Ask the Expert: COVID-19 in 2021

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Dr. Jennifer Vanyo-Novak, D.O. | Family Physician, Medical Director

The COVID-19 pandemic has given us ups and downs over the past year and a half. We hear about the “return to normal” but what does that mean and how do we get there?

NOAH’s Medical Director and Family Physician Dr. Vanyo-Novak breaks down the facts, explains the complex, and clears up rumors and misunderstandings about COVID, vaccines, and the new normal.

Dr. Vanyo-Novak

A lot of places are opening back up. Do we really need masks again since places stopped requiring them? Isn’t COVID almost over?  

Unfortunately, no, COVID is not almost over. Though the number of cases declined for a while thanks to mask mandates, social distancing, and vaccines against COVID-19, we are now seeing the cases rise.  As of 7.27.2021 the CDC has advised that even vaccinated individuals begin to mask again indoors in high risk COVID regions which includes us here in Maricopa County. This is in part due to lower than needed vaccine rates, not enough people following guidelines, and an increase in travel and social gatherings.  Like with most viruses that go uncontained, we are seeing the virus that causes COVID-19 evolve into new variants (strains of the virus) that are smarter, more easily transmitted, and harder to defeat than the original strains of the virus.

Right now we are hearing about variants, especially the Delta variant, but what is the difference? Should we be worried about another outbreak?

Viruses are living things and they continuously change so they can evolve and survive. There are several different strains right now, Delta being the most common one in the U.S. Several new strains are labeled as “Variants of Concern” by the CDC meaning they are more transmissible, cause more serious illness, don’t respond as well to treatments, and can be more resistant to vaccines.

With a rise in cases due to the Delta variant and other “Variants of Concern” we are seeing an increase in hospitalizations in younger patients without risk factors, even young children.  The virus is not just a risk for the elderly or people with underlying conditions. 

If someone got the vaccine, are they safe from new COVID strains? Will they need to take booster shots?

Honestly, we are still learning about the virus, its’ variants, and the vaccines. In the beginning health experts and scientists weren’t sure booster shots would be needed. Now, it looks likely that boosters will be needed but we don’t know when. Originally, they did not think boosters would be needed soon, but this can change as the case numbers rise. What the experts are working on understanding is if vaccinated people are getting COVID, is it because these new strains are outsmarting the vaccines, if the vaccine effectiveness is fading, or a combination of the two. 

Currently 97% of COVID-19 hospitalizations are unvaccinated individuals. That tells us that while we will not ever be 100% protected, most vaccinated people are protected and if they do get infected it is unlikely that they will get seriously ill. That was always a big goal with the vaccine.

If someone didn’t get vaccinated and doesn’t plan to, won’t they be safe since other people got the vaccine and infections are lower than earlier in the pandemic?

It is great that as of 7.28.21 338 million Americans have been vaccinated against COVID. However, that is only 49% of the U.S., putting us well below the 70-80% needed for herd immunity.

COVID cases aren’t looking as good as they were even a month ago. Less than 50% of Maricopa County is fully vaccinated and with school starting, travel increasing, and mask mandates mostly gone, the number of infected people will continue to increase.

Most of us interact with other people: school, work, stores, travel, transportation, exercising at gyms, and more. We can’t just think about ourselves, we must consider our community – the herd – and protect that. We have a responsibility to our friends, family, neighbors, and society to take care of each other.

The virus will continue to mutate into new variants and harm people, and the vaccines are our greatest defense.  We need to achieve herd immunity before we can truly begin to feel safe.

Kids don’t get COVID, so why do they need a vaccine?

In general most children have a much more robust immune system than adults. Children have gotten COVID throughout the pandemic, but they are getting it more now, and ending up in the hospital more. With new variants this trend may continue, and more children may become seriously ill or worse, die from this virus.

Children, like the rest of us, interact with family members, friends, classmates, teammates, and many other people. We want children to be protected from this virus, but also for them to protect their community as well.

How can we possibly know if the vaccines are safe if they aren’t fully approved?

They have all been given Emergency Use Authorization by the Food and Drug Administration (FDA) and here is a short video to explain it. All vaccines have trials that require at least 3,000 people. The COVID vaccine trials were done on 30,000 people before the first approvals in late 2020!

