February 6, 2021

VACCINATING CHILDREN AGAINST COVID-19 IS CRITICAL TO GETTING BACK OUR WORLD!

 

When a high percentage of people develop immunity to an infection, whether through vaccination  or previous infection it becomes harder for the disease to spread to persons who have not yet, cannot or will not be vaccinated.

This is what “herd immunity” is all about.  In the case of COVID-19,  it is estimated that 70-80% of our population should become immune in order to prevent its ongoing spread and to see an approved return to normal living.

There have been over 26 million cases of COVID-19 infection in the U.S. to date.  However the strength of immunity that develops in each case is not the same for everyone and the length of time people remain immune can only be discovered through follow-up immune studies, which take time.

So at this time, the recommendation is for people who have had COVID-19 infection  to still be vaccinated so they can develop a more robust immunity. However they should wait 90 days to be vaccinated to avoid any unwanted interaction between their natural immunity and their vaccine immunity.

The majority of children are not at serious risk from COVID-19 infection.  However, effective herd immunity against COVID-19 infection will require pediatric vaccination because nearly a quarter of the U.S. population is under 18 years old — and the percentage is significantly higher in many other countries.

Vaccinating children will likely have benefits that are both direct [protecting children against rare severe pediatric cases of COVID-19 and life-threatening after-infection conditions such multi-system inflammatory syndrome in children (MIS-C)] and indirect (protecting others by reducing the spread and decreasing the heavy toll on families of parental illness, chronic stress and economic setbacks).

2/6/21
Charlene Blache MD
 

​

​

​

November 14, 2020

COVID-19 VACCINE UPDATE 

Dr. Anthony Fauci recently addressed the American Medical Association (AMA) and expressed “cautious optimism” that by the end of November to early December 2020, we should have information on one or more safe and effective vaccines that can be distributed in a graded fashion to individuals with highest priority, such as health care workers and people on the front line.

There are 6 candidates that the U.S. government is either assisting with development or facilitating testing. Moderna and Pfizer started their phase 3 trials on July 27th and are fully enrolled.  Currently, data are being collected on efficacy and safety.

He recognized the following 2 questions in determining the degree to which public health measures are going to be playing an important part in protecting our country and the people in our country:

 

     1. How effective would the vaccine be? 
     2. How many of us will choose to take the vaccine?‍‍‍

He stated that the vaccine will need to be at least 75% effective and that a substantial proportion of the population will need to take it.  He noted that vaccine-related “reticence”and “skepticism”  will have to be overcome by transparent messaging and outreach to the community.

He has a positive outlook for 2021, provided the above 2 requirements are met.  He thinks that “we’re going to be going in the right direction towards approaching some degree of normality as we head into 202; in the 2nd, 3rd and 4th quarter of 2021.” 

That’s good news!

11/14/20
Charlene Blache MD

​

​

​

November 7, 2020

CAN EXCESSIVE SCREEN TIME HARM A CHILD’S EYESIGHT? 

This question was addressed recently by Dr Ella Faktorovich;  an ophthalmologist of 20 years and founder of Pacific Vision Institute in San Francisco California.  She discussed a rising concern among parents who have kids at home attending virtual classrooms due to the Coronavirus pandemic.

According to her the short answer is “yes it can”. The good news is that there are safety measures that parents can put in place to greatly reduce the risk of vision problems caused by eye fatigue (also called digital eye strain, a physical eye discomfort that is caused by excessive screen use in both children and adults).

The group of kids especially at risk are the ones who are genetically predisposed to myopia or nearsightedness.  Today more than 40% of Americans are shortsighted and the number is increasing quickly in kids between the ages of 3 and 12 years.

