by Ihor Magun, MD, FACP
It has been about three years since the COVID pandemic started, and everyone, including the medical community, is in what we can only describe as "pandemic fatigue." Many, if not most, people feel that COVID no longer carries the risk of bad outcomes as it did when the pandemic started. This shift in thinking has led to the assumption, fueled by political and economical factors, that we may resume pre-pandemic life. Contributing to this factor is misinformation that adds to more confusion as well as mistrust and downplays the actual serious threat that still exists.
In this column, my intention is to provide some useful, substantiated medical information to explain what we currently know about this disease. Obviously, this information is current, and new developments may change how we diagnose and deal with COVID, its immediate effects, and any related long-term issues.
By now, everyone is familiar with the rapid home COVID test and the PCR (Polymerase chain reaction) test. There is also an antibody test that is from blood and identifies past infection. The gold standard is actually the PCR test, since it can detect an infection in its earliest stages, even before symptoms arise. Obviously, this test does not provide instant results; it can take up to 48 hours, depending on patient priority, the travel distance between the sample collection site and the testing laboratory, and the volumes of tests at the performing laboratory. The rapid home test provides results in basically 15 minutes and indicates, if positive, that indeed you have the infection and are considered contagious. If you test negative, you may not be infected, or you may be in either the early or the late stages of the infection. Most individuals who are scheduled for any surgical procedure require a PCR, for obvious reasons.
Many argue that having the COVID infection provides a natural immunity that one would assume is much better than a vaccine. There was some validity to this claim in the early days of the pandemic; however, the turning point occurred when the dreaded Omicron variant emerged and negated the natural immunity theory.
The Omicron variant had over 50 mutations, producing what we might call a perfect storm and negating the positive effects of natural immunity. The take-home message is that natural immunity varies greatly, and up-to-date vaccines provide long-lasting protection. Additionally, vaccines play a major role in stopping the spread of the virus, which in turn decreases the virus' ability to mutate and prevents the emergence of new variants.
Regarding women and pregnancy: vaccination either before conception or during early pregnancy is completely safe. This also holds true for women who are breastfeeding.
Foregoing a vaccine in pregnancy and contracting the virus at that time can lead to premature birth, birth defects, or stillbirth. There is also no evidence regarding changes in fertility or alterations in our DNA.
Long-term post-COVID effects referred to as "long haul" are seen in some individuals. They can manifest in many ways and can last for months. Symptoms vary in intensity and include fatigue, brain fog, muscle pains, digestive issues, chest pain, lack of smell, as well as a combination of everything. No one can predict who will get these symptoms or how long they may last.
Suffice it to say that COVID will not be eradicated soon. It will continue to play a major role in our lives for the foreseeable future. We must learn to navigate a terrain that is more complex and heed the lessons learned from the current successes as well as the missteps. Although we are in a better place with regard to the virus than we've ever been, we must not let our guard down. We must continue to take care of our health issues, continue good hand washing, and follow vaccine guidelines and quarantine recommendations.
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