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  • December 15, 2021

    By MedStar Team

    More than 70% of people who are eligible for the COVID-19 vaccine in Maryland and the District of Columbia have gotten at least one dose—thank you to everyone who is doing their part to keep our neighbors safe!


    That said, the pandemic is not over yet—in October 2021, around 1,200 deaths from COVID-19 occurred each day in the U.S. As we balance the weight of this knowledge with the optimism of successful COVID-19 treatments and vaccines, many people are wondering how to approach a second round of major holidays.


    From travel plans to tough conversations with family members, we’ve answered five questions patients are asking the most.

     
    The pandemic isn’t over, but #COVIDVaccines have changed last year’s holiday guidance. Infectious disease expert Maria Elena Ruiz, MD, and pediatrician Tia Ragland Medley, MD, answer top questions about #HolidayTravel and celebrations: https://bit.ly/3GLSqlr.
    Click to Tweet

    1. Are indoor family gatherings safe?

    After a tumultuous couple of years, it is important for everyone to feel socially engaged right now. Children and teens, in particular, will benefit from social activities; a national state of emergency in child and adolescent mental health was recently called by the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association. 

     

    Spending time with loved ones and simply taking time to relax can help ease the ongoing stress complicating mental health. But we’re hesitant to recommend indoor parties, especially because vaccination only opened up to children age 5-11 the first week of November.

    If you choose to gather with a group indoors:

    • Keep it small with 10-20 people who do not need to travel long distances to attend.
    • Wear masks when you’re not eating or drinking if any attendees are not vaccinated or received a positive COVID test within the last three days.
    • Maintain safe distances of about 6 feet between other people.
    • Wash or sanitize your hands every 30 minutes.
    • Open windows, if possible, to improve ventilation.

    Planning and communication before gathering are key. You may be surprised at who within your circle is not yet vaccinated. Having that conversation ahead of time ensures everyone is on the same page. If everyone is not vaccinated, switch to an outdoor gathering, postpone the event until everyone is vaccinated, or develop a hybrid plan that allows some people to attend virtually.


    Related reading: How to deal with re-entry anxiety and post-pandemic stress.

    2. Is it safe to travel?

    Driving and flying are relatively safe if everyone in your party is vaccinated. Driving significantly decreases the number of people you’ll come in contact with. But if you’ll be stopping at public places in areas with low vaccination rates and high COVID cases along the way, the risk of infection is not lower than if you flew. Cruises and long-distance bus or train trips are not recommended by the Centers for Disease Control and Prevention (CDC).


    If you plan to travel internationally, you must be fully vaccinated.
    Review the CDC’s international travel guidelines

    If you plan to travel within the United States, the CDC recommends being fully vaccinated and following these guidelines:

    • Wear a mask on planes and public transportation.
    • Follow all local recommendations and requirements in the area you travel to.
    • Consider wearing a mask (both indoors and outdoors) in locations with high numbers of COVID-19 cases.
    • Self-monitor for COVID symptoms when you return. Isolate and get tested if you have them.

    If you are not fully vaccinated, the CDC recommends getting a viral test one to three days before your trip and:

    • Wearing a mask and maintaining physical distance at all times.
    • Avoiding crowds.
    • Washing your hands and sanitizing often.
    • Getting a viral test three to five days after traveling and self-quarantining for a full seven days, whether or not you experience COVID symptoms.

    We do not recommend traveling to locations with low vaccination rates. If you choose to do so:

    • Limit the activities you participate in while visiting the area.
    • Wear a higher-grade mask or double surgical masks on the plane if you fly.
    • Consider quarantining once you arrive if you’re visiting someone with a high risk of developing COVID complications.

    Staying at a hotel or with people who have not been vaccinated increases your chances of contracting the virus more than staying with fully vaccinated people. If that’s your only option, wear a mask when you’re not eating or drinking and frequently wash and sanitize your hands.

    It all comes down to being mindful. Before traveling, avoid large groups of people to lower your risk of contracting and spreading the virus. While traveling, practice good hygiene, be respectful of others’ personal space, and avoid large, unmasked crowds.

    3. Can we bring back our favorite holiday outings this year?

    From holiday markets to mall Santa visits, many traditional outings were paused last year. But we expect most of them to return this year, and many already have. Movie theaters, shopping centers, and concert halls have been open for a while now and will likely keep getting busier.

    The safest way to celebrate this year is to be fully vaccinated. Outdoor activities, such as sledding, skating, or light displays, continue to be safer than indoor activities, regardless of your vaccination status.

    Review event guidelines before attending to ensure you’ll be able to comply. Masks or proof of vaccination might be required at certain venues. Even if they’re not, we’ll both be wearing masks in indoor public spaces to help prevent the spread of COVID or any other virus—and we encourage you to do the same.

    4. Should I get a COVID booster shot before attending events?

    If a booster shot is available to you, we highly recommend getting it. But if you’re already fully vaccinated, you don’t have to sit anything out or do anything differently until you get your booster shot.


    Right now, we’re encouraging booster shots for people who:
    • Are 18 or older and received the Johnson & Johnson vaccine two or more months ago
    • Are 65 or older and received the Pfizer or Moderna vaccine six or more months ago
    • Are 18 or older, received the Pfizer or Moderna vaccine six or more months ago, and have underlying medical conditions or live or work in high-risk environments (e.g., long-term care facility, health care setting, school, grocery or department store)

    If you received two doses of the Moderna vaccine, you can get the Pfizer booster—and vice versa—but we advise patients to stick to the same brand of booster if possible. You can get it at the same time as your flu shot to avoid two trips to the clinic.


    5. How can I discuss the vaccine with family members who are not vaccinated?

    COVID-19 will likely be a popular conversation topic during the holidays. Be sure to set firm ground rules regarding masks and vaccination status in your home and around your family before any events.


    Despite the effectiveness and safety of all three COVID vaccines, misinformation continues to persist. We understand the concerns about the vaccine—and the frustration of discussing its benefits with people who aren’t interested in listening or learning.


    Each person who has been vaccinated can help be an ambassador to their community. Increasing our vaccination rates has been challenging and requires effort from all of us: physicians, parents, siblings, and friends.


    Try to understand the source of someone’s objection to the vaccine and really listen to their concern. From there, you can gently use science-based facts to address their specific concern.


