Welcome to Q&A with Dr. K, a podcast by Mountain Pacific Quality Health, where we sit down with Dr. Doug Kuntzweiler and get your health questions answered. Because on Q&A with Dr. K, the doctor is always in. Hello, everyone, I'm Beth Brown your host, and we're here for another episode of Q&A with Dr. K with the brilliant Dr. Doug Kuntzweiler.
We didn't bring the brilliant one today. We have the mediocre Dr. K today.
Well, we'll take the one we've got, because I know you'll still have some great advice for our listeners today. And our question today, Dr. K, is about COVID. And so here's the email. It's pretty short and sweet with lots of questions. So here's how it reads. Can Dr. K please speak about COVID now that it is surfacing again? Signs, symptoms to watch for, information about the new vaccine, risk factors, what to do if you have COVID and/or symptoms of COVID. So let's start with the first part of
that. Is COVID surfacing again?
I thought you said this was a simple question.
Is it not? Sorry? Well, yes, well, the questions but
The truth is COVID never went away. Of course, it has always been here. But the emergency was declared over in May. I don't know if anybody bothered to tell the COVID virus that the emergency was over. But the numbers did drop. During the summer, June, July, August. Numbers definitely were pretty flat. And I think sort of people got lulled into a false sense of well, this is nothing this is all over. But in September, we started seeing a resurgence or resurfacing if you
like it. If it was under the surface, it came back to the top I guess. And I talked to my friends in urgent care and in the emergency department, and they were seeing tons of it in like late September, and even up till now. So things are definitely on the rise again. And that makes sense. We know it's a respiratory virus, it's
spread through droplets. Those typically during the summer months when kids are out of school and everybody's outside and we're not all confined and little heated cubicles. respiratory viruses tend to diminish when the weather turns cold. Again, people are crowded, you're you're not distancing like you're doing the summer, kids are back in school, then we tend to see things rise. And
that's what's going on. I think the average the last time I checked from the first part of October, the average for Montana was about two hospitalizations a day for COVID, which is not anywhere near the peak that we saw on in 2021. But but definitely on the rise. And it's it's on the rise in most states in the United States right now. So sets definitely still around. It doesn't seem to be any worse than the earlier versions that
we've seen. In other words, people aren't there aren't more people who are critically ill with it, it seems to be about the same in terms of how sick it makes people. But you never know that could change too. So
well. The next part is about the signs and the symptoms that we need to be watching for and we know this virus keeps mutating on us. So have the symptoms changed much it is still a respiratory virus. But what are we looking at this day these days as far as symptoms?
Yeah, and all the symptoms don't seem to change much what has changed is that it has gotten more and more contagious. And remember way back in the beginning, it was considered one of the most contagious viruses we had ever encountered second only to measles more contagious than influenza more contagious than the common cold viruses. And so this this latest version the I don't know what they call it the crack and I love that the Kraken was like a deep sea monster so that makes sense. It says
resurface back Yeah. Anyway, it's quite a bit our contagious but it doesn't seem to be making people any sicker. And in terms of the symptoms, it's kind of the usual thing, sore throat cough, sensitive shortness of breath, maybe even some pressure in the chest. Some people run a fever with it and of course then you have chills and muscle aches and pains and all that sort of
thing. So that's very much like other recipes to a viruses very much like influenza, but also we are seeing with this one the loss of taste and, and smell. So that's one of the things that kind of distinguishes it, if you have that pretty good chance to have COVID If you have these respiratory symptoms, you really need to be tested because it's very similar to influenza and RSV, and all these other cold causing viruses.
Okay, and so if someone has symptoms and or they do test positive, what's your advice?
