The Wannabe Mayor And His Spokesperson, Unmasked

Continuous subcutaneous insulin infusion bests injections in T2DM
(HealthDay)—For patients with type 2 diabetes and hemoglobin A1c (HbA1c) >8 percent following multiple daily injections (MDI), continuous subcutaneous insulin infusion (CSII) is associated with a significantly greater reduction in HbA1c than MDI, according to a study published online April 4 in Diabetes, Obesity and Metabolism.

Muriel Metzger, M.D., from the Diabetes Clinic in Jerusalem, and colleagues examined factors associated with the decrease in HbA1c among patients receiving CSII in the OpT2mise randomized trial. Following MDI optimization, patients with type 2 diabetes and HbA1c >8 percent were randomized to receive six months of CSII (168 patients) or MDI (163 patients).

The researchers found that, compared with MDI, CSII produced a significantly greater reduction in HbA1c; the difference increased with baseline HbA1c. Higher baseline HbA1c, geographical region, higher education level, higher total cholesterol level, lower variability of baseline glucose valued on continuous glucose monitoring, and the decrease in average fasting self-monitored blood glucose at six months were the only factors significantly associated with decreased HbA1c in the CSII arm.

"These findings suggest that CSII offers an option to improve glycemic control in a broad range of type 2 diabetes patients in whom control cannot be achieved with MDI," the authors write.

The study was funded by Medtronic.

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Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
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What you need to know about monoclonal antibodies

First, we searched for effective methods to treat seriously ill patients with COVID-19. ICU teams across the country used drugs like remdesivir and treatments such as artificial ventilation to help thousands recover. Then, we anxiously awaited the development of a safe and effective COVID-19 vaccine. Now, we continue to strive to treat those who are at increased risk for severe illness from COVID-19, and monoclonal antibodies have been shown to play a key role.

Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight a particular infection, such as COVID-19. Research has shown that the risk of hospitalization or death was reduced by 85% among those who received sotrovimab, a monoclonal antibody that has been granted emergency use authorization by the U.S. Food and Drug Administration. Sotrovimab joins oral antiviral medications as one of the few treatments for mild to moderate COVID-19 that are effective against the omicron variant.

Studies have shown patients feel better and get back to work faster after receiving monoclonal antibodies. The administration of monoclonal antibodies also reduced the duration of symptoms in patients with COVID-19.

Who qualifies for monoclonal antibody treatment?
According to Dr. Ran Regev, a board-certified emergency medicine doctor affiliated with Sharp Chula Vista Medical Center, monoclonal antibodies are an appropriate treatment for people who are at least 12 years old and 88 pounds, and are at increased risk for severe illness from COVID-19. They must have recently tested positive for COVID-19 and be within 10 days of the onset of any COVID-19 symptoms, such as fever, cough, sore throat, headache, fatigue, muscle pain, stomach upset and loss of taste or smell.

People considered to be at high risk of severe COVID-19 illness include those who:

Are age 65 or older
Are overweight (body mass index over 25)
Are pregnant
Are currently receiving immunosuppressive treatment
Have the following conditions:
Chronic kidney disease
Type 1 or Type 2 diabetes
Weakened immune system
Cardiovascular disease or high blood pressure
Chronic lung disease
Sickle cell disease
Neurodevelopmental disorders
Medical-related technological dependence
“To qualify for treatment, a patient at risk for severe illness with laboratory-confirmed COVID-19 infection must have mild to moderate COVID symptoms and not require supplemental oxygen or hospitalization,” Dr. Regev says.

What happens during treatment?
Once a patient meets the criteria for treatment, Dr. Regev reports that the care team will discuss the risks, benefits and alternatives to monoclonal antibody treatment with them.

The antibodies are administered through a 30-minute infusion or injection. Some people may experience mild bruising or irritation at the infusion or injection site.

Patients will be monitored for signs of an allergic reaction for one hour after receiving the treatment. Though rare, reactions can include:

Fever
Chills
Nausea or vomiting
Headache
Shortness of breath
Low blood pressure
Wheezing
Swelling of the lips, face or throat
Rash or hives
Itching
Muscle aches
Dizziness
Can monoclonal antibodies replace the need for vaccination?
While monoclonal antibodies provide an effective means to prevent the development of severe COVID-19 in those who have already been infected, Dr. Regev says that vaccination remains the best way to prevent infection, severe symptoms, hospitalization and death. “I cannot stress enough the importance of vaccination,” he says.

In San Diego County, the hospitalization rate for people who are not vaccinated is three times higher than those who are fully vaccinated, and the death rate is four times higher. This supports Dr. Regev’s and colleagues’ continued — and confirmed — assertions that the COVID-19 vaccines available in the U.S. are safe and extremely effective.

“I encourage everyone who qualifies for vaccination to vaccinate themselves and to encourage their loved ones to do the same,” Dr. Regev says. “This will not only significantly reduce their chance of morbidity and mortality from COVID, but also will likely help in ending the pandemic.”

If you have been recently diagnosed with COVID-19, talk with your doctor about whether you qualify for monoclonal antibody treatment. The County of San Diego offers treatment at several Monoclonal Antibody Treatment Centers and reports there is ample supply of treatment available, which is available at no cost, regardless of health insurance or immigration status. Additionally, your doctor's referral is not required.

For information about monoclonal antibody treatment in San Diego, call 619-685-2500 or email COVIDtreatment@sdcounty.ca.gov. Learn more about COVID-19 vaccination, testing and care resources at Sharp.

This story was updated in February of 2022.

Is our blood pressure rising due to the pandemic?
Feb. 18, 2022
Illustration of woman wearing a mask
Early in the pandemic, it was revealed that having high blood pressure, also called hypertension, put people at greater risk for having severe complications related to COVID-19. The heightened attention on blood pressure continued, and in December 2021, the American Heart Association reported that blood pressure levels have increased across the board for men and women during the past two years.

Experts attribute the rise to more people engaging in behaviors — fueled by the pandemic — that contribute to high blood pressure, such as eating processed food, which can lead to weight gain; increasing alcohol use; and decreasing exercise and physical activity. There is also the added factor of the elevated stress levels people have been experiencing during this time.

According to Dr. David Hall, a board-certified internal medicine doctor with Sharp Rees-Stealy Medical Group, the nationwide rise in blood pressure is hitting close to home too. Increasing numbers of patients in the San Diego area have been diagnosed with hypertension, some for the very first time.

“I have also noticed elevation of blood pressure in patients with previously controlled hypertension,” he says. “This is concerning because elevated blood pressure over time can lead to serious complications, including stroke, heart attack, heart failure and kidney failure.”

A rise in blood pressure can be gradual or it can rapidly spike. For patients susceptible to hypertension, risk factors that quickly elevate blood pressure include drinking more than two alcoholic drinks a day, eating a high-sodium diet, and dealing with acute and chronic stress.

Such stress can trigger an increase in blood pressure by raising levels of adrenaline and cortisol. Sleep disorders, such as sleep apnea, also contribute to high blood pressure.

Controlling hypertension with the help of your doctor
Dr. Hall recommends that if you experience a sudden increase in blood pressure to promptly contact your primary care doctor to rule out any secondary causes. You should have your blood pressure taken at every appointment. If the reading comes back as elevated, blood pressure should be retaken to verify the numbers.

If you have elevated blood pressure, there are several ways to monitor and control it:

Initial guidance — Your doctor can instruct you on how to take blood pressure recordings at home and make healthy lifestyle changes.
Follow-up — A follow-up visit should be scheduled for high blood pressure. Close contact should be maintained with your care provider until your hypertension is well controlled. Then, follow-up appointments every 6 months are recommended.
Medication and treatment — If your blood pressure remains high, your doctor might discuss treatment options with you, such as blood pressure medication.
Testing — Your kidney function will also be monitored with annual blood and urine tests.
Health coaching — If you have difficult-to-control blood pressure or need additional monitoring or education, Sharp offers health coaches who keep in contact with you and provide support, education and guidance.
Ways to lower blood pressure on your own
While medical intervention to treat high blood pressure is often necessary, dietary changes can also have an immense impact. “Lifestyle modification is crucial and is the backbone of all hypertension treatment,” confirms Dr. Hall.

He recommends switching to a DASH diet or Mediterranean diet. These are generally low in refined carbohydrates and sugar, rich in fruits and vegetables, and include a moderate amount of lean proteins, like chicken and fish, and healthy fats, such as olive oil, nuts and avocados.