    Emphasize that one of the most important things to consider in a pandemic is the health of those around us. Vaccines and masks protect your neighbors, family, and friends and are the only way to stop COVID-19 from spreading. Many pediatric patients have told us they’re excited to get the vaccine because they want to help people.


    You can also recommend that they talk to a trusted health professional. We want people to have as many layers of protection against this virus as possible, which is why we strongly recommend the vaccine for all who are eligible. 


    Related reading: COVID-19 vaccine: Answers to frequently asked questions: Part one and Part two.

    Stay home if you feel sick.

    We’re just as excited as you to celebrate the holiday season with loved ones. But don’t let your excitement overpower your sensibility. If you are experiencing symptoms of COVID-19—or even a cold or flu virus—stay home.

     

    After looking forward to holiday celebrations that feel a little more “normal,” we know it can be difficult to potentially miss out again. But the pandemic has shown just how important it is to sacrifice inconvenience for the health and safety of others. Get the rest and care you need so you can get back to enjoying a healthy holiday season.

     

    Watch our Facebook Live broadcast for more about COVID-19 developments around the Delta variant, booster vaccines, holiday gatherings, and more:


     

    Vaccines are key to safe holiday celebrations.

    Schedule your COVID-19 vaccine today.

    COVID-19 Vaccine Information

All Blogs

  • December 15, 2021

    By MedStar Team

    More than 70% of people who are eligible for the COVID-19 vaccine in Maryland and the District of Columbia have gotten at least one dose—thank you to everyone who is doing their part to keep our neighbors safe!


    That said, the pandemic is not over yet—in October 2021, around 1,200 deaths from COVID-19 occurred each day in the U.S. As we balance the weight of this knowledge with the optimism of successful COVID-19 treatments and vaccines, many people are wondering how to approach a second round of major holidays.


    From travel plans to tough conversations with family members, we’ve answered five questions patients are asking the most.

     
    The pandemic isn’t over, but #COVIDVaccines have changed last year’s holiday guidance. Infectious disease expert Maria Elena Ruiz, MD, and pediatrician Tia Ragland Medley, MD, answer top questions about #HolidayTravel and celebrations: https://bit.ly/3GLSqlr.
    Click to Tweet

    1. Are indoor family gatherings safe?

    After a tumultuous couple of years, it is important for everyone to feel socially engaged right now. Children and teens, in particular, will benefit from social activities; a national state of emergency in child and adolescent mental health was recently called by the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association. 

     

    Spending time with loved ones and simply taking time to relax can help ease the ongoing stress complicating mental health. But we’re hesitant to recommend indoor parties, especially because vaccination only opened up to children age 5-11 the first week of November.

    If you choose to gather with a group indoors:

    • Keep it small with 10-20 people who do not need to travel long distances to attend.
    • Wear masks when you’re not eating or drinking if any attendees are not vaccinated or received a positive COVID test within the last three days.
    • Maintain safe distances of about 6 feet between other people.
    • Wash or sanitize your hands every 30 minutes.
    • Open windows, if possible, to improve ventilation.

    Planning and communication before gathering are key. You may be surprised at who within your circle is not yet vaccinated. Having that conversation ahead of time ensures everyone is on the same page. If everyone is not vaccinated, switch to an outdoor gathering, postpone the event until everyone is vaccinated, or develop a hybrid plan that allows some people to attend virtually.


    Related reading: How to deal with re-entry anxiety and post-pandemic stress.

    2. Is it safe to travel?

    Driving and flying are relatively safe if everyone in your party is vaccinated. Driving significantly decreases the number of people you’ll come in contact with. But if you’ll be stopping at public places in areas with low vaccination rates and high COVID cases along the way, the risk of infection is not lower than if you flew. Cruises and long-distance bus or train trips are not recommended by the Centers for Disease Control and Prevention (CDC).


    If you plan to travel internationally, you must be fully vaccinated.
    Review the CDC’s international travel guidelines

    If you plan to travel within the United States, the CDC recommends being fully vaccinated and following these guidelines:

    • Wear a mask on planes and public transportation.
    • Follow all local recommendations and requirements in the area you travel to.
    • Consider wearing a mask (both indoors and outdoors) in locations with high numbers of COVID-19 cases.
    • Self-monitor for COVID symptoms when you return. Isolate and get tested if you have them.

    If you are not fully vaccinated, the CDC recommends getting a viral test one to three days before your trip and:

    • Wearing a mask and maintaining physical distance at all times.
    • Avoiding crowds.
    • Washing your hands and sanitizing often.
    • Getting a viral test three to five days after traveling and self-quarantining for a full seven days, whether or not you experience COVID symptoms.

    We do not recommend traveling to locations with low vaccination rates. If you choose to do so:

    • Limit the activities you participate in while visiting the area.
    • Wear a higher-grade mask or double surgical masks on the plane if you fly.
    • Consider quarantining once you arrive if you’re visiting someone with a high risk of developing COVID complications.

    Staying at a hotel or with people who have not been vaccinated increases your chances of contracting the virus more than staying with fully vaccinated people. If that’s your only option, wear a mask when you’re not eating or drinking and frequently wash and sanitize your hands.

    It all comes down to being mindful. Before traveling, avoid large groups of people to lower your risk of contracting and spreading the virus. While traveling, practice good hygiene, be respectful of others’ personal space, and avoid large, unmasked crowds.

    3. Can we bring back our favorite holiday outings this year?

    From holiday markets to mall Santa visits, many traditional outings were paused last year. But we expect most of them to return this year, and many already have. Movie theaters, shopping centers, and concert halls have been open for a while now and will likely keep getting busier.

    The safest way to celebrate this year is to be fully vaccinated. Outdoor activities, such as sledding, skating, or light displays, continue to be safer than indoor activities, regardless of your vaccination status.

    Review event guidelines before attending to ensure you’ll be able to comply. Masks or proof of vaccination might be required at certain venues. Even if they’re not, we’ll both be wearing masks in indoor public spaces to help prevent the spread of COVID or any other virus—and we encourage you to do the same.

    4. Should I get a COVID booster shot before attending events?

    If a booster shot is available to you, we highly recommend getting it. But if you’re already fully vaccinated, you don’t have to sit anything out or do anything differently until you get your booster shot.