Well, it really depends. A lot of people, of course, are doing home tests. And if they come up positive, and they're not particularly sick, especially if you're not having any shortness of breath, I think it's okay to first of all, stay home, don't go to work and contaminate everybody else. Don't, you know, go out and about and contaminate everybody else, stay home to the extent
that you can rest. Make sure you keep your fluids up, and simple remedies like Tylenol for the aches and pains, Ibuprofen is fine, sore throat, but really rest and fluids are like most of these respiratory viruses, that's what's going to get you over. But avoid being out and about in crowds. And particularly if you have family or friends who have chronic diseases, avoid them, you should go back to where you should have
never stopped. But you should be doing your hand washing, if you're going to be around somebody that you don't want to infect, then you should wear a mask. I know masks have gotten a bad rap. But I don't know I don't think a lot of people want their surgeon to take their appendix out without wearing a mask. We know that masks sure they do they work. And and there are simple thing that's not that onerous to wear masks. So just kind of common sense things.
That's pretty much it. Now on the other hand, if you have almost any chronic disease, but chronic lung disease, chronic heart disease, kidney disease, liver disease, and you think you might have it or you do a home test, and you test positive, that it's worthwhile to see your primary caregiver, because there is medication or oral medication you can take that can help prevent you from getting sicker.
And if you are worried about that, then that's worthwhile to see your primary caregiver or if you don't have one, go to an urgent care, go to the emergency department and talk to somebody about it. I recommend that you have a primary caregiver, of course, it gets to know you, and they can estimate your risk better. But that's kind of a shared decision making is whether or not you should take medication for it. It really depends on how old you are and how healthy you are.
That's when those hospitalizations can happen is along with those chronic conditions.
Yeah, almost almost universally that people who get really sick and die or people who have underlying chronic illnesses. But that can be something as simple as high blood pressure or maybe some mild kidney disease or you know, some chronic lung disease, asthma. You don't necessarily have to feel like you're on death's doorstep before you take medication for
COVID. If you have any chronic illness, and especially if you have anything that alters your immune system, things like rheumatoid arthritis, lupus or in any of those autoimmune diseases, then it's it's important that you check in with your primary caregiver if you if you think you might have COVID, or if you test positive for it at home.
All right, great. All right, let's move on through the email. The next question was about the new vaccines. And let's talk about that new vaccine. What strains does it cover? And what else can you tell us about it.
The initial vaccines were aimed at the initial COVID 19 virus. Now this new one is aimed at the latest Omicron five cracking variant. And what we know is that it is safe and effective as earlier vaccines are. And it does seem to protect people from serious illness, if you get the latest variant, it still protects you from all of the other variants that are
circulating around. And it doesn't mean that if you get the vaccine that you can't get COVID, you can still get COVID but it drastically reduces the chance that you will get very sick with it. So it's worth while getting the vaccine, as contagious as this latest variant is it's likely you're going to run into it at some point this winter. If you have the vaccine, you don't have to worry so much that it's going to cause you to wind up in the hospital or or even kill you.
It seems like there has been some delays because new vaccine coming out I went to get my flu shot was hoping to get my COVID vaccine at the same time and they didn't have the COVID vaccine. So with that just because of the new strain coming out and the vaccine wasn't ready or do you know what was going on with the delays?
No, I don't know exactly what the delay is. I know that the distribution it has to do with the distribution more than the manufacturing. You know, there are three different companies that are manufacturing this latest vaccine and I think it's got more to do with distributing it. I went to the VA AE and the VA had it. So I got that and I got my high dose influenza at the same time, I wanted to get RSV, but they did not have RSV, so I'm gonna have to search for
that somewhere else. So yeah, there have been some problems with finding it at this point. You know, we're we're getting into late October, I think people should really start pushing pretty hard to find out, especially if you're over 65. Or, as I mentioned, if you have a chronic disease, I would start calling pharmacies, calling primary care places, calling public health departments, because some people have it and some people don't. And it just depends on where you're at.
And you mentioned, especially if you're over the age of 65, who else should really be looking to get the vaccine?
Well it's recommended for six months and older, so it isn't necessarily just that you want to protect yourself. It is if you have family or friends or you're a caregiver for somebody who maybe has a chronic illness or has an immune compromised, you don't want to give them Coronavirus. So that's another group that should think pretty strongly about getting themselves immunized to protect those family and friends or people
that you are taking care of. But as as I said almost any kind of chronic illness diabeetus is a big one. I should have mentioned that before. If you have diabetes, or if you have chronic lung disease, you really ought to consider strongly getting vaccinated, this latest vaccination. Even if you had the earlier vaccine, this this we can look at as being more of a booster but it's aimed at the variant that is most prevalent right now. So I would strongly urge you to get it.