In some studies, this type of diet has been shown to reduce blood pressure 5 to 10 points. Cutting back on sodium to no more than 1,500 milligrams a day can reduce blood pressure an additional 4 to 5 points.

Combined with a healthy diet, exercising for 90 to 150 minutes a week can also significantly lower blood pressure. These changes will often lead to weight loss, which also improves blood pressure. Stress reduction and limiting alcohol intake can also make a big difference.

Talk with your primary care doctor if you are concerned about your hypertension management. Together, you can come up with an appropriate plan to treat it, make lifestyle changes and reduce your risk of serious complications.

Relief in sight for pain-in-the-neck disks
Feb. 17, 2022
Julie Goecks of San Diego
Cervical disk replacement helped Julie Goecks regain full range of motion in her neck.

After, as she puts it, being “stuck looking forward” for years, Julie Goecks’ two degenerated disks are no longer a pain in the neck.

“When I wanted to turn my neck, I pretty much had to turn my whole body,” says Julie. “It was frozen in one spot, and I couldn’t turn from side to side, or even tip my head back.”

The neck, or cervical spine, includes the first seven disks of your spinal column. Damaged disks can greatly limit your mobility and quality of life — and can be very painful. Tissue damage in the disks creates what is called degeneration, and when inner disks squeeze through the outer disks, it is called a bulging or herniated disk.

In the past, treatment was limited to either fusion surgery, which simply stabilizes the spine, or the use of older-generation cervical replacement disks. These tended to be big and bulky and did not provide a full range of motion. Also, they were designed for patients who needed only one disk replaced.

Groundbreaking option provides relief
Today, however, a state-of-the-art replacement disk, called Mobi-C, stands apart. Its design mimics the natural motion of a healthy cervical spine, allowing people to get back to living their best life.

Dr. Ramin Raiszadeh is an orthopedic surgeon affiliated with Sharp Grossmont Hospital, who specializes in spine care and is a champion for cervical disk replacement using this technology.

“With a fusion, patients lose the ability to move that segment of their spine, putting a lot of strain on the disks above and below the fusion,” says Dr. Raiszadeh. “With the Mobi-C disk, patients are able to move their spine at the location of that new disk, and don’t have those issues with the adjacent disks that were a problem with the older technology.”

Mobi-C is also the first cervical disk to be approved by the FDA for use in patients who need multiple disk replacements. That’s what made Julie an ideal candidate for this technology.

When she first saw Dr. Raiszadeh, she had been living with her condition and physical limitations for years.

“He said, ‘I’m very confident you’ll feel much better after this procedure or I wouldn’t be recommending it,’” says Julie.

He was right. “Now, I can drive, tie my shoes, and do the normal day-to-day things we take for granted,” she says.

A return to activities after life-changing procedure
Dr. Raiszadeh wants to spread the word to patients that this option is out there. The procedure could allow them to avoid unnecessary fusion and, possibly, subsequent surgeries to those disks above and below the damaged one.

Cervical disk replacement is an option for patients who have tried conservative treatments, such as physical therapy and injections. However, patients with more than two damaged disks, osteoporosis or very severe neck pain are typically not ideal candidates.

For those patients fortunate enough to have the procedure, Dr. Raiszadeh says the difference is life-changing. Most can return to a desk job within a week after the procedure, and to all their favorite activities within three months.

Just ask Julie. Before her surgery, she remembers playing softball with her daughter and granddaughter but not being able to look straight up. She says she just kept her fingers crossed that she didn’t get knocked out by a fly ball.

“Now I can look up and, hopefully, catch the ball,” she says.

Top gadgets to reduce loneliness in older adults
Feb. 16, 2022
Man using tablet
Life can get busy with working, caring for children and running errands. It can become easy to forget the last time you checked in with the older adults in your life, such as family members, neighbors or senior acquaintances.

According to the U.S. Census Bureau, many older adults are struggling with loneliness, as nearly one-third live by themselves — that’s close to 14 million people. Life events, such as losing family and friends, and hearing and memory loss, put older adults at higher risk of isolation.

Loneliness and social isolation in older adults have been linked to serious health conditions. And as the pandemic continues, the persistent lack of connectivity can impact their mental health and well-being.

“Isolation of older adults is dangerous for many reasons, especially when it comes to mental health,” says Dan McNamara, program coordinator for the Senior Resource Centers at Sharp Grossmont Hospital. “People are social by nature. We have to remember that older adults are people too.”

Gadgets to stay connected
Relationships are important to everyone, as they can make a difference in happiness, physical health and lowering stress. Fortunately, some popular devices can help you stay close and connected with the older adults in your life when you are unable to be together in person. These include:

Smartphones or tablets — While many of us associate smartphones and tablets with younger people, older adults also recognize the benefits of these convenient communication tools. According to the Pew Research Center, 61% of people over age 65 use smartphones. Family and friends can share special moments by uploading photos and videos, as well as stay in touch through video chats.

Virtual reality — Seniors around the world are using virtual reality to help reduce loneliness and improve their mental health. Virtual reality tools can transport them to different places without leaving the comfort of home. The virtual reality experience also allows older adults to enjoy adventures with friends who live in another part of the country. They can enjoy experiences that may no longer be physically possible, such as riding a roller coaster, visiting a place they have never been to, or taking a trip down memory lane to their favorite places.

Robotics — Hearing the word “robots” may take an older adult back to Will Robinson’s adventures in “Lost in Space.” As seniors encounter social isolation and loneliness, many are rethinking the role of robotics in improving their mental health. Artificial intelligence, or AI, can be used to create a digital home companion for older adults that can respond to questions, initiate calls, monitor and analyze the person’s environment, as well as provide entertainment and emotional enrichment activities — effectively serving as a virtual personal assistant.

Monitoring systems — According to the National Council on Aging, over 80% of older adults have at least one chronic disease. Add to this list other common age-related issues, such as risk of falls, heart disease, stroke and Alzheimer’s disease, and monitoring systems can provide an extra sense of security. In the event of an emergency, these systems can receive alerts via a phone app. Some monitoring systems even include sensors that allow conversations with the person while they are being monitored.

Continued need for technology solutions
The demand for more solutions to minimize isolation among older adults will only grow as the number of people age 65 and older — as well as the number of adults living alone — increases. According to the Census Bureau, by 2034, there will be 77 million people age 65 and older, and just 76.5 million people under age 18. If the projections are correct, this will be the first time in U.S. history that older people will outnumber children.

However, according to McNamara, using technology might help us gain an advantage in caring for the increased number of older loved ones. “Whether that means a short visit on a video call or using a camera system as a second set of eyes and ears, we can show love to our older adults in a variety of ways. Connecting with them is one of the absolute best,” he says.

Walking together for good health
Feb. 8, 2022
Sharp Grossmont Center Mall Walkers
The Grossmont Mall Walkers look forward to their weekly group gathering at Grossmont Center.

On Saturday mornings at the Grossmont Center Food Court, you’ll find Daphne Miller and her bright smile, ready to welcome a group of friends in their athletic wear and laced-up sneakers. Armed with energizing music and cheerful encouragement, Daphne gets the group started with a warmup before they set out for their weekly walk at the shopping complex.

This lively group of older adults gathers weekly to participate in the Grossmont Mall Walkers program. Established more than three decades ago at the La Mesa mall — long before Zumba, CrossFit and kettlebell workouts became trendy — the program brings together individuals from all walks of life who seek cardiovascular exercise in a non-gym setting.

The free program, supported by the Senior Resource Center at Sharp Grossmont Hospital, not only promotes an active lifestyle, but also provides a social outlet for participants. According to Deborah Maddern, a participant in the walking program, the group is a great fit for her.

“I’m so glad I joined the group!” she says. “I recently celebrated turning 70, and I’ve been able to participate in this with ease, even after having surgery. I’m so glad I learned that this program was out there.”

With a walk and a smile
“Having this program essentially in our own backyard is fantastic,” says Dan McNamara, program coordinator at Sharp Grossmont’s Senior Resource Center. “Participants look forward to this every week.”

Daphne, who radiates positivity and has a degree in gerontology, says that the walkers inspire her. “This is very beneficial for their health — and it’s free,” she says. “The more you do for people, the more they feel connected.”