    Right now, we’re encouraging booster shots for people who:
    • Are 18 or older and received the Johnson & Johnson vaccine two or more months ago
    • Are 65 or older and received the Pfizer or Moderna vaccine six or more months ago
    • Are 18 or older, received the Pfizer or Moderna vaccine six or more months ago, and have underlying medical conditions or live or work in high-risk environments (e.g., long-term care facility, health care setting, school, grocery or department store)

    If you received two doses of the Moderna vaccine, you can get the Pfizer booster—and vice versa—but we advise patients to stick to the same brand of booster if possible. You can get it at the same time as your flu shot to avoid two trips to the clinic.


    5. How can I discuss the vaccine with family members who are not vaccinated?

    COVID-19 will likely be a popular conversation topic during the holidays. Be sure to set firm ground rules regarding masks and vaccination status in your home and around your family before any events.


    Despite the effectiveness and safety of all three COVID vaccines, misinformation continues to persist. We understand the concerns about the vaccine—and the frustration of discussing its benefits with people who aren’t interested in listening or learning.


    Each person who has been vaccinated can help be an ambassador to their community. Increasing our vaccination rates has been challenging and requires effort from all of us: physicians, parents, siblings, and friends.


    Try to understand the source of someone’s objection to the vaccine and really listen to their concern. From there, you can gently use science-based facts to address their specific concern.


    Emphasize that one of the most important things to consider in a pandemic is the health of those around us. Vaccines and masks protect your neighbors, family, and friends and are the only way to stop COVID-19 from spreading. Many pediatric patients have told us they’re excited to get the vaccine because they want to help people.


    You can also recommend that they talk to a trusted health professional. We want people to have as many layers of protection against this virus as possible, which is why we strongly recommend the vaccine for all who are eligible. 


    Related reading: COVID-19 vaccine: Answers to frequently asked questions: Part one and Part two.

    Stay home if you feel sick.

    We’re just as excited as you to celebrate the holiday season with loved ones. But don’t let your excitement overpower your sensibility. If you are experiencing symptoms of COVID-19—or even a cold or flu virus—stay home.

     

    After looking forward to holiday celebrations that feel a little more “normal,” we know it can be difficult to potentially miss out again. But the pandemic has shown just how important it is to sacrifice inconvenience for the health and safety of others. Get the rest and care you need so you can get back to enjoying a healthy holiday season.

     

    Watch our Facebook Live broadcast for more about COVID-19 developments around the Delta variant, booster vaccines, holiday gatherings, and more:


     

    Vaccines are key to safe holiday celebrations.

    Schedule your COVID-19 vaccine today.

    COVID-19 Vaccine Information

  • December 03, 2021

    By Glenn W. Wortmann, MD

    Change has been a constant theme throughout the COVID-19 pandemic. Regardless of what  professional athletes or celebrities might suggest, this is a good thing—science is all about learning and adapting to new information.


    The progress we’ve made worldwide in preventing and treating COVID-19 is nothing short of incredible. But it will continue to be a bit of a bumpy ride as we make new science-based discoveries. 


    The latest update many people are asking about is the COVID-19 booster shot—and how it’s different from additional vaccine doses recommended for immunocompromised patients. To provide more clarity, I’ll discuss questions we’re hearing the most from patients.


    Keep in mind that we still have much to understand about the coronavirus. When searching for answers, stick to trusted health professionals and the Centers for Disease Control and Prevention (CDC) for the most up-to-date and accurate information.

    It can be hard to keep up with #COVID19Vaccine information. Get answers to FAQs about the #COVIDBoosterShot from @MedStarWHC Section Director of Infectious Diseases Glenn W. Wortmann, MD: https://bit.ly/3pl0G4O.
    Click to Tweet


    What is a COVID-19 booster shot?

    Booster shots enhance your immune system’s ability to protect you from a COVID-19 infection. Boosters are approved from Moderna, Pfizer, and Johnson & Johnson, and include all the same ingredients as the manufacturer’s original vaccines.

     

    New data is showing that the effectiveness of the COVID-19 vaccine slightly decreases over time. By getting a booster shot, adults who have received two full doses of the Moderna or Pfizer vaccine—or one dose of the Johnson & Johnson vaccine—can increase and extend their protection against the virus. If these people do not receive a booster shot, they are still considered fully vaccinated.

     

    How is a booster shot different from an "additional dose" of the COVID-19 vaccine?

    A booster shot extends protection against COVID-19 in people who developed high immunity to COVID after being fully vaccinated. An additional dose of the vaccine increases immunity in people who developed a low amount of immunity after being fully vaccinated.

    Additional doses are not the same as booster shots. For example, the Moderna booster is only half of the dose administered for a primary series dose.

    People who are immunocompromised are not likely to develop much immunity to COVID-19 after receiving two full doses of the Moderna or Pfizer vaccine or one dose of the Johnson & Johnson vaccine. This includes individuals who:

    • Are receiving immunosuppressive treatment for cancer or other medical conditions
    • Have received an organ or stem cell transplant 
    • Have an advanced or untreated HIV infection

    The CDC recommends that immunocompromised individuals who received two doses of the Pfizer or Moderna vaccine get an additional full dose—from the same vaccine manufacturer—at least 28 days after the second dose. Sometimes a fourth dose is recommended, depending on the person’s health. 


    Additional full doses of the Moderna and Pfizer vaccines have been shown to improve COVID-19 immunity in these patients. The CDC now recommends that anyone who received a single dose of Johnson & Johnson vaccine should get a second dose of a COVID vaccine 2 months after the first dose. It is preferred to use an mRNA vaccine (Moderna or Pfizer) for the best immune response. However, if this is unavailable, a repeat dose of J&J/Janssen can be given instead.


    Talk with your doctor to see if you might benefit from an additional dose of the COVID-19 vaccine. It is not recommended for people who had a serious reaction to their initial vaccine series; have a fever over 100.4 degrees Fahrenheit; or have received a monoclonal antibody infusion (Regeneron or Lilly) in the last 90 days to treat COVID-19.


    Who should get a booster shot—and when?

    The U.S. Food and Drug Administration recently approved the Pfizer booster shot for all adults 18 and older.