Dr. Faktorovich cautions parents to look for the following warning signs:

​

•  eye irritation

•  watery eyes

•  headaches

•  blurry or double vision off and on

•  sore eyes

•  difficulty concentrating

•  sore neck, shoulders and/or back

•  increased sensitivity to light

•  tiredness

•  poor posture

And finally, here are some tips to reduce digital eye strain:

 

•  Set limits on screen time where possible

•  Schedule at least 8 hours of outdoor activity per week

•  Keep screens at least 8 inches (20 cm) away from your child’s eyes

•  Place your child’s desk near a window (unless they have ADHD) and instruct them to look out every hour for a few minutes

•  Ensure that your child’s glasses are being worn full-time

•  Be sure to keep your child’s eye doctor appointments

“The eye is the lamp of the body.  So if your eye is healthy, your whole body will be full of light”.
Matthew 6:22

Charlene Blache MD

 

​

​

November 1, 2020

VIRTUAL SCHOOL: NOW IS NOT THE TIME FOR PERFECTIONISM

​

I recently read this comment in an article written by Dr. Swick, physician in chief at Ohana, Center for Child and Adolescent Behavioral Health, Community Hospital of the Monterey (Calif.) Peninsula and Dr. Jellinek, professor emeritus of psychiatry and pediatrics, Harvard Medical School, Boston.

 

The article  highlighted the fact that virtual school is especially difficult for children with ADHD (attention deficit hyperactivity disorder).

 

These children, especially the ones in elementary school, have difficulty shifting their attention and maintaining focus on material that is less-engaging.  Many of them are also physically busy, poorly organized and struggle with impulse control.

 

Even with effective medicines , they usually require redirecting with cues, serial prompts before transitions and the on-going support, reassurance and patience of their teachers.  With their years of experience, training, and support in the school setting, teachers are often better equipped than parents  to manage the demands of teaching children with ADHD.

 

Parents are more likely to personalize challenges and feel worried, guilty, discouraged, frustrated or even out of control.  Here are some tips to help children to adapt better to a virtual classroom.

 

• Promote sufficient and restful sleep  

• Create routines around the “school day”

• Set the stage by finding a good spot in the home (without lots of tempting toys/games)

• Adjust expectations and set reasonable goals(avoid focusing on perfectionism or mastery of challenging material)

• Offer positive rewards when goals are met (end of each day) 

• Build in breaks from the screen  (snack, bathroom break, get wiggles out)

• Ensure some physical activity  

• Know your child and what he/she may need to enhance the learning experience  

 

I hope this information is useful!

​

- Charlene Blache MD

​

​

​

​

October 16, 2020

HOW IS IT EVEN POSSIBLE TO HAVE A VACCINE AGAINST COVID-19 BEFORE 2021?

The race to produce a safe and effective vaccine against COVID-19 has been unprecedented in many ways.  Never before have there been more than 180 vaccines in clinical trials and over 100 worldwide  companies involved in this venture.

Billions of dollars have been contributed by Bill Gates, WHO (World Health Organization), and BARDA (a department of Health and Human Services).  This level of financial support has allowed the US government to take the risk out of vaccine development.  Phase 3 trials and mass production of vaccines are happening at the same time (even though it is unknown for sure if the vaccines will be safe and effective). This is one way in which time  is being saved, by leveraging the riskiness of mass producing the vaccines still in clinical trials with available funding to do so.

As I mentioned in my last post, the one thing that cannot be cut out or shortened are the phase 3 trials which are planning for roughly 30,000 participants.  Phase 3 trials ensure safety and efficacy. The companies that are furthest along with phase 3 trials are Moderna and Pfizer.  Their vaccines are what are called “messenger RNA”
(mRNA) vaccines.  To fully explain how all this works will require a deep dive into the field of genetics and is beyond the scope of this post.

If an mRNA vaccine is approved for coronavirus, it would be the first of its type.  It is a very unique way of making a vaccine and, so far, no (such) vaccine has been licensed for infectious disease.  It could be more powerful and straightforward (hence time saving) to produce than traditional vaccines, which take several years.

“Getting a flu vaccine will not protect against COVID-19.  However flu vaccination has many important benefits.  Flu vaccines have been shown to reduce the risk of flu illness, hospitalizations and death”  (CDC Oct 7, 2020).
 

​

October 12, 2020

WILL YOU BE GETTING THE VACCINE AGAINST COVID-19?

 

It is totally reasonable and human to be skeptical about a new vaccine against COVID-19.   Clinical trials are still being conducted, yet a vaccine is expected to be available for distribution as early as November 2020.