An avid member of the fitness classes for over seven years, Barbara Wallbank appreciates that anyone can participate in Daphne’s classes, no matter their skill level. “Even though I could be sleeping in late on a Saturday, I wake up early to come to her class because I enjoy the energy,” she says.

The Grossmont Mall Walkers meet every Saturday at 9 am in the food court at Grossmont Center in La Mesa. New walkers are always welcome.

Vegetables that get a bad rap
Feb. 15, 2022
Roasted potatoes
It’s no secret that vegetables are an important part of a healthy diet. Yet, some vegetables get a bad rap as being less healthy.

According to Lauren DeWolf, RD, a registered dietitian and wellness education specialist with Sharp Rees-Stealy’s Center for Health Management, certain vegetables might be more nutrient-dense than others. These vegetables tend to get all the attention as superfoods. However, every vegetable has something to offer nutritionally.

“Oftentimes, the processing and preparation method can have a big impact on the final nutritional profile of a vegetable choice,” she says.

DeWolf reports that although the following four vegetables often get a bad reputation, they don’t necessarily need to be eliminated from your diet:

Potatoes
You may have heard that you should eliminate white foods from your diet. Generally, this can help reduce the amount of refined, processed foods we eat, such as white sugars and white flours. However, this thinking doesn’t necessarily apply in the same sense to vegetables. Cauliflower, garlic, onion, turnips and potatoes are all white vegetables and have many redeeming qualities.

Potatoes offer nutritional benefits, such as fiber, protein, potassium, vitamin C and phytonutrients. When we peel and deep fry potatoes, the final result is a calorie-dense food that is difficult to moderate. However, when we prepare potatoes in a manner that minimizes added fat, they can serve as a healthy choice. Additionally, baked potatoes can be a blank canvas for other nutritious toppings, such as broccoli, black beans, salsa and avocado.

Peas
Peas are categorized as a starchy vegetable, which some people may equate to a bad choice nutritionally. For those managing their blood glucose levels, consuming starchy vegetables requires some balancing and moderation of total carbohydrate intake from their meals and snacks. However, not only does a half-cup serving of peas provide 4 grams of fiber, but it also packs 4 grams of protein, in addition to a wealth of vitamins and minerals — all for under 60 calories.

Frequently sold frozen, peas are a convenient add-in to soups, stir-fries and other mixed dishes. Easy-to-incorporate veggies such as peas can make a difference between getting in a serving versus skipping them.

Iceberg lettuce
While iceberg lettuce isn’t as nutritionally dense as other leafy greens, it does have redeeming qualities. Lettuce is high in water content and provides a crunchy texture for meals. Iceberg lettuce also provides folate, potassium and calcium.

In addition, iceberg lettuce is a low-calorie choice at just 10 calories per cup. Adding iceberg to a meal can help displace more calorie-dense food while still allowing for a full plate of food.

Corn
When we think of corn, we might think of corn syrup or the particularly villainous high fructose corn syrup. Fresh or frozen corn is quite different nutritionally from the highly refined syrup. Corn provides fiber, B vitamins, lutein and an abundance of antioxidants.

Consider adding corn to salads, soups and salsas, or enjoy it on the cob. The added fiber can help you feel full and improve your digestive health.
When it comes to vegetables, DeWolf says to keep the big picture in mind. While kale may be more nutritionally dense than iceberg lettuce, either would be a fantastic choice when compared to chips, soda or any processed snack.

“The key consideration is to ensure we are getting those veggies in each day,” she says.

3 things to know about high blood pressure and pregnancy
Feb. 15, 2022
Pregnant woman blood pressure
High blood pressure — also called hypertension — in pregnancy may not be a common condition, but it can be a concerning one.

Women are considered to have chronic hypertension in pregnancy if they had a preexisting hypertensive condition before getting pregnant or developed high blood pressure within the first 20 weeks of pregnancy. This type of hypertension should not be confused with gestational hypertension, which is high blood pressure identified after 20 weeks of pregnancy paired with normal blood pressure before pregnancy.

For women with chronic hypertension who are pregnant or planning to become pregnant, there are a few things to know.

Know the risks
While many women with chronic hypertension do well in pregnancy, it is important to know the risks associated with the condition. New research shows mortality rates have increased for pregnant women with chronic hypertension, especially among Black women. Obesity and advanced age contribute to even greater risk of hypertension-related maternal deaths.

Women who are pregnant and have chronic hypertension are also at increased risk for possible pregnancy complications, including:

Eclampsia
Superimposed preeclampsia
Fetal growth restriction
Placental abruption
Preterm birth
Cesarean section
Miscarriage
Fetal demise
Stroke
Maternal death
“It's important for women to know the risks of chronic hypertension to help prepare for additional surveillance before and after pregnancy, as well as to modify lifestyle choices prior to conception,” says Dr. Sara Junya, a board-certified obstetrician-gynecologist with Sharp Rees-Stealy Medical Group.

Work closely with designated doctors
As with any pregnancy, it’s important to adhere to regular prenatal care checkups. For pregnant women with chronic hypertension, more frequent prenatal visits are recommended.

It’s also not uncommon for women with chronic hypertension to consult with various doctors. At some point during the pregnancy, for example, a referral to a cardiologist might be necessary.

Dr. David Hall, a board-certified internal medicine doctor with Sharp Rees-Stealy Medical Group, advises that women on antihypertensive drugs should work closely with their primary care doctor and obstetrician to switch to drugs with an established fetal safety profile.

“Do not be afraid to ask questions of your doctor,” adds Dr. Junya. “No question is silly or too small. I often recommend writing down any questions and bringing them to your visit to ensure that we do not miss a topic you would like to discuss.”

Working closely with doctors includes maintaining care into the postpartum period. “We will work closely with you to make sure that the blood pressure fluctuations after delivery are not too low or too high, which can often require longer monitoring in the hospital postpartum or frequent postpartum visits to check blood pressure values,” Dr. Junya says.

Focus on factors within your control
Even though having chronic hypertension may seem overwhelming on top of managing pregnancy, there are strategies women can concentrate on to feel more in control. Dr. Hall recommends increasing one’s attention to lifestyle changes, such as sustaining a healthy diet, reducing sodium intake, and getting regular exercise and sleep. And Dr. Junya emphasizes the critical importance of stress reduction, as well as quitting use of tobacco, drugs and alcohol.

Additionally, following doctors’ instructions to check blood pressure at home and report any elevated values or signs or symptoms of increasing blood pressure is one action patients can focus on, Dr. Junya says. Another is being diligent in taking prescribed or over-the-counter medications as recommended by your doctors.

Experts agree that while experiencing chronic hypertension during pregnancy is not without its risks, having an attentive care team and following good health habits will help ensure a successful pregnancy.

High blood pressure’s connection to COVID-19
Feb. 2, 2022
Blood pressure monitor
When cases of COVID-19 began to surge around the world, experts realized the virus was particularly dangerous for people with heart disease and related conditions, especially high blood pressure. Nearly half of all adults in the U.S. — 103 million people — have high blood pressure, also known as hypertension.

More concerning is that only 1 in 4 adults have their blood pressure under control. Blood pressure that’s not well-managed can lead to serious complications, such as heart attack and stroke. As COVID-19 outbreaks continued, a new concern emerged. People with high blood pressure may be at greater risk of more serious complications from the coronavirus, including death.

Possible link between blood pressure regulation and COVID-19
“Early reports from areas of the world most affected by COVID-19 showed higher morbidity and mortality rates in patients with conditions like hypertension, coronary artery disease, diabetes and obesity,” says Dr. Steven Rough, a cardiologist affiliated with Sharp Chula Vista Medical Center. “What was found is COVID infects the cells that help regulate blood pressure, suggesting a possible link between hypertension and severe COVID infection. More studies are needed to determine if there is, in fact, a cause and effect.”

While the link between hypertension and serious complications isn’t entirely clear yet, what is clear is keeping blood pressure under control is extremely important.

COVID-19’s other dangerous implication is that it has kept many patients away from local hospitals and emergency rooms due to fears about getting the coronavirus. Hospitals across the country are reporting fewer visits for urgent medical needs, which some experts believe isn’t because patients are having fewer of them, but rather they’re avoiding or delaying seeking treatment.

