Brief Messages or Announcements – Go Retire Psychiatrist

UIHC Covid-19 Q&A: Omicron and Vaccines

Here’s a recently published YouTube by University of Iowa Health Care on the Covid-19 virus, the Omicron variant, and vaccines (actually there are two, see update below). Points that grabbed our attention were:

Omicron is more transmissible, but overall seems to cause less severe disease.

Current vaccines, especially with the booster, protect against getting severe disease, although may not protect against infection.

It’s not a great idea to just get it over with by getting infected with Omicron. Getting the disease can lead to severe medical complications (including myocarditis) leading to hospital admission. The vaccines rarely cause myocarditis as a side effect and it generally resolves without treatment.

Vaccines make getting Covid-19 long haul syndrome less likely.

Avoiding getting together in groups of 10 or larger decreases the risk of infection with Omicron. The Swiss Cheese method of protecting yourself against Covid-19 still works best:

Include a slice getting the vaccine with booster: image credit Univ Iowa Health Care

There are medical treatments for Covid-19 disease if you get infected and have to be hospitalized. The treatments are not without side effects. One of them is dexamethasone, a corticosteroid. It can be used to reduce the immune system reaction that Covid-19 infection can eventually cause. Corticosteroids can cause neuropsychiatric side effects that can range from anxiety to frank delirium marked by psychosis. Fortunately, the duration of steroid treatment is relatively short. Vaccines don’t cause side effects of this type. Over the course of my career before I retired, as a psychiatric consultant in the general hospital, I was not infrequently called to assist in the management of extreme psychiatric side effects from high dose steroids (reference: García CAC, Sánchez EBA, Huerta DH, Gómez-Arnau J. Covid-19 treatment-induced neuropsychiatric adverse effects. Gen Hosp Psychiatry. 2020;67:163-164. doi:10.1016/j.genhosppsych.2020.06.001: quote : “Short course high-dose corticosteroid treatment, as occurs in COVID-19, may cause delirium and changes in mood (with a frequency of up to 52% of patients treated with more than 20 mg a day of prednisone during 3 months) [5], being mania and hypomania more frequently observed than depression.”)

Wearing a mask is protective. Recently the CDC recommended preferring medical grade or surgical masks over cloth masks. The guidance has a link to a YouTube on how to make the 3 layer disposable surgical mask fit closer to the face to provide a more effective barrier (and tends to reduce fogging on eyeglasses). N95 masks may be more widely available soon.

The vaccines are very safe and effective. We had minimal side effects, mainly sore arms.

Update: We watched the UIHC Covid-19 Family Forum last night which ran from 6:30-7:30 PM. I just noticed that it was recorded. It’s similar to the presentation above. It also contains helpful slides with graphs. There were great questions from the audience, which the experts answered and which are helpful to all of us. Many thanks to Dr. Dan Diekema, MD and Dr. Patricia Winokur, MD for this outstanding forum.

Martin Luther King Jr. Celebration of Human Rights Week 2022

The 2022 Martin Luther King Jr. Celebration of Human Rights Week gets kicked off on January 12, 2022 with Chair of Emergency Medicine Jenice Baker, MD, from Chestnut Hill Hospital in Philadelphia giving a lecture via Zoom, “Racial Perspectives on the Institution of Medicine.”

And on Wednesday January 19, 2022, Dr. Feranmi Okanlami, MD, MS, director of student accessibility and accommodation services at the University of Michigan, will deliver the Martin Luther King Jr. Distinguished Lecture: “Disabusing Disabilities.” You can register on line for this lecture and see the following link for a full list of events which will be updated.

Take a Cup of Kindness and Say Goodbye to 2021

It’s been a quiet day around here. It’s New Year’s Eve. I got a great message from a former resident who has started his own Psychiatry Consultation Fellowship training program in Bangkok, Thailand. Dr. Paul Thisayakorn and his wife are welcoming 2022 with their 2 lovely children and hoping 2022 will be a better year, as we are. The Covid pandemic has been hard around the world.

Paul also looks forward to establishing a C-L Psychiatry academic society in Thailand in the coming year. Paul did his psychiatry residency at University of Iowa and his C-L Psychiatry fellowship in Cleveland. Sena and I wish him and his family all the best in the new year.

Today was quiet, but tomorrow the big snowstorm will come. We’ll be digging out all day because the forecast is for 5-8 inches, high wind gusts, and ice. It’s Iowa, after all.

But for tonight we’ll take a cup of kindness and say goodbye to 2021.

And if you like MacLean’s version of Auld Lang Syne above, you might have a listen to another with the Scottish lyrics translated.