    We are following the CDC’s guidance to encourage all fully vaccinated adults to get a booster shot and strongly recommend it for people who are:

    • 18 or older and received the Johnson & Johnson vaccine two or more months ago
    • 65 or older and received the Pfizer or Moderna vaccine six or more months ago
    • 18 or older, received the Pfizer or Moderna vaccine six or more months ago, and have underlying medical conditions or live or work in high-risk environments (e.g., long-term care facility, health care setting, school, grocery or department store)

    You can get a booster shot from any of the three vaccine manufacturers, no matter which type you received the first time. Some data has shown that mixing vaccines could provide better protection, but we still can’t say for sure. What we do know is that all three are highly effective.

     

    Is the booster shot safe?

    Just like the first COVID-19 vaccines, which contain the same ingredients, booster shots are not only safe but also protective against the Delta variant

     

    Over 7 billion doses of the COVID-19 vaccine have been administered across the world, so we have excellent data showing that it is very safe. COVID-19 can become a severe infection that results in death or long-term symptoms, which is why we recommend vaccination so strongly. 

     

    I understand people’s hesitancy to receive a new vaccine, especially when it doesn’t completely erase your chances of getting infected—even with a booster shot.

     

    However, getting vaccinated significantly lowers your risk of experiencing severe COVID-19 symptoms if you do become infected. And it reduces the chances that you’ll spread an infection to people who have a high risk of developing severe COVID symptoms. Booster shots extend this protection to help you and the people you care about stay as healthy as possible.

     

    Does the booster shot have side effects?

    Reported side effects have been mild to moderate and similar to symptoms experienced after the first vaccines: fever, headache, fatigue, and pain at the injection site.

     

    Mild side effects are triggered by the immune system’s reaction to learning how to fight the virus—and everyone’s body acts differently. Experiencing side effects does not mean the vaccine or booster shot gave you a virus. The vaccine also does not cause cancer or infertility.

    Serious side effects from the COVID-19 vaccines are extremely rare. People who have an allergic reaction to their first dose should talk with their doctor about getting their next dose from a different manufacturer.

    Will we need booster shots every year?

    It’s too early to say what the future of COVID-19 vaccination looks like. It will likely depend on the spread of COVID over the next year or so—which should decrease as vaccination rates increase. 

    The best way to reduce the number of COVID vaccinations recommended in the future is to become fully vaccinated now and receive a booster shot when you’re eligible—even if you’ve already had COVID-19. The natural immunity that develops after an infection does not last as long as the immunity from the vaccine.

    MedStar Health patients can schedule a COVID-19 booster shot through their provider’s office. If you are not a current patient, review our list of clinics offering the vaccine.

    Are you ready to receive your COVID-19 booster shot?

    Request an appointment to extend your protection against COVID-19.

    Call 202-877-DOCS (3627) or Request an Appointment

  • December 01, 2021

    By Sarah Heins, Medical Student, COVID Recovery Program

    Experiencing “long-term COVID” or as it is medically termed, post-acute sequelae SARS-CoV-2 infection (PASC), can be a confusing and circuitous process, full of uncertainty and non-linear progress. Firstly, it can be difficult for many people to know whether they are experiencing long-term COVID symptoms, and even more difficult to know what to do about them. To provide some clarity and firsthand knowledge, three MedStar Health COVID Recovery Program patients—Patrick, Stephanie, and Debbie— have generously shared their perspectives on this journey. 


    Any patient’s first step in joining the program is realizing that acute COVID-19 symptoms are transitioning into long-term sequelae. Many patients report that some of their initial COVID symptoms tend to improve before PASC symptoms occur, while other acute symptoms—such as shortness of breath, respiratory difficulties, or loss of taste and smell—might linger from the acute period into the PASC period. Finally, other symptoms—such as brain fog, anxiety and depression, fatigue and exercise intolerance, or other more unique symptoms—may not arise at all until later in the PASC trajectory.

    When interviewed, Patrick stated that after his acute infection he “felt better and thought I would bounce back easily, but then didn’t get to 100%, and instead stayed at 90% for months
    .” He described lingering fatigue relating to long standing exercise intolerance, explaining that heused to go to gym every other day, but then it took 3 months before I could even go on a light jog without winding myself.


    Choosing MedStar Health and the initiation of care at the clinic.

    Prior to being established in our program, patients reported difficulty finding providers who understood and had experience with treating lingering symptoms of COVID—which was a key motivator for them to seek care in our program. Many began with treatment through their primary care providers (PCP), or tried to navigate the healthcare system on their own by requesting to see specialists they felt could treat their symptoms. Lack of widespread knowledge and understanding about PASC led patients to feel frustrated, dismissed, and ignored. Then, as specialized clinics devoted to seeing and treating patients with PASC began to emerge across the country, many patients were able to establish care at MedStar through word of mouth or referrals from their PCP or other providers. 


    To enter our COVID Recovery program, patients must be 6 weeks out from symptom onset and have either a laboratory confirmed positive COVID-19 test from their initial infection, or a clinical presentation indicating COVID-19. Patients complete an online medical-history form and standard patient assessment prior to their first appointment. For the initial visit, patients may be seen by one of the physical medicine and rehabilitation (PM&R) doctors that have dedicated part of their practice to helping patients suffering from PASC. A comprehensive medical history is performed, including details of the acute phase of a patient's COVID illness, as well as focusing particularly on addressing PASC symptoms and goals for recovery. From there, referrals are made to various specialists to address the specific needs and symptoms of each person.

    The role of the COVID Recovery Program is not to replace a patients’ PCP, but instead to serve as the patient’s PASC “home-base” and provide the framework of care during their recovery journey.  Finally, as treatment proceeds and patients see the various specialists and rehabilitative therapists relevant to their case, they will also complete online assessment forms at two, four, and six-month intervals, which helps track their progress and the program’s effectiveness.


    Perspectives on the journey’s beginning.

    In describing their outlook after the initial intake appointment, one of the main emotions patients described was “validation”. One of our patients, Patrick, stated his initial visit with the MedStar Health COVID Recovery Program was the “first time I talked to someone who actually understood and validated the reality of my symptoms, and also the first time the doctor explained that other people had those symptoms too.” Another patient, Stephanie, explained her first experiences with our program made her “feel like people really want to listen and help me get to the other side.” This validation came alongside feelings of relief and a return to self-control, but also came with feelings of apprehension. 