In San Diego County, there have been 20 to 40 fewer heart attacks reported each month since the COVID-19 pandemic began, as well as a 70% decrease in calls to the Emergency Medical Services (EMS) system. With high blood pressure being a risk factor for serious conditions like heart attack, stroke and heart failure, it’s important that patients do all they can to keep it under control despite the pandemic.

Blood pressure measurement includes two numbers: systolic (top number) and diastolic (bottom number). People with a systolic above 130 or a diastolic above 80 — a reading of higher than 130/80 mmHg — are considered to have hypertension. Extreme high blood pressure, a reading of 180/120 mmHg or higher, should seek immediate medical attention. Anyone with a reading of 180/120 mmHg or higher who is also experiencing chest pain, shortness of breath, or changes in vision or speech should call 911.

“Having high blood pressure can lead to serious complications like heart attack, stroke, heart failure and aneurysm formation,” says Dr. Rough. “There is a lot that can be done for prevention, though. The best thing I can tell my patients with high blood pressure to do throughout this pandemic is to eat as healthy as possible, make time for exercise, stay current with appointments with your doctor, and don’t ever delay going to the emergency room for a serious medical need. We’ve already taken a lot of steps, and continue, to make the ER and hospital safe for patients to come in.”

To learn more about the extra safety precautions in place at Sharp Chula Vista Medical Center, visit sharp.com/getcare.

How does COVID-19 affect your eyes?
Feb. 7, 2022
Woman wearing mask rubbing her eyes
They may be baby blue, beautiful brown or groovy green. Whatever their color, the eyes are the second most complex organ after the brain and are made up of more than 2 million working parts. In fact, you only see one-sixth of the eyes when looking in the mirror.

We rely on our eyes thousands of times a day. Unfortunately, among the many challenges related to COVID-19, some people’s eye health has been negatively affected during the pandemic.

Pandemic-related eye problems
According to Dr. Gayle Howard, a board-certified ophthalmologist affiliated with Sharp Community Medical Group and Sharp Chula Vista Medical Center, even the use of face masks has caused some eye troubles. In the past two years, she reports there has been an increase in dry eye diagnoses.

“Wearing a mask forces the airflow upward, out of the mask, causing dry eye,” Dr. Howard says. “And the positioning of the face masks on the lower lid may cause it to be pulled downward, causing greater exposure and worsened dry eye.”

But don’t ditch those masks. With a few adjustments for a snug fit, you can remove any gaps that allow air to leak out of your mask. This will help you avoid dry eye, and ensure you continue to use this effective method to protect you from getting COVID-19, which can lead to a variety of eye conditions.

These include:

Decreased tear production due to inflammation in the lacrimal gland — the gland above the eye that produces tears
Sensitivity to light
Conjunctivitis, also known as pink eye
“There have been rare reports of episcleritis and iritis — more serious inflammation of the front parts of the eye,” Dr. Howard adds. “These conditions require immediate medical intervention.”

The American Academy of Ophthalmology also advises that after having COVID-19, some people will develop eye conditions ranging from mild to vision-threatening. These include:

“Cotton wool” spots — Blood clots prevent nutrients from reaching the retina, and the tissue in the retina begins to swell and die.
“Eye stroke” or retinal artery occlusion — Blood clots in the arteries of the retina block the flow of oxygen, causing cells to die, sometimes causing sudden, painless vision loss.
Retinal vein occlusion — A vein in the retina becomes blocked, raising blood pressure levels inside the eye, which can cause bleeding, swelling and fluid leaks, and lead to vision changes from blurry vision to sudden, permanent blindness.
Retinal hemorrhage — Blood vessels in the retina start bleeding, sometimes due to retinal vein occlusion, and can lead to blind spots and gradual or sudden loss of vision.
Dr. Howard encourages everyone to make an effort to maintain their eye health. Have a vision exam every year. And seek care from an ophthalmologist if you had COVID-19 and notice changes to your eye health or vision; have eye pain or dryness; get an eye infection; or are experiencing pressure in your eyes.

High blood pressure’s connection to COVID-19
Feb. 2, 2022
Blood pressure monitor
When cases of COVID-19 began to surge around the world, experts realized the virus was particularly dangerous for people with heart disease and related conditions, especially high blood pressure. Nearly half of all adults in the U.S. — 103 million people — have high blood pressure, also known as hypertension.

More concerning is that only 1 in 4 adults have their blood pressure under control. Blood pressure that’s not well-managed can lead to serious complications, such as heart attack and stroke. As COVID-19 outbreaks continued, a new concern emerged. People with high blood pressure may be at greater risk of more serious complications from the coronavirus, including death.

Possible link between blood pressure regulation and COVID-19
“Early reports from areas of the world most affected by COVID-19 showed higher morbidity and mortality rates in patients with conditions like hypertension, coronary artery disease, diabetes and obesity,” says Dr. Steven Rough, a cardiologist affiliated with Sharp Chula Vista Medical Center. “What was found is COVID infects the cells that help regulate blood pressure, suggesting a possible link between hypertension and severe COVID infection. More studies are needed to determine if there is, in fact, a cause and effect.”

While the link between hypertension and serious complications isn’t entirely clear yet, what is clear is keeping blood pressure under control is extremely important.

COVID-19’s other dangerous implication is that it has kept many patients away from local hospitals and emergency rooms due to fears about getting the coronavirus. Hospitals across the country are reporting fewer visits for urgent medical needs, which some experts believe isn’t because patients are having fewer of them, but rather they’re avoiding or delaying seeking treatment.

In San Diego County, there have been 20 to 40 fewer heart attacks reported each month since the COVID-19 pandemic began, as well as a 70% decrease in calls to the Emergency Medical Services (EMS) system. With high blood pressure being a risk factor for serious conditions like heart attack, stroke and heart failure, it’s important that patients do all they can to keep it under control despite the pandemic.

Blood pressure measurement includes two numbers: systolic (top number) and diastolic (bottom number). People with a systolic above 130 or a diastolic above 80 — a reading of higher than 130/80 mmHg — are considered to have hypertension. Extreme high blood pressure, a reading of 180/120 mmHg or higher, should seek immediate medical attention. Anyone with a reading of 180/120 mmHg or higher who is also experiencing chest pain, shortness of breath, or changes in vision or speech should call 911.

“Having high blood pressure can lead to serious complications like heart attack, stroke, heart failure and aneurysm formation,” says Dr. Rough. “There is a lot that can be done for prevention, though. The best thing I can tell my patients with high blood pressure to do throughout this pandemic is to eat as healthy as possible, make time for exercise, stay current with appointments with your doctor, and don’t ever delay going to the emergency room for a serious medical need. We’ve already taken a lot of steps, and continue, to make the ER and hospital safe for patients to come in.”

To learn more about the extra safety precautions in place at Sharp Chula Vista Medical Center, visit sharp.com/getcare.

Can you get COVID more than once?
Feb. 2, 2022
Woman wearing mask feeling ill
When attempting to explain the basic difference between the two recent variants of the coronavirus that causes COVID-19, you could say that delta is more dangerous, but omicron is everywhere. However, that doesn’t tell the whole story.

Early reports indicate that omicron may cause less severe illness. However, because it is far more contagious than previous variants, it has led to a surge in cases, an increase in hospitalizations, and a higher risk for COVID-19 reinfection — when someone is infected, recovers and then later becomes infected again.

Ask anyone who has had COVID-19 and they’ll tell you that once is bad enough — even severe or life-threatening for some. Getting it two or three times is certainly not appealing. But a repeat infection is possible, especially if you’ve not yet received a COVID-19 vaccine and booster.

Omicron presents increased risk
According to a recent U.K. study, the risk of COVID-19 reinfection is now 16 times greater than when delta was causing most COVID-19 cases. Also, the study revealed a few other significant findings related to omicron:

People who received a COVID-19 vaccine were less likely to be reinfected than those who were not vaccinated.
People who were unvaccinated were twice as likely to be reinfected than people who had their second vaccine within the last 3 months.
People who previously had COVID-19 were less likely to be reinfected than people not previously infected; however, their risk of reinfection with the omicron variant was greater than their risk of reinfection with delta.
“Essentially, the stakes are higher when it comes to omicron,” says Dr. Abisola Olulade, a family medicine doctor with Sharp Rees-Stealy Medical Group. “You’re risking a variety of things that can cause problems and may be debilitating for a lot of people, including long-term COVID.”