 

My goal is to give you some information that may help you in making a decision.  I know that some people have made up their minds and will not change with any amount of data, logic or reason.

 

How Are Safety And Efficacy Ensured For New Vaccines? 

​

• Pre-clinical trials are first performed in animal models (e.g. mice, monkeys, hamsters). They are inoculated with inactive virus and observed for an immune response and sickness. These are “proof of concept studies,” and if results are positive, adult human volunteers are invited to clinical trials.

 To protect volunteers, the Food and Drug Administration (FDA) sets rules for the three phases of clinical trials: 

• PHASE 1 trials test 20-100 healthy volunteers with inactivated viral protein, at lower doses first. The dose is gradually increased until a consistent protective immune response is seen‍‍‍.

•  PHASE 2 trials inoculate several hundred volunteers to ensure that there are no serious common side effects‍‍‍‍‍‍.

• PHASE 3 trials test hundreds or thousands of volunteers and compare people who get the vaccine with others who do not get the vaccine.  The goal is to confirm the SAFETY and EFFICACY of the vaccine and to learn the most COMMON SIDE-EFFECTS.  This phase of trial cannot be cut out‍‍‍‍‍‍‍‍‍‍‍‍.

 

How Could A Vaccine Be Produced In Record Time...Operation Warp Speed?  

​

• To answer this question it is necessary to understand how the vaccine against COVID-19 is different from other previously manufactured vaccines. This will be the focus of my next post.

• In the meantime though, please try to get your flu shot as soon as possible to help prevent complications in the event that you get COVID-19.

​

​

August 22, 2020

WHY WE NEED A VACCINE AGAINST COVID-19

​

This week, many medical offices, including ours, were contacted by the Georgia Immunization Program (GIP), concerning our interest in becoming a vaccination site for the Novel COVID-19 vaccine.  We are of course very interested in partnering with the GIP to help vaccinate our community when the vaccine becomes available.

 

People just want the Coronavirus to go away!  However, wishful thinking isn’t enough.  Many people are against vaccines for various reasons.  I am hoping that this post will encourage you to think more on the subject.

 

What is natural immunity? 

​

Infection with an actual disease results in natural immunity which may be for a limited time or for a lifetime depending on the disease.  Exposure to the disease organism triggers our immune system to make antibodies to fight the disease now and in the future.

 

What is vaccine-induced immunity?   

​

Introduction into the body of a killed or weakened form of the disease organism will trigger our immune system to make antibodies to fight the disease now and in the future. (Kids will love the story of Edward Jenner, cowpox, and the discovery of immunity to smallpox).

 

What is herd immunity? ‍‍‍ 

​

When a large percentage of people in a community has become immune to an infection, whether through vaccination or previous infections, it becomes more difficult for the disease to spread to susceptible individuals who have not yet, cannot or will not be vaccinated.

 

Why is vaccination against COVID-19 infection a better idea than relying on natural immunity?  

​

• Whilst the majority of people who get COVID-19 infection recover from it, to date, we have lost 175,000 of our citizens, many elderly, and we’re learning that many people are not experiencing a complete recovery.

• Natural infection with COVID-19 brings natural immunity 100% of the time (per Dr. Fauci), but no one knows as yet, for how long and all the factors that determine its duration.

• Trying to achieve herd immunity by allowing the virus to naturally make its way through the population would be an amoral decision since it would mean putting many people at risk of dying or developing prolonged symptoms of the disease, unnecessarily. Unnecessarily, because we have several tools to protect lives until we have a safe and effective vaccine.  They are social-distancing, the wearing of face coverings when social distancing is not possible, robust hand washing and hand-sanitizing and testing, including surveillance testing.

• Vaccines are a safer and more predictable way to develop immunity, without the risks associated with having the disease.

• Everyone is concerned about safety since this is a new virus.  And there are other questions about whether or not vaccine immunity will wane.  If it does, then we will need to give boosters, which we already give for most vaccines.  For now though, we should probably focus on vaccine protection for one season and figure out later what would be needed in the future.

