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CMAAO Coronavirus Facts and Myth Buster: Around the Globe

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Dr KK Aggarwal    11 March 2021

With input from Dr Monica Vasudev

1443: National Comprehensive Cancer Network (NCCN)- Preliminary recommendations for COVID-19 vaccination in patients with cancer

Patients receiving hematopoietic cell transplantationor cellular therapy: COVID-19 vaccination should be done ≥3 months afterhematopoietic cell transplantation (allogeneic or autologous) or cellulartherapy (eg, chimeric antigen receptor [CAR] T cell therapy).

Patients with hematologic malignancies: Forpatients receiving intensive cytotoxic chemotherapy, vaccination against COVID-19must be delayed until the absolute neutrophil count has recovered. For patientswith marrow failure due to disease or treatment who are likely to have limitedor no recovery, and for those on long-term maintenance therapy, vaccinationshould be done when the vaccine becomes available.

Patients with solid-tumor malignancies: Forpatients who are receiving cytotoxic chemotherapy, targeted therapy, checkpointinhibitor therapy or other immunotherapy, or radiation therapy, vaccinationshould be done when the vaccine becomes available.

For patients who have to undergo a major surgery,COVID-19 vaccination must be postponed until at least a few days after surgery.

1444:  Involve private practitioners in theNational Program to give the vaccine

1.          Private practitioners can meet patients where they are. The most vulnerablepatients do not have to stand in a queue or travel several kilometers to bevaccinated. They are present within the communities, are easily accessible, andcan shift people away from gatherings of large groups of people who may be sick.

2.          One can avoid wasting time and resources

3.          Vaccines are being distributed only to hospitals that are already overwhelmedwith COVID-19 patients.

4.          Practising doctors can identify the most vulnerable patients and contact them toget them vaccinated first.

5.          Their knowledge of their patients is current and deep, while hospital systemsknow comparatively lesser about peoples chronic conditions, recent healthproblems, lifestyles, and other risk factors.

6.          Physician practices can fight the myths and misconceptions.

1445: The US Food and Drug Administration (FDA) issuedemergency use authorization (EUA) for the first molecular COVID-19 test forhome and over the counter use - the Cue COVID-19 Test. This will be the firstmolecular diagnostic test that will be available without a prescription.

1446: The US Food and Drug Administration (FDA) cautionsagainst using ivermectin for the prevention or treatment of COVID-19. Ivermectinhas not been approved by the FDA for treating or preventing COVID-19, statedthe FDA guidance.

The FDA stressed that using any treatment forCOVID-19 that has not been approved or authorized by the FDA, unless as part ofa clinical trial, can lead to serious harm.

1447: A few people have tested positive forCOVID-19 more than two weeks after being fully vaccinated. This is also knownas a "breakthrough" case.

Those with breakthrough cases have had mild or nosymptoms.

The Minnesota Department of Health has asked to reportany cases where people test positive for COVID-19 at least 14 days after theirsecond vaccine dose.

Vaccine are, at best, 95% effective in preventingserious illness. Minor illnesses can occur.

Some breakthrough cases are expected. The focus of researchersis on whether patients develop symptoms.

Of 14 breakthrough cases seen in Minnesota, allwere healthcare workers who tested positive during routine screening for work,and all of them reported mild or no symptoms.

The Pfizer vaccine is 95% effective. This meansthat theoretically, out of 100 vaccinated people, five may not have the samelevel of response to provide protection.

1448: Individuals who have been fully vaccinatedagainst COVID-19 can safely gather without mask and inside with non-vulnerablepeople who are not yet vaccinated, suggest guidance issued by the CDC.

The new guidance states that people for whom it hasbeen at least 2 weeks since their last required dose can:

•           Meet other fully vaccinated people indoors without wearing masks or physicaldistancing

•           Visit with unvaccinated people from one other household who have a low risk forsevere COVID-19 indoors without wearing masks or practising physical distancing

•           Avoid quarantine and testing after exposure to someone infected with COVID-19 ifthey remain asymptomatic.

However, some restrictions continue to be thereuntil further data is obtained. Those who are fully vaccinated must:

•           Wear masks and practice physical distancing in public settings and aroundpeople at high risk for severe disease

•           Wear masks and practice physical distancing when visiting unvaccinated peoplefrom more than one household.

•           Avoid medium- and large-sized gatherings

•           Avoid traveling.

Individuals who are considered to have a high riskfor severe disease include cancer patients, those with chronic kidney disease,COPD, Down syndrome, heart disease, heart failure, a weak immune system,obesity, sickle cell disease, and type 2 diabetes. It also includes pregnantwomen and smokers.

In public places, fully vaccinated people arerequired to follow guidance to protect themselves and others, which includes wearinga well-fitted mask, physical distancing (at least 6 feet), avoiding crowds,avoiding spaces that are not well-ventilated, covering coughs and sneezes,washing hands frequently, and following any applicable workplace or schoolguidance. Fully vaccinated people should also be vigilant of symptoms ofCOVID-19, especially after exposure to someone with suspected or confirmedCOVID-19.

Vaccinated grandparents can visit children andgrandchildren who are healthy and local.

Studies from Spain and Israel have shown that theamount of viral load appears to be significantly lower if someone gets infectedafter receiving vaccination, compared to people who get infected and have notreceived the vaccine.

[Excerpts from Medscape]


Dr KK Aggarwal

President CMAAO, HCFI and Past NationalPresident IMA

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