People who are unvaccinated at greater risk
The County of San Diego continues to report that the majority of people hospitalized for COVID-19-related complications are unvaccinated. In fact, the hospitalization rate in the county is 2 times higher for those not fully vaccinated. And the death rate for those who are not fully vaccinated is 7 times higher than fully vaccinated San Diegans.

“All of this definitively tells us that the best way to get protected is by vaccination,” says Dr. Olulade. “Vaccination is always going to be the safest way to get protected from this virus.”

The Centers for Disease Control and Prevention (CDC) recommends that everyone age 5 and older receive a COVID-19 vaccine. Those age 12 and older are also eligible and encouraged to receive a vaccine booster.

Experts also advise everyone to continue to follow other preventive measures:

Wear a well-fitting face mask in public locations
Stay 6 feet apart from people not in your household
Avoid crowds, people who are sick and poorly ventilated indoor spaces
Wash hands often with soap and water or use hand sanitizer with at least 60% alcohol
People should also get tested for COVID-19 if they have symptoms, have been in close contact with someone who has COVID-19, or are directed to be tested by their doctor, school, workplace or public health department.

Testing is available through several community and health care partners. At-home tests are also available online or in stores. Follow CDC quarantine and isolation guidelines while waiting for — and after receiving — test results.

Does the COVID-19 vaccine affect your period?
Jan. 27, 2022
Woman holding heat pack on abdomen
There are well-documented common side effects of the COVID-19 vaccines — arm soreness, headache, fever and fatigue. What’s more, some women have also reported experiencing changes in their menstrual cycle after COVID-19 vaccination.

“In our clinical practice, we have seen patients with complaints of irregular and heavier menses after receiving the COVID-19 vaccine,” says Dr. Ray Kamali, a board-certified OBGYN affiliated with Sharp Chula Vista Medical Center. “This was echoed by anecdotal reports from individuals on social media and various blogs.”

However, a recent study funded by the National Institutes of Health (NIH) indicates that the changes, if connected, are minimal.

Changes remain within normal range
According to researchers, those who received a dose of a COVID-19 vaccine did have an increase in cycle length — of just one day — when compared to unvaccinated women. The experts noted that menstrual cycles regularly vary month to month, and the slight deviation of one day was within a normal range of change.

“It is important to clarify that while the study findings did show an increase in cycle length — which refers to the time between one menstrual cycle to the next — the authors did not find any changes in menstrual duration, which is the number of days of bleeding,” Dr. Kamali says.

The study authors noted that additional research is needed to determine how COVID-19 vaccination might influence other menstrual characteristics, including symptoms such as water retention, mood changes and cramps, as well as the heaviness of blood flow during menstruation.

Causes other than vaccination
According to Dr. Kamali, however, some of the menstrual abnormalities reported in the last two years likely have more to do with the lifestyle changes brought about by the pandemic and less to do with the COVID-19 vaccines.

“Some of these changes can been attributed to the social, psychological and financial stress associated with the pandemic,” he says. “This includes changes in lifestyle from a more active to a more sedentary routine and subsequent weight gain.”

Additionally, Dr. Kamali points out that the reproductive system is closely linked to other internal systems, including the immune system. It is possible that the immune response created by the vaccine can cause a short-lived change to one’s periods. “We are not exactly sure why these changes occur,” he says.

No effect on fertility
And just as the vaccines have been shown to minimally affect menstrual cycles, there is currently no evidence that COVID-19 vaccination causes infertility. This is supported by another recent NIH study that did not find any difference in pregnancy success rates from women who had natural antibodies from COVID-19 infection, antibodies from vaccination, or no antibodies at all.

“In our region in Southern San Diego, vaccination rates are over 70% in reproductive-age women,” says Dr. Kamali. “And we certainly have not seen a decrease in new pregnancies.”

While Dr. Kamali stresses he understands that the decision to receive the vaccine can be a complex one for some patients, especially those who are pregnant or are planning to conceive, he encourages them to list their concerns and have an honest conversation with their doctor.

“This conversation must include the risks associated with COVID-19 infection,” he says. “Based on the available data, due to the risks of COVID-19 infection during pregnancy to mother and fetus, vaccination is recommended to those who are pregnant, breastfeeding and planning on becoming pregnant.”

Can omicron cause long COVID-19?
Jan. 25, 2022
Woman sick in bed
By mid-January, close to 99% of all new COVID-19 cases in the U.S. were due to the omicron variant. Since then, case numbers have continued to soar and hospitals across the country now find themselves overwhelmed by people with COVID-19 seeking care.

Early reports have indicated that the omicron variant is different than other variants of the coronavirus. It was labeled a variant of concern by the World Health Organization (WHO) because of the number of mutations within it — 22 more than the delta variant. And while omicron spreads like no other previous variant, it is believed that it may lead to milder illness.

However, questions about the symptoms of COVID-19 caused by omicron remain: Are the symptoms different, or just milder? Can the symptoms last after the infection and even be long-term — known as long-haul COVID-19 or long COVID?

According to Dr. Kaveh Bahmanpour, a board-certified family medicine and geriatric medicine doctor affiliated with Sharp Community Medical Group, some of the answers to these questions about omicron have been revealed and some are still unknown.

“It has become apparent that omicron generally leads to milder symptoms for the most part,” Dr. Bahmanpour says. “And symptoms usually last 5 to 10 days, which is shorter than previous variants, which could last up to 14 days.”

The Centers for Disease Control and Prevention (CDC) does not differentiate between the symptoms caused by each variant. Common symptoms of COVID-19 — regardless of which variant may have caused the infection — include the following, with the symptoms in bold being the most reported now:

Cough
Congestion or runny nose
Fatigue
Headache
Sore throat
Muscle or body aches
Shortness of breath or difficulty breathing
New loss of taste or smell
Fever or chills
Nausea or vomiting
Diarrhea
The possibility of long COVID
While omicron may cause less severe symptoms, this may not mean a decreased risk of long-term sickness. In fact, the CDC advises that long COVID — a range of symptoms that can last weeks or months after a person is first infected, or can appear weeks after infection — can happen to anyone who has had COVID-19, even if their illness was mild or they didn’t have any symptoms (asymptomatic).

Experts estimate up to 30% of people who have experienced COVID-19 are likely to have persistent symptoms. These symptoms can include those commonly experienced with COVID-19, along with:

Brain fog
Chest or stomach pain
Lightheadedness
Fast-beating or pounding heart (heart palpitations)
Sleep problems
Change in smell or taste
Sensation of pins and needles
Rash
Mood changes
Also, a small number of children with COVID-19 — or who had COVID-19 — experience multisystem inflammatory syndrome (MIS-C). MIS-C is a rare, life-threatening condition that can cause dangerous inflammation in the eyes, skin, blood vessels and heart.

“The possibility of long-term symptoms was something that we found out later in the course of the disease,” Dr. Bahmanpour says. “As we collect more data about each variant, we will be able to predict more. For now, while omicron seems to cause milder symptoms, the possibility of long-term effects is something yet to be determined.”

Decrease your risk
Hospitals across San Diego County are experiencing a surge of patients with severe COVID-19 due to the increased contagiousness of omicron, indicating that not all omicron-related cases are mild. In California alone, the average daily number of patients hospitalized with COVID-19 in the first two weeks of the year was over 11,000.

What’s more, unvaccinated people in the state were found to be eight times more likely to be hospitalized with COVID-19 than fully vaccinated people. This is why vaccination — and receiving a booster shot when eligible — remains vital to stop the spread of COVID-19 and reduce the risk of severe illness, hospitalization and death.

If you experience a coronavirus infection, regardless of your vaccination status, Dr. Bahmanpour advises following the CDC guidance to isolate for no less than 5 days from when symptoms started or testing positive. Isolation can end only if you are fever-free for 24 hours without the use of fever-reducing medication and any other symptoms are improving. You should then wear a face mask around others — in your home and in public — for 5 more days.

“Most of the symptoms should improve after 10 days,” he says. “However, if you are still feeling fatigue and headache or persistent cough, you should be seen by a doctor. Additionally, if you experience shortness of breath anytime during the course of the disease, you need to seek immediate care.”