 

When can we expect a Coronavirus vaccine?

​

• “Having a safe and effective vaccine distributed by the end of 2020 is a stretch goal for the American people”, said National Institute of Health (NIH) Director Francis S. Collins MD, Ph.D.

• Moderna Therapeutics, is developing a vaccine against the Coronavirus and is headquartered in Cambridge, Massachusetts.

• As of yesterday, they had enrolled 13,194 participants in the on-going late-stage 30,000-volunteer US trial.  Enrollment started in July and is expected to be completed in September.

• This trial is amongst the first late-stage studies supported by the Trump administration’s effort to speed development of an effective vaccine to help end the pandemic.

 

Let’s pray for our country, the world and for our elected government officials as they make decisions that affect our lives.

 

“Let every person be subject to the governing authorities.  For there is no authority except from God, and those that exist have been instituted by God”

Romans 13:1

 

- Charlene Blache MD

​

August 15, 2020

GOT COVID-19 BACK-TO-SCHOOL QUESTIONS?

 

The answers to several questions should be clear to parents, teachers and school administrators, in order to prevent the entry and spread of COVID-19 in schools and in the community.  Here are 6 important ones:

 

1. When should my child (student) stay home?  

 

Answer:

• If they have symptoms of COVID-19 (fever at least to 100.4 degrees F, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headaches, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea)

• If they are suspected of having COVID-19 and are awaiting test results

• If they have a positive COVID-19 test (whether or not they have symptoms)

• If they have been in close contact with someone who tests positive for COVID-19

 

In all the above situations, a medical provider should be involved in decision-making.

 

2.  What is the meaning of "close contact?"  

 

Answer:

• Being within 6 feet of someone with COVID-19 for more than 15 minutes

• Sharing a drinking class/eating utensils, physically touching the person/things that may have their germs, like dirty tissues

• Being coughed or sneezed on

 

3.  Many COVID-19 symptoms are seen with other illnesses, so how will I know when my child should be tested for COVID-19?  

 

Answer: 

• Most COVID-19 symptoms are non-specific, therefore teachers and students, quite often will need to be tested and should call their medical provider’s office for guidance.

 

4.  What do the terms “isolation” and “quarantine” mean?

 

Answer:

• Isolation means keeping sick people away from healthy ones.  This usually means that the sick person rests in their own bedroom or area of your home with a face covering and keeps away from others as best as possible.  It is usually for a period of at least 10 days after the beginning of symptoms or 10 days after testing positive (when persons have no symptoms).

• Quarantine means separating people who appear well, but were exposed to a sick person, away from others.  Because someone can spread COVID-19 before they have symptoms, quarantine stops them from accidentally spreading the virus to other healthy people.  People in quarantine should stay at home, avoid being around others and wear a face covering for a period of 14 days from the last day of contact with the sick person.

 

5. When would my child (student) be able to return to school after isolating?

 

Answer:

• At least 10 days have passed since their symptoms started AND

• They haven’t had a fever (100.4 F or greater) in at least 24 hours without using any medication to lower fever AND

• Their other symptoms are getting better

 

6. If one of our children has to quarantine because he/she came in close contact with someone who has COVID-19, should our other children, who do not have symptoms, stay home too?

 

Answer:

No.  Your other children may continue to go to school.  However, if the child who was in close contact gets sick, then your other children should stay home.

 

Please remember to listen to and talk to your children in a calm and reassuring way, daily, about COVID-19 and the changes that they are having to handle at school.  Let them know that new actions will need to be taken from time to time in order to help protect them, the school’s staff, and their family.

 

“All things work together for good to them that love God, to them who are the called according to His purpose”.  

Romans 8:28 

- Charlene Blache MD

​

August 10, 2020

Making Sense of Testing and Retesting for COVID-19

 

Testing for COVID-19 is still not readily available to everyone in our country.  As such, COVID-19 testing resources should be used wisely and  heath professionals are the best ones to direct their usage in the most cost-effective ways.