    The hope of recovery was mixed with worry that symptoms may not improve. Amidst this unshakeable worry, however, is trust. Patrick commented on his appreciation for his providers’ honesty. With his initial infection occurring back in March 2020, he was at the forefront of COVID long-haulers, and the providers in our program admitted that they may not have answers to explain some of his symptoms. Yet he still “felt grateful to be talking to someone who is aware of what is happening.” Stephanie expressed similar sentiment, describing a feeling that she was “getting a fresh set of eyes on a problem,” and that particularly in such a focused clinic, the providers’ “knowledge of other patients and situations has really helped.”

     

    Through our COVID Recovery Program, many people not only find their long-term COVID symptoms improving, but also feel a renewed sense of hope for their progress. Learn more about how our program can help from patient's perspectives: https://bit.ly/3xIp8Rh.
    Click to Tweet


    Treatments and specialists.

    Though the list of specialists differs for each patient, the most common referrals have been to cardiologists, neurologists, pulmonologists, rheumatologists, and rehabilitative therapists. The treatment trajectory can also vary from patient to patient, and for some may involve medical testing and specialist visits in the early weeks, followed by more time with rehabilitative therapists later on. 


    To give further insight into the integration of these multiple treatment specialties, Debbie gave a detailed outline of the care each specialist provided:

    • Cardiologist: Performed an electrocardiogram (EKG) and an echocardiogram and gave her a wearable heart monitor to assess her tachycardia (fast heart rate) and check for associated abnormalities. 
    • Neurologist: Performed a magnetic resonance imaging (MRI) to rule out a stroke as possible explanation for the cognitive symptoms she was facing. This confirmed that her cognitive and mental-health issues were COVID related.
    • Gastroenterologist: Did exams and provided treatment to help with reflux.
    • Neuropsychologist: Performed a 4-hour cognitive assessment to further address cognitive symptoms. 
    • Psychiatrist: For help with anxiety and panic attacks. 
    • Occupational therapist: Helped establish techniques for energy conservation and provided help with the more physically interactive elements of maintaining energy.
    • Speech and language therapist: Also established techniques for energy conservation, as well as making return to work plans. 

    Debbie explained that working with such a diverse group of physicians and therapists to find the treatment plans that worked best for her was like “throwing darts at a dartboard and hoping something would hit the middle.” In this sense, treating PASC often involves lots of trial and error, in which the physician and patient work together to track all attempted treatment tactics, assess what is and is not effective, and move forward with the best methods.


    Rehabilitative therapies are the cornerstone of treatment, playing a particularly effective role in helping patients overcome fatigue, malaise, and cognitive challenges. These therapists help patients incorporate concrete tools into their daily lives that help mitigate PASC’s impact on functioning. For example, Patrick uses a G-Mail plug-in that helps read his emails out loud to him, while Debbie implemented a plan with her coworkers in which they communicate with her largely over email rather than in-person. This allows for control of her information intake and offers her the ability to respond to them at her own pace. 


    Managing all aspects of PASC.

    Our comprehensive program requires patients to communicate with a wide range of specialists and manage various integrated therapies on top of keeping track of their own medications and symptoms. Following this complicated schedule requires personalized strategies to control its multiple moving pieces. The online patient portal is one central and extremely helpful tool that allows for easy communication with specialists and care navigators. However, in addition to using the portal and following the care provided by the program, many patients establish their own coping strategies to stay on top of their care needs. Patients report using an app or online calendar to keep track of all appointments, medications, and exercises, which ensures that every element of treatment is updated in real time and preserved in a central location. 


    Stephanie checks her online calendar every night to make sure she knows what is scheduled for the next day. She has also developed a strategy of leaving schedules and to-do lists in strategic locations—such as the car, bathroom, or dresser—to provide immediate reminders of her daily tasks. She emphasizes the value of finding someone in your own life to help you as you recover from PASC. Relying on a spouse, child, or friend can be an enormously beneficial asset. An additional coping strategy she suggests is to make a file of all the notes and resources provided by each specialist, which can be helpful to keep track of progress and treatments, as well as provide a way to keep information easily accessible at all times.


    Our program's environment.

    The culture of our program is extremely team-oriented, emphasizing communication, integration of care between specialists, and doctor-patient collaboration. One of our patients, Debbie, describes her experience as characterized by partnership with her physicians, explaining that they give her the autonomy to diagnose and identify her needs, and then they work alongside her to address them. Furthermore, Patrick, another of our patients, says he was given the opportunity to provide feedback on his rehabilitative therapy sessions, thus playing a role in bettering his own care experience.


    Final thoughts and valuable advice.

    Through our COVID Recovery Program, many people not only find their physical PASC symptoms improving, but they also feel a renewed sense of hope for their own progress. Patrick also describes a welcome feeling of empowerment, explaining that he “now can make it all day without logging off or closing my eyes,” and “no longer feels defeated.”


    Another common feeling is one of being increasingly accepted and heard. Stephanie explains that she is finally confident enough to be a part of her own treatment. She feels more capable of participating in her medical care and much less afraid to wonder if a new symptom is part of her long-COVID or not. She no longer hesitates to describe her symptoms or feelings to providers because she knows that she will be cared for.


    In sharing their experiences, current patients of the program say that their main piece of advice for those just embarking on their treatment journey is to be patient. Debbie offers further advice, saying: “Believe that it will help. It may not fully heal you, and might not happen as fast as you want, but believe that the steps are making a difference.” 


    Debbie also encourages people not to give up—as “everyone is different and has different problems to focus on.” 


    The MedStar Health COVID Recovery Program is one of just a few comprehensive COVID recovery programs in the country, and just like the knowledge of PASC itself, is constantly evolving in its understanding of the illness and its strategies for treatment. As Patrick explains to future patients, “you are at the forefront of what the medical community knows—so they are still learning,” highlighting the fact that our program will continue engaging in learning and research that will only make its treatment stronger.


    Interested in the MedStar Health COVID Recovery Program?

    Click below to learn more.

    MedStar Health COVID Recovery Program

  • November 08, 2021

    By Sarah Heins, Medical Student, COVID Recovery Program

    Over the past year the use of rehabilitative therapies has been an integral part in treating Post-Acute Sequelae of COVID-19 (PASC) symptoms. 