COVID-19 antiviral drugs arrive as surge strikes
Jan. 20, 2022
Pharmacist explaining medication to patient
As the omicron variant began to rapidly spread across the country in late 2021, two new treatments for those at greatest risk of serious illness from COVID-19 were given emergency use authorization (EUA) by the Food and Drug Administration (FDA). Drugmakers Pfizer and Merck’s prescription oral antiviral medications were added to the toolbox of treatments for mild to moderate COVID-19.

“The two new treatments give physicians another tool to fight COVID,” says Suzanne Shea, RPh, vice president of Sharp HealthCare’s system pharmacy services. “Pfizer’s Paxlovid and Merck’s molnupiravir are both authorized for COVID-positive patients who are at high risk for severe illness.”

However, Shea is quick to point out that the medications are not prophylactic treatments, meaning they are not intended to prevent disease. But because both are oral medications in tablet form, a trip to an infusion center is not needed. “This saves time for our clinicians, and patients can be treated at home,” Shea says.

How COVID-19 antiviral medications work
The two new COVID-19 antiviral medications prevent the coronavirus from replicating, allowing people with COVID-19 who may be at risk for developing severe illness to avoid hospitalization. And with hospitals throughout the U.S. overwhelmed by increasing numbers of patients needing care for COVID-19, the medications are arriving at the perfect time.

While Shea reports that there are differences in the drugs’ effectiveness — studies have found Paxlovid 89% effective and molnupiravir 30% effective in treating COVID-19 — both are showing the ability to be effective against the delta and omicron variants when taken as directed. The prescription oral antivirals are to be started as soon as possible after a diagnosis of COVID-19 and within 5 days of symptom onset.

Eligibility for treatment with the new antiviral drugs
According to the drugs’ EUAs, Pfizer’s Paxlovid can be used in patients age 12 and older with confirmed COVID-19. Due to its possible effect on bone and cartilage growth, the Merck drug molnupiravir is limited to COVID-positive patients age 18 and older.

Additionally, the Merck drug is not for use with pregnant women, and the Pfizer drug should not be taken by people with kidney or liver disease. Pfizer’s Paxlovid may also cause interactions with commonly prescribed drugs, such as blood thinners, statins, HIV treatments and antidepressants. Talk with your doctor about whether Paxlovid is right for you.

Vaccination remains vital
While the addition of the two new antiviral medications to treat COVID-19 is to be celebrated, experts agree that vaccination is the best way to lower the risk of getting and spreading COVID-19. Vaccines are also safe and highly effective at preventing serious illness and death.

What’s more, doctors are reporting difficulty in accessing supplies of the new antiviral medications for their patients. So, availability of the drugs cannot be counted on as a substitute for vaccination.

On the other hand, access to COVID-19 vaccines is abundant in most areas of the country. Children age 5 and older can receive the Pfizer COVID-19 vaccine, and adults age 18 and older can receive either the Pfizer or Moderna COVID-19 vaccines. Additionally, the Centers for Disease Control and Prevention (CDC) now recommends that all adults and adolescents age 12 and older receive a booster shot.

“Our first line of prevention of COVID-19 is still the vaccine and now, getting a booster,” Shea says. “These are shown to prevent COVID-19 and if infected, patients are far less likely to be hospitalized and suffer a severe form of the disease. Most hospitalized patients are not vaccinated, and so we can’t emphasize enough the importance of receiving a COVID-19 vaccine and booster when eligible.”

Which mask should you wear?
Jan. 18, 2022
Woman wearing mask
Most COVID-conscious people have a basket, drawer or hook overflowing with face masks. They might be fabric, surgical or specialty. And depending on what material they’re made of, some might be less effective than others.

According to recent guidelines from the Centers for Disease Control and Prevention (CDC), it is important that people wear the most effective mask they can get to protect themselves from the rapidly spreading and highly contagious omicron variant, as well as the still circulating delta variant, which may cause more severe disease.

Here’s what you need to know now about face masks:

Mask-up when warranted. While face masks are no longer mandated for people who are vaccinated in California – with the exception of schools, health care settings, and a couple of other locales — all people who have not yet received a COVID-19 vaccine must continue to wear a face mask in public locations. Additionally, everyone age 2 or older — regardless of vaccination status — may want to consider wearing a mask in crowded indoor public places, when sick and when around people who are or might be sick.

Snug is safest. Face masks should completely cover the nose and mouth and fit snugly against the sides of the face. While comfort is important in ensuring you’ll continue to wear the mask as needed, a snug fit will help keep you better protected during an exposure. However, avoid making the mask so snug that it is difficult to breathe. If you have a beard, consider adding a mask fitter or brace, or double mask for added protection.

Mind the gap. Face mask coverage should be without gaps, and masks should have a nose wire to prevent air — and germy aerosols and particles — from leaking in or out. Do a gap check: Put on your face mask and exhale heavily — if you can feel your breath’s breeze on your nose, cheeks, chin or neck, your mask likely needs to be adjusted.

N is for NIOSH-approved. Studies have shown that authentic National Institute for Occupational Safety and Health (NIOSH)-approved N95 masks, also known as respirators, and authentic KN95 masks do the best to protect people from the highly transmissible omicron variant — capturing and filtering 95% of airborne particles as small as 0.3 microns. NIOSH-approved N95 masks pass rigorous inspection and certification processes in the U.S., and authentic KN95 masks must meet Chinese standards for effectiveness and are approved by the Food and Drug Administration (FDA) for sale in the U.S.

The rest are second best (but not bad). While well-fitting surgical-style masks or cloth masks — in that order — are better than no mask at all, consider them your second choice if you can get authentic N95 or KN95 masks. But buyer beware: The CDC estimates that approximately 60% of the N95 and KN95 masks currently being sold in the U.S. are counterfeit. Without access to one of the more authentic protective masks, try snugly layering a cloth mask over a surgical mask to better catch droplets and aerosols.

While the CDC’s updated guidance does not state that you must wear an N95 or KN95, health officials strongly suggest you consider it. Most importantly, the guidelines state that to protect yourself and others from COVID-19, it is recommended that you “wear the most protective mask you can that fits well and that you will wear consistently.”

This story was updated in February 2022 to reflect updates to mask mandates.

Omicron and kids: what parents need to know
Jan. 14, 2022
Mother and son wearing masks
Most pediatricians have spent lots of time, energy and passion encouraging parents to allow their children age 5 and older to receive a COVID-19 vaccine. Their expertise, the data and their trust in science offer all they need to know that vaccination is safe, effective and vital in our efforts to stop the spread of the coronavirus and keep children — and those around them — healthy.

For Dr. Ahmad Bailony, department chief of pediatrics at Sharp Chula Vista Medical Center, his own experience as a child has afforded him a unique viewpoint when it comes to vaccine-preventable diseases: He almost died due to the complications of one.

“When I was a kid, I was hospitalized for weeks with meningitis,” he says. “In my entire career as a doctor, I’ve never seen a case of that specific type of meningitis among my patients, and that’s because we now have a vaccine for that disease.”

The contagiousness of omicron
Another thing Dr. Bailony says he’s yet to see in his 17 years as a pediatrician is a virus that is as contagious as the omicron variant of the coronavirus.

“It is no exaggeration that approximately every other call coming into our office is about COVID-19,” he says. “COVID, in general, and the rapid spread of omicron are really causing parents a lot of stress and anxiety, which is understandable.”

According to Dr. Bailony, anecdotal evidence is showing that omicron may cause less severe illness in people of all ages than previous variants. However, he says that more children are seeking care and requiring hospitalization now that omicron is spreading.

“Given that this variant is more contagious, an increased number of children are getting COVID-19, especially those under the age of 5 who are not yet eligible for vaccination,” he says. “So, as more children get COVID, you’ll inevitably see more kids becoming more severely ill from it.”

This is why, Dr. Bailony says, it is crucial that everyone who is eligible for COVID-19 vaccination — including children age 5 and older and their family members, and those age 12 and older eligible to receive a booster shot — get vaccinated so we can stop the spread and protect more children from becoming ill. “This is a matter of all of us taking care of each other — we’re in this together,” he says.