Covid-19 Omicron Variant Update

This is just a short message wishing a safe and happy holiday to all. I’m passing readers a couple of links to update information on the Covid-19 Omicron variant and how to stay as safe as possible this winter.

First is the Rounding@Iowa link to the Omicron Variant update. It’s an interview with University of Iowa Hospitals & Clinics (UIHC) infectious disease expert, Dr. Patricia Winokur, MD. It’s about a 16 minute interview. Highlights are that it’s important to get the booster for solid protection against variants including Omicron and that the Covid-19 vaccine is, in general, likely to turn out to be a 3-shot vaccine similar to others, such as the Hepatitis and Shingles vaccines.

The other link is to UIHC infectious disease specialist Dr. Daniel Diekema, MD and his thoughts about the Omicron variant. They echo those of Dr. Winokur and the emphasis again is on the importance of getting vaccinated.

Lastly, there is some guidance by UIHC in a graphic below on how to stay safe from getting infected with Covid-19, (whatever the variant) during winter activities. Happy Holidays!

Merry Christmas to My Wife…and to You

Christmas will be here Saturday and there’s no snow. At least we won’t have to shovel. I want to say a big thank you to my wife, Sena. She has put up with me for 44 Christmases. That’s asking a lot.

Here’s hoping for a better New Year in 2022. Happy holidays!

The Park

It’s balmy for December. Sena and I went for a walk on the Terry Trueblood Trail and ran into our neighbors doing the same thing! Seabirds were diving headlong into the lake. We’ve never seen them do that. Maybe they were fishing for minnows. About a week ago we saw a hawk. It might have been a Cooper’s Hawk or a Sharp-Shinned Hawk. It had a yellow spot at the base of its bill, so I’m going to say it was a Cooper’s Hawk.

We also saw a small brown creature in the lake on a stack of tree limbs. It was eating something. I couldn’t see its tail, but it could have been a young beaver or a muskrat. Its nose tapered instead of looking blunt and boxy, so maybe it was a muskrat.

Last week a squirrel chattered at us almost nonstop. It was pretty grumpy for some reason. We sure know a bald eagle when we see one.

Sometimes it’s more fun to enjoy a little mystery than to hunt for all the right answers.

CDC Identifies Omicron as Covid-19 Variant of Concern

I’ve been seeing news items about the Omicron variant of Covid-19. The CDC only yesterday announced that it is now a Variant of Concern. Other CDC comments are here in a news release. There’s not a lot of solid information yet about how dangerous it is. Most of what I see on the internet are comments about the need for more information. Vaccine manufacturers don’t seem to agree on whether or not current vaccines would be effective against Omicron.

Interestingly, there seem to be about as many news articles about how to pronounce “Omicron” as there are about the variant itself.

When I compare the Omicron news to that of the recently identified Delta plus (AY.4.2) subvariant, I see very few references to the latter after late October. I never saw any CDC indications that the Delta plus was ever a Variant of Concern, although news items generally carried an alarming tone. As the CDC says, there will be variants. So far, as of yesterday, no U.S. cases have been found.

Great YouTube Q&A on Covid-19 Vaccine for Children Ages 5-11: It’s better than a stick in the nose!

There was a great live stream YouTube Q&A presentation today on the Covid-19 vaccine for kids ages 5-11 through the University of Iowa Stead Family Children’s Hospital this afternoon at 2:15 and it ran for about 30 minutes (scrub the play button forward to about a minute to start the recorded video). There were excellent questions and informative answers as well as helpful guidance for parents by Chief Medical Officer Dr. Theresa Brennan, MD and Pediatrician Dr. Rami Boutros, MD.

Parents have been eager to bring their kids in to the pediatric clinic to get the vaccine. Dr. Boutros shared a funny anecdote about his interaction with a child who had just got his shot yesterday. It’s about 34 minutes into the video. After the child received the shot, Dr. Boutros asked him, “How was it?” The child replied, “The vaccine is better than a stick in the nose!” Anybody who’s been tested for Covid-19 can relate to that.

How’s that for a meme? Get the vaccine; it’s better than a stick in the nose!

CDC Recommends COVID-19 Vaccine for Children Ages 5-11

Following the Advisory Committee for Immunization Practices (ACIP) vote yesterday recommending the Pfizer Covid-19 vaccine for children ages 5-11, CDC formally announced agreement with the committee’s decision after the meeting.

Rattlesnake Hat vs Hornet’s Nest Snoot Flute

OK, so this should have been in yesterday’s post but I don’t care. You remember I mentioned the guy who wore the live rattlesnake on his head while strolling down State Street in Madison, Wisconsin? Well, in Iowa we have The Sitting Man who wore a hornet’s nest on his nose. It’s all about style points.

Beat that, Wisconsin.