    These rehabilitative therapies are a cornerstone of MedStar Health’s COVID Recovery Program, with physical therapy (PT), occupational therapy (OT), and speech and language pathology (SLP) playing an essential role. Our PTs, OTs, and SLPs work with each patient, virtually or in person, to help them overcome symptoms and achieve their treatment goals.  These three specialties work in tandem while also following their own unique methods to bring about successful recovery.


    The basics.

    All three of these specialties treat a vast spectrum of PASC symptoms including fatigue, cognitive symptoms, and post viral deconditioning.  Patients may also be referred at various points in their post-infection trajectories.


    The logistics.

    Treatment with PT, OT, and SLP in the program may involve working with their therapist 1-2 times per week for several weeks, depending on individual needs and symptom severity. Treatment plans are often individualized and can be tailored towards those who are working to regain basic functioning to those aiming to return to work or vigorous exercise. 

     

    What do each of these therapies look like?

     

    Physical therapy.

    In our program, physical therapists report treating a variety of symptoms. Kimberly Agan –a Physical therapist at MedStar Health-has been working with several PASC patients and reports the main symptoms she helps treat include:

    • Decreased cardiovascular capacity—involving deconditioning of the aerobic system, low O2 levels, and difficulty breathing
    • Vestibular issues—including dizziness and difficulty with balance
    • Muscle fatigue and weakness

    A typical PT appointment can include cardiovascular exercises to rebuild physical strength and endurance, breathing exercises to improve respiratory capabilities, as well as manual therapy to relax the muscles of inspiration. Other techniques include balance and eye exercises to improve vestibular senses. PT programs for PASC include many at-home exercises as well, including self-massage techniques or further breathing techniques that patients are able to perform themselves. All patients have access to an online exercise portal and are provided with instructions and tutorial videos.


    Our program’s PTs track and monitor progress to help direct therapy and ensure patients are meeting their goals. Completion of PT usually occurs when the patient has made substantial progress towards their physical goals and is able to continue a therapeutic program on their own. PTs in the program advise that being committed and consistent in doing at-home exercises is one of the biggest steps to take towards achieving the ultimate goal: a return to pre-COVID function.

     


    Over the past year, the use of rehabilitative therapies has been an integral part in treating long term COVID-19 symptoms. Learn how physical therapy and more can help via the #LiveWellHealthy blog: https://bit.ly/3BOqmeh.
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    Occupational therapy.

    In our COVID Recovery Program, OTs may help patients struggling with symptoms of fatigue, energy deficits, and challenges that can interfere with activities of daily living.  


    One of the most common techniques for management of fatigue is energy conservation planning, in which the OT helps patients structure their schedules and environment in ways that minimize fatigue. Developing cognitive fatigue management strategies is another central component. OTs help patients recognize physical signs that occur before they experience fatigue and then develop a plan for how to proceed after those signs occur. Adopting strategies such as scheduling pre-emptive rest periods at crucial times, building in cognitive breaks, or putting tasks in a strategic order can maximizes energy usage. Reduce distracting environmental stimuli, such as limiting ambient background noise and controlling strong lighting are also effective strategies. 


    Adjusting the home or work environment in order to use the body more efficiently are also ways OT’s help with energy conservation. Examples include sitting down when brushing your teeth, utilizing adaptive equipment such as a shower chair, or delegating tasks to friends or family members. 


    Similar to PT, the main goal of OT is to return patients to their original pre-COVID functioning levels. Karen Gragnani, occupational therapist at MedStar Health, recommends “keeping an open mind for treatment strategies, and to be willing to try new techniques along the way. It is also important to be kind and forgiving towards oneself, be willing to take breaks and not push progress too hard, and most importantly to be patient and trust the process.”

     

    Speech-language pathology.

    In our program, SLPs help to address cognitive symptoms, which can include:

    • Attention: difficulty focusing to read, quickly losing energy when focusing on a task
    • Word-finding: inability to choose the correct word to express oneself
    • Memory: forgetting things quickly, being overwhelmed by large amounts of information
    • Organization: difficulty managing schedules, medical referrals and medications, finances and bill payments, deadlines at work

    They also help with other COVID-related symptoms such as voice changes—hoarseness or weakness, as well as chronic cough.  


    SLP centers around education, in which the therapist works to teach people about how their brain works. Understanding how attention, memory, problem solving, and cognitive endurance function can help patients manage and overcome specific weaknesses. Similar to OT, SLPs also help patients develop compensatory strategies such as making to-do-lists or implementing an organizational system to manage daily tasks.


    SLPs also have patients practice and strengthen their cognitive abilities on their own. For example, reading a complex passage in a book or listening to a podcast, and then eventually adding in distractions and additional tasks to perform simultaneously--such as cooking.


    Unlike physical injuries, it is sometimes difficult to identify the limits cognitive fatigue causes in daily life, and hard to recognize its exact manifestations. Patients can often feel trapped and discouraged by living within the limits of their cognitive fatigue. SLP works to encourage patients that progress is possible, and the cognitive limits can certainly be overcome. Breanne Reynolds, a Speech-Language Pathologist with MedStar Health, reinforces this by encouraging her patients to “give themselves some grace,” and to remember that “recovery is complicated and does not follow a single straight path.” She tells them to “be open to adjusting your expectations and getting away from judging yourself.” 


    Similarities and differences.

    PTs, OTs, and SLPs assisting our program all share the same objective of partnering with each individual to personalize and maximize their recovery process. While the methods they employ to achieve it are unique to each therapeutic specialty, they all work in pursuit of the same goal: returning patients to their pre-COVID capabilities.



    Are you suffering from long-term COVID symptoms?

    Click below to register or learn more about our COVID Recovery Program.

    COVID Recovery Program

  • August 25, 2021

    By Naheed Ahmed, PhD

    Thanks to the COVID-19 vaccine, local schools are inviting teachers and students back to the classroom for the upcoming school year. While many families and kids anxiously await the return to normalcy, the highly-contagious Delta variant reminds us that the pandemic is still not over. With COVID-19 cases on the rise again, it’s important to remain vigilant in keeping kids healthy as they go back to school.

    Vaccination is the best way to protect kids from COVID-19 at school.

    If your child is headed back to the classroom, you may be worried about your child contracting the virus. As COVID-19 cases surge across the country, vaccination is as important as ever, especially for kids who will be in close contact with their peers at school in the fall. With 93 percent of all new COVID-19 cases in the United States caused by the Delta variant, coronavirus is still permeating our communities, vaccinated or not. While pediatric hospitalizations remain low, the Delta variant seems to affect children more than the COVID-19 virus we battled last summer.