Okay about that part too. Because when we initially started talking about the COVID vaccine in two years ago, you got that initial shot, and then you got your two boosters. Now, what is the recommendation? How do we know when we're up to date on the COVID vaccine?
Well, we don't. These are things you learn with experience. And we and obviously, we have more experience now than we did in 2019 2020. But because of this Kraken that is so much more contagious, it's recommended that if you've had the vaccine prior to the 12th, of September of 2023, so a month ago, if you had a vaccine prior to that, it's recommended that you get this new vaccine, and then you will be considered to be up to
date. In the CDC, this, this gets pretty confusing, because a lot of the recommendations are are based on age and risk factors. But the CDC has a lot of really detailed charts that kind of break it down and make it easier for you to follow. And if you don't want to do that then goes to your primary caregiver, and they can look at the charts and break it down and follow the guidelines. But really, it's recommended for almost everybody.
Okay, do you know where folks can go to try to get it?
Well, I've been making some phone calls today. I didn't have much luck. I know that the VA has I know that county health department has it peer view has it. Some of the pharmacies, like the chain pharmacies have it. Some of them don't, most of them are requiring an appointment. So you'd have to call in wearing an appointment. And I didn't get a sense of what kind of volume of vaccine any of these places have. So I don't know what their
supply looks like. But but all I can say is call before you go and find someplace who will hold a vaccine for you and then go get it.
That sounds like a good plan. And then what about costs is the current vaccine, something that insurance usually covers?
Yeah, that's a course if you have Medicaid or Medicare, that's they're going to cover it, it's going to be free. If you have any private insurance, the Affordable Care Act mandates that the COVID vaccine be given for free. So if you have any kind of private insurance, you're covered, the vaccine is
going to be free. If you don't qualify for Medicaid or Medicare and you do not have private insurance, HHS Health and Human Services Department of the federal government has a program called Bridge access that will pay for your COVID vaccination. I talked to a couple of pharmacies who are aware of the program but they weren't sure exactly how it operated. So all I know is that you can get your vaccine, it shouldn't cost you
anything. And probably the people who administer it are going to be a little bit puzzled about exactly how to do it. But you should be able to get the vaccine for free no matter what your status is.
Okay, well, maybe that's a good opportunity to put a website with this episode.
You know, the vaccine just got released not that long ago. And I think like many of these things, there's there's going to be a little bit of stuttering before they smooth out the whole bureaucratic part of this but the vaccine is approved. It's it's manufactured, it's around, you might have to be a little Have it persistent, find some someplace where you can get it. But it's, it's worth the time investment.
And while you're here, let's talk about some of the other vaccines. You know, we're in October. So I know we should be getting on it if we haven't gotten the flu vaccine. And I know we've been talking about RSV, but holidays are coming up. And those are the times where we're going to be around more people. So what's safe to get together? You mentioned you tried to get your flu and COVID together? And RSV. Can you get all of those together? If all three are available?
Oh, yeah, I would take nine or 10 vaccines at the same time, if I could. Here's the way I explain it. So you're walking around doing your job and your coworker sneezes, and your cat bites you before you go to work. And you know, you cut yourself shaving and so your body is constantly being exposed to viruses, to bacteria to fungi. I mean, we we live in a sea of various kinds of germs and our body encounters them all
the time. And our immune system is experienced at dealing with many different insults at the same time. So your cat bites you and your immune system reacts to the bacteria that it injected and your coworkers sneezes, and your immune system responds to the virus that you breathe in from that blah, blah, blah, you eat some questionable tuna for lunch. And our immune systems can handle all of that it's designed to handle all of that
simultaneously. So you can give multiple vaccines at the same time now, I'm not saying that you won't be hurt in your arm, I got influenza and COVID in the
same arm and it was sore. But you know, 24 hours and you can't even tell that it happened I was gonna get all three but they didn't have the RSV available but Oh, and when I when I went in the military, they did not worry about that they gave you about 10 That literally gave you five vaccines and one arm and five in the other arm and then they had to stand in formation to see who fainted from it. But
wow,] that's but it's it's safe and it your body is is adapted to that so it's safe and the vaccines will all work.