 

Currently testing and re-testing requests can be directed at the following facilities:

1. Department of public health (DPH).  This Is polymerase chain reaction (PCR) testing, that is free, not rapid (results take a few days), appointments are necessary and can be made by calling the DPH hotline at 1-844-955-1499.  This is a very well organized system that is efficient, effective and includes contact tracing for positive cases.

2. Smith Northview Hospital (SGMC). This is a drive through clinic (no appointment needed), rapid PCR testing (though results may not be available to you until next day because of high volumes), person must have signs or symptoms of COVID-19 or have a request from a doctor’s office or other facility that is necessitating testing.  This is not a free service and insurance will be billed where applicable.

3. Doctors’ offices and urgent care centers, many of which are now offering rapid antigen testing available in 15 minutes as well as the more sensitive (truly negative when test is negative) PCR testing that will take a few days for results.  You will mainly be asked to pay cash for the rapid test and your insurance will be billed for the PCR test which may be needed if the rapid test is negative but COVID-19 is still strongly suspected.  

4. Local private labs like Lapcorp; which will require an order from a health care professional unless they contract directly with your health insurance company.

5. Pharmacies like CVS whose protocol is specific and should be contacted directly for details before showing up.

 

Lastly, I would just like to summarize the CDC’s most recent guidelines on the 4 populations for which COVID-19 testing with viral tests (PCR and rapid antigen tests) is appropriate.  They are people who:

• Have signs or symptoms of COVID-19 

• Have no symptoms but recently had contact with someone known or suspected to have COVID-19

• Have no symptoms and no known contact with someone known or suspected to have COVD-19 but still may be tested for early identification in special settings

• May be tested by public health officials to track spread of the virus that causes COVID-19

 

Here is a big change to the guidelines as of July 17th, “Except for rare situations, a test-based strategy is no longer recommended when an individual with COVID-19 infection is no longer infectious” and has to return to work, play or other setting.  The reason for this change is that many people continue to shed the dead virus for weeks to months after they have sufficiently self-isolated and that shedding may cause their tests to be positive even though they are no longer infectious.  This change significantly decreases the need for retesting after people have recovered from COVID-19 infection.

- Charlene Blache MD

​

June 23, 2020

Why Should I Wear a Mask?​

 

Healthcare professionals wear special N95 masks to protect them from getting infected in medical facilities.  But simple cloth masks when worn by anyone can prevent the spread of infection to others.

 

HOW WOULD MY WEARING A MASK MAKE A DIFFERENCE?

If we lower the chance of one person infecting just one other person, the impact is great!

Every infectious disease has a reproduction rate, called R.  When it is 1.0 that means that the average infected person infects one other person.  COVID-19’s rate when we don’t wear masks and practice social distancing, is at least 2.4. A disease dies out if its R falls under 1.0.  The lower the number, the faster the disease dies out.

 

HOW EFFECTIVE IS MASK-WEARING?

This depends on three things: 

•  The basic reproduction rate, R, of the virus in the community

• The effectiveness of masks in blocking spread of the virus

• The percentage of people wearing masks

 

HOW EFFECTIVE ARE CLOTH MASKS?

The main way in which COVID-19 is transmitted is via droplets that fly out of our mouths when we cough, sneeze and even speak.  Some of those droplets become tiny particles which are easy for us to inhale.  Research shows that even wearing cloth masks will greatly reduce the number of virus particles coming out of our mouths, by as much as 99%.  This reduction has 2 huge benefits:

  - With fewer virus particles hanging around, people are less likely to become infected.

  - If people become infected, they are likely to be less sick because their viral-exposure load is lower.

 

HOW MANY PEOPLE NEED TO WEAR MASKS TO STOP THE SPREAD OF COVID-19?

Models show that if 80 percent of people wear masks that are 60 percent effective, we can get to an R of less than 1.0.

 

WHY SHOULD I WEAR A MASK EVEN THOUGH I FEEL FINE?

COVID-19 has been hard to control partly because people can infect others before they themselves show any symptoms and even if they never become sick.  Many people are not aware of the risk they pose to others, because they don’t feel sick and may never become sick with symptoms.  Wearing masks is a “public good”: something we can all contribute to that eventually benefits everyone.