    You may not have control over whether or not the virus spreads to your child. But, if your child is vaccinated, they’re far less likely to become severely ill or hospitalized. That’s why the Centers for Disease Control and Prevention (CDC) recommends vaccination for everyone above the age of 12. Unvaccinated kids are at a greater risk of developing serious symptoms if they become infected with COVID-19. This is especially true for kids with a chronic illness, such as asthma, diabetes, or sickle cell anemia.

    If your child is over the age of 12 and still unvaccinated, it’s not too late. To be considered fully vaccinated, your child will need two doses of the Pfizer vaccine over a period of 21 days. While eligible children should ideally get vaccinated before the school year begins, getting the first dose of the vaccine as soon as possible will ensure some protection as they await the second dose.

    The COVID-19 vaccine can be given alongside other childhood vaccines.

    Schools have always had health prerequisites for childhood vaccines to keep everyone safe, and the COVID-19 vaccine is no different. While initial vaccine recommendations suggested that people wait two weeks after getting other vaccines before getting vaccinated for COVID-19, you no longer need to wait. As your child is getting other required vaccines in anticipation of school, they can also receive the COVID-19 vaccine, if they’re 12 or older.

    Most MedStar Health primary care and pediatric offices offer the COVID-19 vaccine. If your doctor’s office isn’t offering the vaccine, they can direct you to a vaccination site nearby.

    Addressing vaccine hesitancy.

    As a parent or caregiver of a school-aged child, it’s common to overthink decisions related to your kids. We want the best for our children, and the misinformation around COVID-19 circulating the Internet can cause us to doubt ourselves.

    If you’re hesitant to vaccinate your child or if you come across someone who is, the following tips can encourage an informed decision.

    Review the data.

    While the COVID-19 vaccines have been labeled for emergency use, they’re not “experimental”, as some might think. Researchers have been studying and investing in mRNA technology for years. And, the COVID-19 vaccines have been rigorously tested and evaluated for safety and efficacy. You can read Pfizer’s published reports on their clinical trials and the CDC continues to provide the most up-to-date information on their website.

    Get the facts on side effects.

    Experts agree that the risk of illness is more severe than any side effect of vaccination for both adults and kids. Children have robust immune systems and side effects after vaccination indicate that the vaccine is working. Just like the flu shot and other vaccines, children may experience injection site soreness, fatigue, or headaches after getting vaccinated for COVID-19. Tylenol or Motrin can help alleviate discomfort.

    Although extremely rare, there are instances where the vaccine results in short-term inflammation of the heart, called myocarditis. In these cases, heart palpitations, shortness of breath, or chest pain may appear within seven days after the second dose. Symptoms typically self-resolve and there are no long-term effects. Talk to your child’s doctor if they experience any side effects that seem abnormal.

    Discuss any concerns your child has.

    From videos circulating on Tik Tok to classroom rumors, your child may be susceptible to believing myths or false narratives spreading across their peers. Invite an open dialogue where they can be honest about what they’re hearing so you can dispel any false information with the truth.

    Talk to your child’s doctor.

    If you’re concerned about getting your child vaccinated, talk to their pediatrician. They’ll also be happy to address any questions or hesitancies that your child may have about getting the COVID-19 vaccine.

    MedStar Health associate Shreejana Pokharel decided to get her 13-year old daughter vaccinated, but it wasn’t an easy decision. “It was challenging to decide,” she notes. “But the study data published by Pfizer was convincing, as the vaccine was 100% effective among children.” She also had a heart-to-heart conversation with her daughter who had concerns because of her peers’ experiences. Shreejana was able to explain the benefits of the vaccine while addressing false rumors her daughter had heard. At the end of the discussion, her daughter said, “Mommy, I hate needles, but I’m excited for this one so I can go back to school safely”.

    How can I keep my child safe at school if they’re ineligible for vaccination?

    Nearly half of Americans remain unvaccinated against the novel coronavirus, including 48 million children under the age of 12 who are ineligible for vaccination. Yet returning to face-to-face education is important for the social wellbeing of our children. MedStar Health Pediatrician Tia Medley, MD witnessed firsthand the negative social impact on kids who didn’t attend school in person last year. She encourages the parents of her patients to attend school in person this year, regardless of vaccination status, provided that the school is actively ensuring safety through other means.

    48 million children are currently ineligible to get the #COVID19Vaccine. On the #LiveWellHealthy blog, learn how you can protect them as they head #BackToSchool: https://bit.ly/3zhlzl9.

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    Even if your child is ineligible for vaccination, it’s still possible to return to school safely. As an adult, getting vaccinated yourself can reduce the likelihood that you contract the virus and spread it to your children. And, with the proper protocols in place, schools can mitigate the risk of a major outbreak. Ensure your child’s school and teacher is:

    • Encouraging mask-wearing inside the building
    • Facilitating social distancing when possible
    • Providing frequent opportunities for hand-washing and sanitizing
    • Actively screening and monitoring kids with symptoms
    • Sending kids with symptoms home and ensuring health before they return to school

    If your child has the sniffles or is showing any sign of illness, keep them home. While it may just be the common cold, it’s important to be abundantly cautious to minimize the spread of the virus in the classroom.

    To learn more, watch our Facebook Live video below:

    Consider participating in a local clinical trial.

    Currently, Pfizer and Moderna are both conducting clinical trials for kids under the age of 12 across three age groups, including:

    • Six months to two years
    • Two to five years
    • Five to twelve years

    Pfizer and Moderna expect to have results for the older cohort later this fall. And, both offer clinical trials within the Maryland, Virginia, and Washington, D.C., region. If you have a child between the ages of six months and 12 years, you may consider participating in a trial. Doing so would offer a 50 percent chance of your child getting vaccinated.

    Stay healthy and have a terrific school year.

    Widespread vaccination is the best way to keep kids safe from COVID-19, if they’re eligible. But if your child is under 12, it’s still possible for them to stay safe and healthy this school year, as long as their school establishes and enforces good screening and prevention protocols that minimize the spread of COVID-19.

    As your kids head back to school during a worldwide pandemic, remind them that their class is a community. Wearing a mask and getting vaccinated can protect both themselves and the other members in their community from COVID-19.