The main difference in the approval and process for the COVID vaccines is that while most vaccines go through a series of steps, finishing one step before moving the next one, with COVID vaccines, they moved to the next step once all the data showed things were looking good (as opposed to fully completed). But every step was still included, all the monitoring and review was still happening, but in a more fluid way.

At this time, every step has been fully completed and vaccine makers are beginning to apply for full FDA approval.

If the risk of getting really sick from COVID-19 is still low, why should someone take a new vaccine?

Possible side effects from the vaccine are still much less than the risk of COVID-19 and serious illness, including what we are now seeing as long-haul COVID. The vaccine side effects are mostly normal, expected, and mild. COVID is mutating and with each strain it can be more deadly, or more infectious than before.

We cannot just consider ourselves; we have to consider the effects of our choices on those around us. 

If the mRNA (vaccine technology used in some vaccines) isn’t new medical technology, why haven’t we used it in vaccines before.

t hasn’t been used in vaccines before COVID because we haven’t needed a new vaccine on this scale until now. The mRNA technology has been used successfully for decades, with a lot of research done on its benefits and any risks.

Anyone 12 and older can schedule their vaccine appointment one of NOAH’s locations. Click here to request an appointment. If you have additional questions or concerns about COVID-19 or the vaccine, make an appointment with one of our medical providers.

The Benefits and Support for Breastfeeding Month

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By Dr. Roberta Matern, MD

I am a family physician who delights in caring for the couplet (newborn and new mother) because helping growing families is so rewarding, and I strongly encourage breastfeeding and support families however I can.

Trusted organizations like the American Academy of Family Physicians and the American Academy of Pediatrics recommend babies are breastfed until at least 6 months old. Studies show that exclusively breastfed babies are generally healthier, but any amount of breastmilk is wonderful and encouraged!

Benefits of Breastfeeding

In general – though individual babies may differ – babies fed only breastmilk for their first 6 months have many benefits; moms too!

  • Babies tend to be healthier with fewer colds and doctor visits.
  • Decreased likelihood of SIDS (sudden infant death syndrome).
  • Babies are less likely to have diabetes, obesity, leukemia, and high blood pressure later in life.
  • Helps moms lose weight.
  • Decrease mom’s chances for breast cancer, diabetes, heart disease, and high blood pressure.
  • Breastfeeding has the added bonuses of no waiting for formula to warm up, it is free, and it is easy on the environment.
  • And more!

It’s Not Always Easy

While natural and better for babies and moms, breastfeeding can have challenges, and helping the couplet through that is important.

Challenges include:

  • The time it takes to get it going, especially if it is your first baby
  • The time commitment, which can be stressful for some moms and families
  • Moms needing to watch what they eat and drink – too much caffeine and alcohol, dairy, spicy foods, etc.

The good news is, we have lactation consultants that love being able to help moms and families through these issues!

Plan for Breastfeeding

I start talking about breastfeeding during prenatal visits, exploring mom’s feelings and answering questions. If there are any issues with mom’s breasts or nipples, I try to coordinate with a lactation consultant before delivery.

Next is promoting skin-to-skin contact right after delivery. Putting the newborn directly on mom’s belly or chest right after birth improves chances of exclusive breastfeeding and increases the duration of breastfeeding! Skin-to-skin helps mom and baby bond by increasing their levels of oxytocin…the “love” hormone.

Helping families know what is normal and what to expect during the first few days is key. At first, mom’s breasts produce colostrum – a very important food for babies full of nutrients and antibodies that fight infection. There is only small amounts of colostrum produced and babies will eat frequently because their stomachs are only about the size of a cherry – so they fill up and empty quickly.

A few days after delivery, mom’s breast milk will come in and that’s about the time babies’ stomachs start to grow. Newborns eat a lot and it’s important (regardless of breastfeeding or not) to learn your baby’s ques to know when they are hungry. Moms should have babies close to them and continue skin-to-skin during those early days and weeks.

