers of beds in use by Covid patients and of new-case admissions, Rutland County was ranked medium and Windsor County was ranked low.

“We are very lucky in Vermont,” Hildebrant said, citing outdoor activities as one reason the state has fared better in the summer months. “Now is the time to strike while the iron is hot — plan weddings and parties before fall,” he advised.

Perras added most positive cases this summer followed recent travel when people were packed together for long periods — waiting in lines, mass transit, crowded bars, conference rooms, theaters, concerts, etc.

He said while vigilance and summer activities reduced hospitalizations and deaths, infected healthcare workers create a problem. Feeling sick and quarantines take them out of the workforce.

“Each person unable to perform hurts us,” Perras said.

Both local doctors (and most nationwide) worry about the fall when people will spend more time indoors in close quarters. New variants are also probable and those vaccinated (or boosted) over six months ago won’t have much protection at all, Perras told the Mountain Times.

As fall approaches, the sage advice from the medical community continues to be: keep up-to-date on Covid boosters and mask up when in close space with others.

Unlike the early days of the pandemic, Vermonters now know what to do, and have the tools to do it.

“Our early national Covid response was like building a plane while flying it,” he said. “We underestimated the threat early on, but we won’t do that again with new viruses.”

Scientists are developing antibody vaccines for BA-5, the current Covid variant, which accounts for 80% of new cases in the U.S. Others are working on a vaccine that may be effective for all future coronal viruses.

Perras said because Covid precautions also reduced exposure to the flu, there was “almost zero” incidence of flu this past winter season.

“Eventually, we will manage Covid like we manage the flu,” Perras said. “Long Covid is the difference — there is no such thing as ‘long flu’.”

Hildebrant said the bad news is, the current vaccines don’t “exactly match” the BA-5 variant — the cell’s spikes don’t perfectly dock with those of the vaccine. Efficacy is lower than with other variants. The good news is, BA-5 is the least deadly variant so far.

“Viruses don’t want to kill their host,”Hildebrant said. “Over time they become less deadly, more contagious.”

To protect yourself and your family from infection, check current case counts in your county regularly, Hildebrant advised. Up-to-date data are available on the CDC.gov website, county by county. People should adjust their precautions and risk factors based on the current situation, he said. And that advice follows if you’re going to travel, he said, check the data at your destination and adapt your behavior accordingly.

Monkeypox

Both local doctors were glad to talk about Monkeypox, and dispel some common fears. Monkeypox probably originated among rodents, but it became known as Monkeypox because it was first identified in lab monkeys in 1958, and spreads rapidly among primates.

Last month, on July 23 the World Health Organization declared Monkeypox a “global health emergency” because of increasing case counts in North America and Europe. Previously, the illness was persistent, but not widespread, in West Africa.

The latest data indicated that there were 3,900 cases in the U.S., mostly in cities; 3,900 in Spain, and most of the balance of 18,000 global cases in Africa. Five people have died of the disease — it is generally not deadly, presents as a rash of pimples or open sores like chicken pox, fever and swollen lymph nodes, and is very painful.

Transmission is through skin-to-skin contact or through body fluids, unlike Covid, which is spread by airborne particles.

With Covid it’s the sneeze — with Monkeypox it’s the squeeze, according to Hildebrant.

New York City suffers the highest number of cases, San Francisco close behind. Vermont’s first documented case was reported Friday, July 29.

The fluids from Monkeypox sores are what spreads the disease and are used for diagnosing. A fluid swab will provide evidence of the virus.

Doctors clarify that Monkeypox is not a “gay men’s disease.” While men who partake in risky, multiple partner sexual contacts with other men are at the most risk, people can also contract the virus by wearing an infected person’s clothing, sleeping on sheets previously used by a Monkeypox victim, kissing or even shaking hands with an infected person.

As with the flu and Covid, washing your hands frequently and maintaining your personal space are very effective.

“It isn’t one’s demographic that puts one at risk,” Perras said, “it’s one’s behavior that puts one at risk.”

Some have blamed a lack of Monkeypox vaccine, which is very much the same as smallpox vaccine, for the spread. But Hildebrant said the U.S. government actually has a stockpile of pox vaccine as protection against possible bioterrorism. And local health officials plan to offer the vaccine to people who have the infection and to anyone who has been exposed.

Supportive Monkeypox treatment includes quarantine and vaccination, similar to Covid.

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