    Do you have questions about the COVID-19 vaccine?
    Click below to learn more.

    COVID-19 Vaccine Information

  • August 11, 2021

    By Sarah Heins, Medical Student, COVID Recovery Program

    As the status of the COVID-19 virus in the United States continues to improve amidst widespread vaccinations and the fresh outdoor air of the warm summer months, many people’s lives are beginning to approach a welcomed sense of pre-pandemic normalcy. However, for many Americans suffering from new or persistent symptoms after an initial COVID-19 infection, such normalcy feels much farther from reach.

    While a majority of people fully recover from COVID-19 infections, it is increasingly evident that many experience symptoms that last long after recovering from the virus. These post-COVID conditions are often referred to as “long COVID” or “long-term COVID,” and have been officially entitled by the CDC as PASC (Post-Acute Sequelae of COVID-19). PASC is defined as a “wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19.”

    As we learn more about the effects of #COVID19, it’s increasingly evident that many people’s symptoms last long after testing negative for the virus. Read more about the symptoms and treatment of long-term COVID on the #LiveWellHealthy blog: https://bit.ly/3jMeZwn.

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    Long-term COVID symptoms.

    These symptoms occur in anywhere from 5-80% of patients, and are seen in patients who experienced COVID at all levels—from those who had no symptoms, to people with very serious illness.

    The long-term symptoms patients experience are wide-ranging, and include:

    • Anxiety
    • Blurry vision
    • Chest pain
    • Chills
    • Cough
    • Depression
    • Difficulty focusing (sometimes called “brain fog”)
    • Fatigue
    • Fever
    • Gastrointestinal changes
    • Headache
    • Heart Palpitations
    • Lightheadedness or dizziness
    • Loss of appetite
    • Loss of smell or taste
    • Memory impairments
    • Painful joints or muscles
    • Post-exertional malaise (PIM)
    • Sinus congestion
    • Shortness of breath
    • Trouble sleeping

    MedStar Health COVID Recovery Program.

    The COVID Recovery Program is a collaboration among medical specialists across all MedStar Health hospitals. The program aims to treat those struggling with PASC and guide them through the care needed for recovery.

    Our team is led by physical medicine and rehabilitation physicians, and advanced practice providers who specialize in the rehabilitation of patients with a variety of physical impairments. We will perform a detailed evaluation and provide necessary referrals to specialists who can further address your symptoms. A patient navigator and community health advocate will assist you with scheduling and managing your plan of care.

    Who can participate in the program?

    Patients interested in this program should be at least 6 weeks from the start of COVID symptoms and should have documentation of at least one positive COVID-19 test. Your doctor can also state that your symptoms indicated COVID without a positive test. If you do not have a documented positive test, a referral from a provider will be necessary to enter the program.

    Our patients have demonstrated a wide variety of post COVID-19 symptoms, similar to the ones listed above. However, some of these manifestations have proven to be especially prevalent, namely, fatigue, shortness of breath, and brain fog. Our COVID Recovery Program has drawn on a variety of resources and treatment techniques to help patients overcome them.

    Fatigue.

    Chronic fatigue is the most prevalent and substantial symptom seen in patients in our program. It may involve constant low-energy levels, exhaustion, and/or tiring more easily when performing daily functions such as housework or exercising. Oftentimes, the fatigue worsens substantially after minor exertion and does not improve with sleep. While the causes of this fatigue are still unknown, it may be related to the body’s initial reaction to the viral infection, such as a dysregulated immune-system response and associated inflammation.

    Although there are not yet any specific treatments for post-COVID fatigue, our program has developed various strategies that can bring short term relief and enhance long-term recovery. Treating any additional conditions—such as autoimmune diseases, diabetes, or other chronic illnesses—is an important step. Additionally, referring to specialists to perform sleep studies are also valuable tools in combating fatigue.

    Our program also refers patients to physical and occupational therapy to provide hands-on rehabilitative care to help patients improve their energy levels and functional abilities. Patients with recurring and chronic fatigue are often referred to neuropsychologists or psychologists to provide more specific therapy. They may also be placed on medications that can help combat fatigue.

    Shortness of breath and breathing difficulties.

    Following the acute respiratory symptoms of COVID-19, many patients continue to face troubles with breathing. These long-term respiratory manifestations include shortness of breath, coughing, wheezing, and chest heaviness. Our COVID-19 Recovery Program helps patients struggling with catching their breath during exertion. This may occur while doing daily activities, such as walking up stairs or exercising. Patients often notice that they cannot capture a full breath, or consistently feel that their airway is trapped or congested.

    There are many treatments that our program uses to relieve patients’ breathing difficulties. The program often refers patients to specialists, such as pulmonologists and cardiologists, who can perform various tests on the lungs and respiratory system, as well as order imaging such as chest X-Rays or CT scans. Providing patients with physical therapy and speech therapy are common and helpful ways to restore lung function and bring patients back to their baseline function levels.

    Brain fog.

    Another frequent symptom is a set of cognitive difficulties commonly referred to as “brain fog.” Patients often come to our COVID-19 Recovery Program reporting lapses in their memory, difficulty focusing, easily losing their train of thought, increased forgetfulness, challenges with finding words when speaking, and other changes. These symptoms appear with various levels of severity. From trouble focusing on tasks at work, to forgetting to pay bills, or turning off the stove.

    One of the main strategies our program employs to help with these symptoms is providing speech therapy and occupational therapy. These are used to develop new strategies to successfully prioritize, organize, and attack complex needs at work or at home. Patients struggling with more substantial symptoms will be referred to a neurologist who can perform further testing, imaging, and advanced treatments.

    MedStar Health is here to help.

    Because of the novel nature of COVID-19 and its long-term effects, there is still much to learn about the manifestations and causes of post-COVID symptoms. The techniques and rehabilitative strategies our program employs to help patients today are constantly evolving and improving, following information from current research, CDC guidelines, and the needs and stories of the patients it serves. Our goal is to provide patients with a one-stop service to bring resources and care to you. We understand you and your family have been through a life-changing experience with all the challenges a new virus and pandemic bring, and we are ready to help.


    Interested in the MedStar Health COVID Recovery Program?
    Click the button below.

    MedStar Health COVID Recovery Program