Yeah, and side effects that might happen if you do do all three other than the sore arm people might expect?
The usual stuff, you know, muscle aches, I always around a little bit of a low grade fever whenever I get influenza vaccine. So I feel kind of crummy. You know that first evening, but by the next day, I can't tell what I get out of it. So people know how they're gonna feel you get a sore arm, you get a little flu feeling but it shouldn't last more than 24 to 48 hours. If it does, you know, you probably ought to be seen, but now they're, they're safe. They're effective. They're cheap.
Yeah, especially if they're free. Alright, so if anybody has any questions or concerns and they want the most up to date information, what are some resources that we can put along for them to take a look at?
Well, one of the things we didn't talk about was the pneumonia shot two, that's another one that you should be worrying about. And again, it's recommended 65 and older that get vaccinated against the pneumococcal pneumonia, which is a bacterial illness, but it's a big deal, because that's one of the top causes of death is actuarial pneumonia. And it's recommended for children, especially children that maybe have chronic illnesses like diabetes, that
sort of thing. It's complicated, because there are about five different pneumococcal vaccines and how you get them and when you get them as a little bit complicated. But again, the CDC has a chart that you can walk yourself through and, and help figure out which vaccine you
need. Basically, you need two different vaccines in a year apart, but because there are four different vaccines there various combinations of them that you can get, and so takes a little bit of sleuthing to figure out exactly what's your best combination. But again, you know, if you get COVID, or you get influenza that lowers your resistance to bacterial pneumonia, and that's a that's a big deal. So you really should get vaccinated against a whole raft of them.
That's good to know. And I would guess your doctor would be able to sleuth with you as far as what you should be doing for that.
You're paying them so make them do the hard work.
Perfect. Okay, good. Did we forget anything else? Then I want to make sure we're covering all the bases here. We're getting into that season, for sure.
Well, yeah, I think we certainly covered all of the important parts, the highlights, it's hard to say, you know, people try to predict what kind of a season we're going to have based on what happened in the southern hemisphere during our summer in their winter. People are worried. We haven't had a really horrible influenza epidemic in a while so people are worried about COVID and influenza hitting at the same time. of RSV, we're seeing more and more
adults now. So people are worried about this triple epidemic of RSV, influenza and COVID didn't happen really too badly last winter, but you just you just never know. It's like trying to predict the weather really, we don't really know for sure what what's going to happen. But the way to mitigate all that is to get yourself vaccinated.
Yeah, trust the experts as best you can and do what you can and and hope for the best.
Yeah, there's so much misinformation, especially on the worldwide web. The people who study this, you know, they're just middle class, hardworking people. They're not multimillionaire politicians. It's people who got fascinated by, you know, health stuff, and they studied viruses and bacteria, and they help develop these vaccines and just hardworking bright people, and there's no reason not to trust them.
So where are those reliable resources? Dr. K, where can folks go so that they don't get misled?
Yeah, there's the Centers for Disease Control, the World Health Organization, major medical centers, like Johns Hopkins have some really good material on their websites, the Mayo Clinic, there any number of them, but stay away from the loan doctor who knows more than anybody else on the face of the planet. Those are the guys you want to stay away from.
Okay, they might have their own agenda.
Yeah, they missed the bus somewhere. The bus stop.
Well, thank you, Dr. K. We appreciate it. That was great information. I don't buy for a second that the brilliant Dr. K didn't show up today. We'll put the COVID and vaccine resources that Dr. K mentioned along with this episode. And if you have a question for Dr. K, please just email us at QandA...
As long as it's easy, no hard questions.
Any question you want to - email it to QandAwithDrK@mpqhf.org and we will keep your identity anonymous. We'll just ask your question and you can get your answers, and we'll put that email address with this episode as well.