Dr. Bailony also recommends that families continue to practice all other COVID-prevention strategies:

Choose outdoor activities over indoor activities.
Wear a face mask when in indoor public locations.
Avoid places that are poorly ventilated.
Avoid crowded places and gatherings where it is difficult to stay 6 feet away from others.
Wash hands often with soap and water or use a hand sanitizer with at least 60% alcohol.
Avoid touching your eyes, nose and mouth.
Sanitize frequently touched surfaces.
Avoid people who are sick.
Monitor your health for symptoms of COVID-19 — cough, nasal congestion, fatigue, sore throat, headache, body aches and fever — and get tested if symptoms develop.
If your child has COVID
As COVID-19 cases rise within the community, your child’s chance of COVID exposure and infection also rises. However, Dr. Bailony stresses that in most cases, you can treat your child as you would if they had any other respiratory illness.

Symptoms are usually mild and last a few days to a week. Although, a very small number of children may experience multisystem inflammatory syndrome (MIS-C), a rare, life-threatening condition that can cause dangerous inflammation in the eyes, skin, blood vessels and heart.

“If your child is not having trouble breathing, is taking fluids pretty well and still making good urine output, generally, you can watch them at home,” he says. “You should definitely have them tested for COVID, which may take some patience as there is a great demand for testing. And then, you should isolate your child from others and contact your child’s pediatrician for further advice.”

The Centers for Disease Control and Prevention (CDC) also recommends talking to your child’s doctor about using pediatric over-the-counter medications for fever, aches and pain. And make sure your child rests and drinks a lot of fluids.

Also, you should monitor your child for signs of severe illness, and seek emergency medical care immediately if they are experiencing any:

Trouble breathing
Pain or pressure in the chest
Confusion
Inability to wake or stay awake
Pale, gray or blue-colored skin, lips or nail beds
“The best way to protect your child from illness is to get them vaccinated and boosted when they’re eligible,” Dr. Bailony says. “We have been vaccinating kids for months now, and 100% that have come through our office and received a vaccine have been fine. In fact, a lot of them are excited to get it, and their parents are relieved that we have vaccines to avoid severe pediatric illness and hospitalization like my own.”

My kid got COVID, but I didn’t — here’s why
Jan. 14, 2022
San Diego teenager Evie Spengler
After the effectiveness of her COVID-19 vaccine waned, 13-year-old Evie Spengler got infected, but her symptoms were mild.

Jennifer Spengler is a health and wellness writer for Sharp Health News.

I have written about how my daughter, a 13-year-old eighth grader, participated in the Pfizer COVID-19 vaccine trial for adolescents in 2020. I was incredibly proud of her for stepping up to help stop the spread of COVID when some adults refused to do so much as wear a face mask around others.

Unfortunately, it was her participation in that very trial that may have led to a recent breakthrough infection. And yet, we wouldn’t change a thing.

You see, most kids ages 12 to 15 could not roll up their sleeves for vaccination until May 2021, when the FDA granted the Pfizer COVID-19 vaccine emergency use authorization for this group. But my daughter received her first vaccine dose on Dec. 15, 2020 — several months earlier and even before the majority of U.S. health care workers received their first shot. By mid-January 2021, she was fully vaccinated.

So, when she was exposed to COVID-19 at school in early December 2021, nearly a year later, the effectiveness of her vaccination had likely waned. While we hoped her immunization would continue to prevent infection, even as word of the omicron variant — and the variant itself — began to spread, we soon learned our luck and her protection had worn out.

However, not for a second have we felt disappointed in the effectiveness of the vaccines or regretted her trial participation. On the contrary, the lessons we learned from her breakthrough infection gave us more reason than ever to believe that vaccination is vital. It is our hope that in sharing our experience, more people will feel the same.

Here are some of our takeaways:

The COVID-19 vaccines work. My daughter had been exposed to people with COVID-19 previously during the pandemic. Not once before did the exposure cause infection. It was not until approximately a year after she received the vaccine that the virus was able to break through. Research has found that protection against infection remains high for six months after the second shot of the Pfizer vaccine. So, her vaccination was effective nearly twice as long as expected. What’s more, studies now tell us that infection after vaccination may lead to “super immunity” to the coronavirus, which is super news to this parent.

Vaccinated people tend to experience mild or no symptoms. My daughter had a little congestion and a headache for a few days, starting about three days after her exposure. However, her discomfort was never great enough to make her want to stop binge-watching her favorite shows, put away the Lego set she was working on, or take a break from playing remote video games with her friends. Admittedly, she was a bit bored during her 10 days of isolation but rarely uncomfortable, and over-the-counter pain relievers, hydration and lots of TLC helped keep her that way.

The boosters worked for the rest of us. My husband, our adult daughter who came home from college for the holidays, and I all received vaccine booster shots. While we were careful around our infected one, we weren’t overly exacting about maintaining 6 feet at all times or keeping her restricted to just one room. We allowed her to sit in the family room — several feet away and masked — to watch a movie, and we set up a chair and TV tray about 8 feet away a few times so she could join our dinner conversations. And because I hated not being able to hug her while she was isolated, I occasionally gave her a quick squeeze from behind, which she thought was “totally weird” — she’s 13, after all — but felt “totally great” to me.

COVID-19 can be slow to show. One Monday in December, we received notification from our daughter’s school that she was considered a close contact to someone who tested positive for COVID-19 during that morning’s on-campus COVID screening. A student she spent over an hour with that same morning later confirmed it was their test that came back positive. Because of this exposure, my daughter was tested every day that week. It wasn’t until Friday night that an at-home antigen test displayed a positive result — all other test results had been negative until then. She did not test positive for more than four full days after the initial exposure and one full day after she began to experience symptoms. However, research tells us she could have been contagious to others up to two days before she started to experience symptoms or tested positive.

Even if mild, COVID-19 can be alarming. I work in health care, so I hear the latest data on COVID-19 case numbers (still shockingly high), read many of the studies, and know that even kids can become severely ill. While we were very lucky that she was vaccinated, we were vaccinated and boosted, and our daughter’s case was mild, I couldn’t help but worry about the many “what ifs” surrounding COVID. We were unable to learn which variant she was exposed to, so what if delta — thought to possibly cause more severe illness than omicron — had caused her infection and could have led to more serious complications? What if her breathing, heart or other organs were affected? What if she experienced long-term symptoms? All of these things are preventable with vaccination, so I can’t imagine going without, now that we have such safe and effective options.

While I obviously wish that my daughter had never been exposed to COVID-19 or had the illness, I am incredibly pleased that she is doing so well, and that we can share what we learned. We know how fortunate we are to have access to safe and effective vaccines, have a school that places importance on regularly testing students to prevent further spread, and that we had the space and know-how to keep the rest of the family safe throughout her contagiousness.

Our greatest takeaway from this experience is that our daughter is now healthy and well, and we have the vaccines — and her participation in the vaccine trials along with thousands of others — to thank for that. Hopefully, those who have yet to be vaccinated will join us in recognizing the value in receiving a COVID-19 vaccine to protect themselves, their loved ones and everyone in our community.

Which COVID-19 test is best?
Jan. 13, 2022
COVID-19 swab test
COVID-19 testing experiences across the country have been varied. While one person may receive test results within minutes, another can wait more than a week to know whether or not they have been infected. Some people choose to pay hundreds of dollars out of pocket at a pop-up testing site, while others are able to secure free at-home testing kits at their local library.

Regardless of the amount you might pay for a test or the time it takes to receive your results, Dr. Omid Bakhtar, a board-certified pathologist affiliated with Sharp HealthCare, says testing plays a vital role in helping to stop the spread of COVID-19.

Types of COVID-19 diagnostic tests
There are currently two primary types of approved COVID-19 tests used to determine the presence of viral infection in both vaccinated and unvaccinated people:

Nuclear acid amplification tests (NAAT) — a common example is a PCR test — detect the virus’s genetic material. The sample is taken with a nasal or throat swab, or from a person’s saliva. The tests are highly accurate, but results can take up to 1 week. In fact, these tests are so incredibly sensitive that in some scenarios they may detect “genetic” fragments of a prior or waning infection, meaning the person whose sample was tested and is deemed positive may be carrying a very low viral load and is less likely to be contagious.

Antigen tests — sometimes referred to as rapid tests — detect specific proteins on the surface of the virus. The sample is taken with a nasal or throat swab either at a testing facility or using an FDA-approved at-home test, and results can be produced within minutes in some cases. While positive results are usually accurate, negative results may need to be confirmed with a PCR test. These tests perform best when the person is tested in the early stages of COVID-19 infection, when viral load is highest.
“While antigen tests are faster, less expensive and don’t require the level of laboratory equipment that PCR tests do, they are specifically made to be used in people who have symptoms,” Dr. Bakhtar says. “They also have a higher likelihood of producing false-negative results.”

However, Dr. Bakhtar reports that antigen tests are highly accurate in determining positive results and are valuable when used to perform screening within large populations, such as school students or employees of large companies. This type of screening must be done repeatedly to quickly identify people with active COVID-19 infection and to accumulate data on the rate of infection within a population.

“Similarly, antigen tests can also be used in asymptomatic people who have had a COVID exposure,” he says. “In such scenarios, they are best used in a repeated fashion, such as performing two to three tests, two days apart.”

Another type of testing, antibody testing — also known as serology testing — screens for past infection or prior vaccination. The test determines the presence of antibodies — nucleocapsid antibodies from past infection or spike antibodies from prior vaccination — which are proteins that fight off infections and can often provide immunity against catching the same infection again.

However, most currently available antibody tests do not screen for active COVID-19 infection and cannot be used for diagnostic purposes. Moreover, the utility of antibody testing for vaccination status is not well established and is currently not recommended.

When to be tested and what to do with the result
The CDC recommends people should be tested for COVID-19 if they:

Have symptoms of COVID-19, regardless of vaccination status
Are unvaccinated and had close contact — were within 6 feet of an infected person for a total of 15 minutes or more — with someone who is confirmed to have COVID-19, regardless of whether experiencing symptoms or not
Are vaccinated and had close contact with someone who is confirmed to have COVID-19 and are experiencing symptoms
Have been asked or referred to get testing by their health care provider or the health department
Once tested, people should quarantine at home until they receive their test results.

If you test positive, you can assume you have COVID-19 and are contagious. You should follow all isolation and prevention guidance to protect others from getting sick.

In California, this includes staying home for at least 5 days. Your isolation can end after day 5 if you do not have symptoms and test negative on day 5 or later. However, you should continue to wear a well-fitting mask around others for a total of 10 days, especially in indoor settings.

In all other cases, the isolation guidance is:

If you are unable to test or choose not to test, and you do not have symptoms or your symptoms are resolving, your isolation can end after day 10.
If you have a fever, your isolation should be continued until your fever resolves without the use of fever-reducing medication.
If your symptoms other than fever are not resolving, you should continue to isolate until all symptoms are resolved or until after day 10.
If you test negative, it means that you probably did not have COVID-19 at the precise moment your sample was collected. However, it is important to remember the risk of false-negative results if a rapid antigen test was performed.

According to Dr. Bakhtar, a follow-up PCR test may be in order, especially if you have been exposed to COVID-19 or are experiencing symptoms. Until that test can be performed, you should continue to follow prevention guidance.

How to get tested
San Diego emergency rooms and urgent care centers are currently experiencing high volumes of patients. If you need a COVID-19 test, it is recommended you go to a designated testing location, rather than an ER or urgent care, unless you have significant COVID-19 symptoms and are at risk for serious illness.

Local health experts recommend the following testing resources:

If you have severe illness — or are at risk for severe illness — contact your health care provider.
If you need to be tested due to a confirmed exposure or you are experiencing symptoms and are under age 65 with no underlying health conditions, you can visit one of the options offered by San Diego community and health care partners. You can also purchase self-test kits at some local pharmacies or online. Some public health agencies and school districts are providing free at-home kits as supplies allow.
If you do not have COVID symptoms, have not had an exposure, or are under age 65 with no underlying health issues, but need to be tested for school, travel, work or for other purposes, visit a County of San Diego testing location or consult your school, employer or travel company for testing options.
“Knowing whether you have COVID-19 is a ‘here and now’ situation, as a test today can’t tell whether you might have it two, five or 10 days from now,” Dr. Bakhtar says. “Regardless of your vaccination status, if you are experiencing symptoms, you should get tested and could consider testing again five days later.”

Learn about COVID-19 screening and testing at Sharp.

Oh my, ‘flurona’!
Jan. 13, 2022
Woman sick on the couch
Whether you call it “flurona,” “double trouble,” a “twindemic” or a “surge upon a surge,” combining the flu and COVID-19 sounds like a miserable proposition. Unfortunately, it is possible.

According to the Centers for Disease Control and Prevention (CDC), the flu and COVID-19 are caused by different viruses, but there are several similarities between the two. They share common symptoms, affect the respiratory system, are contagious, and can cause mild to severe illness.

Medical experts around the globe are concerned about the likelihood of an overwhelming number of cases of both illnesses. And in some cases, being infected by both viruses at the same time may occur. Not only are many people at high risk for severe illness caused by flu and COVID-19 — separately or together — but some hospitals might not have the resources to care for the increased number of severely ill patients.

“We’re anticipating a higher than normal flu season this year along with an underlying pandemic,” says Dr. Jyotu Sandhu, a family medicine doctor with Sharp Rees-Stealy Medical Group. “Normally, about 50% of the population receive a flu shot, leaving an additional 50% who don’t get vaccinated, along with a whole population that was not exposed to last year’s strains due to COVID mitigation efforts. Now, you’ve got a tidal wave of flu waiting to come in just as the COVID-19 omicron variant is increasing our case numbers.”

Additionally, according to Dr. Sandhu, contracting both viruses at the same time could be serious. “They’re both respiratory infections, they both can cause severe illness, even death, and when contracted together, they can have dangerous outcomes,” he says.

Vaccines can help prevent both illnesses
The good news is that there are safe and effective vaccines for both the flu and COVID-19 that can prevent severe illness, hospitalizations and deaths. This offers a solution for lightening the load of illness in each region if everyone who can get vaccinated does so.

In fact, the CDC reports that the flu vaccine has been shown to reduce the risk of having to go to the doctor with the flu by 40% to 60%. Flu vaccination among adults was also associated with a 26% lower risk of ICU admission and a 31% lower risk of death from flu compared to people who were unvaccinated.

What’s more, the COVID-19 vaccines are extremely safe and effective. While the omicron variant has led to some mild breakthrough cases among vaccinated people, the vaccines, when paired with a booster shot, remain highly effective at preventing severe illness, hospitalization or worse.

“It is so important to share the message that vaccination can protect you from severe illness and help local health care systems avoid being overwhelmed,” Dr. Sandhu says. “And it is vital that you get a COVID-19 vaccine, a COVID vaccine booster, and a flu vaccine to avoid what they’re calling ‘flurona.’”

The CDC says: Get the shots
But what if you’ve already had COVID-19? Do you still need to get a COVID-19 vaccine or flu shot? If so, is it safe to get either vaccine while sick with or shortly after recovering from COVID-19?

Because different viruses cause the flu and COVID-19, having recovered from COVID-19 does not make you immune to the flu. But the annual flu vaccine offers protection against the flu strains thought to be the most common during this year’s flu season.

Having COVID-19 may provide you with some immunity to having that disease again in the future, but it is unknown how long your natural immunity will last. And immunity gained through infection varies from person to person.

The CDC recommends receiving both vaccines, including a COVID-19 vaccine booster when eligible, even after having COVID-19, with the following in mind:

If you currently have COVID-19, both your flu and COVID-19 vaccination should be postponed for no less than 10 days from your positive test result; at least 10 days after your symptoms first began; and only if you have no fever without the use of fever-reducing medicines for 24 hours.
Even if you have no or very mild symptoms, you should postpone getting your vaccinations to avoid exposing others — including your health care provider and other patients — to the virus that causes COVID-19.
If you had a known exposure to a person with COVID-19, you should also wait to receive your vaccinations until your quarantine period has ended.
After that, the CDC reports that it is safe to receive both your flu and COVID-19 vaccine (or COVID-19 vaccine booster) and you can even receive them at the same time. It’s also important to note that the flu vaccine cannot give you the flu and the COVID-19 vaccines cannot give you COVID-19. Additionally, neither the flu vaccine nor the COVID-19 vaccines makes you more vulnerable to the other illness.

“Hospitals across the country are already showing signs that they can’t handle the sheer numbers of seriously ill patients, so we’re advising people to stay safe and prevent both flu and COVID-19 infection through vaccination before they become a greater problem,” Dr. Sandhu says. “They’re both very real, they’re both very active and they’re both happening concurrently. We have to take both seriously.”

Learn more about how to get flu shots and COVID-19 vaccines in San Diego.