While breastfeeding is recommended through 6 months, it can continue for months (or even years) after that. The World Health Organization recommends breastfeeding until age 2, while most couplets in the US do not breastfeed for that long. But any amount of breastfeeding is super healthy for baby and mom!

If you have questions about breastfeeding, talk to your NOAH prenatal doctor or your baby’s pediatrician. 

Back to Bed for Back to School

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By Annette Liao, DO | Family Medicine PGY-1

Can you believe it? The end of summer is quickly approaching. With fall around the corner, many families are thinking about the school year and how to prepare their kids for the classroom. This could prove to be a bigger challenge this year, as schools reopen their doors for in-person classes after a very different year. Now, after a summer of staying up late and sleeping in, it is time to help kids get back on a normal classroom schedule, and that starts with a good night’s sleep.

Back-to-School Kids Sleep Tips

  • As their brains develop, school-aged children need more sleep than adults to do their best in school and to stay alert during the day. Here is how much sleep kids should have:
    • Preschoolers (ages 3-5) require 10-13 hours of sleep
    • School-age children (ages 6-13) require 9-11 hours of sleep
    • Teenagers (ages 14-17) require 8-10 hours of sleep
  • Start slow – most kids will not be able to suddenly switch from being night owls to morning birds. A slow transition over a few weeks is best. Move bedtime by 15 minutes each day until they are getting the amount of sleep they need.
  • Keep a clock in each child’s bedroom so that they know what time they should go to sleep and what time they should wake up.
  • Avoid using electronics at least 1 hour before bed, and no electronics in bed! The light from the screens on TVs, tablets, and phones tricks our brains into thinking it is daytime and keeps us from a good night’s sleep. It’s good for everyone to turn off screens starting two hours before bedtime.
  • Instead of electronics, establish a relaxing bedtime routine. This could involve reading, stretching, or meditation. Routines will train the body that it is bedtime and can decrease anxiety around bedtime in kids and adults. Make the environment as relaxing as possible.
  • Keep the schedule, even on weekends. Parents and caregivers should all be on the same page with the sleep schedule. Children over the age of 5 should be informed on what that plan is as well.

Having quality sleep is essential for success in school. Not getting enough sleep affects a student’s ability to function, learn, and grow. These tips will not only help to get your kids back on track for school, but also set them up for a lifelong healthy habit! Learn more about other back-to-school tips for a healthy and happy start to the new school year.

Time to get Back to School!

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The 2021-2022 school year is just around the corner and the back-to-school feeling is nice to have back. As kids everywhere get ready for in-person learning this year, here are ways to make sure the start of the school year is a healthy and safe one.

  1. Get Well-Child appointments. During the pandemic, many people got behind (or forgot about) medical appointments like well-child and other annual preventative check-ups. Make sure your child has their well-child appointment before school starts!
  2. Schedule a sports physical. If your child is playing any sport this fall or spring, it’s a good time to get them a physical before the season gets into full swing.
  3. Make sure immunizations are up to date. Schools require immunizations and they keep your child and their classmates protected from unnecessary, dangerous, and sometimes fatal diseases. If students are 12 or older, they should also get the COVID-19 vaccine. Here is the CDC list of childhood vaccines.
  4. Start a good sleep routine. Kids need enough sleep to develop and do well in school and everything else. Most children need between 9 and 12 hours of sleep each night, so start a routine now and keep it up!
  5. Be physically fit. Kids need at least one hour of exercise every day. Make sure they get enough activity whether it is walking, swimming, playing soccer or basketball, dancing, or something else.
  6. Get school supplies ready. Start the school year with a sturdy backpack. Make sure your student has whatever supplies, like notebooks, folders, pens, and pencils, etc. to start the year successfully.
  7. Talk about bullying. Make sure your child knows about the seriousness of bullying. It can hurt people emotionally and mentally and can harm their learning. If your child is being bullied or sees another student bullied, make sure they know to tell a bully to “Stop!” and to talk to a trusted adult (teacher, counselor, nurse) at school.

Ready to start this school year and get your student in for their back-to-school medical appointments? NOAH pediatricians, counselors, nutritionists, and community resource specialists can help your student and family head into the year with everything you need for success. Make an appointment today!

NEWS: NOAH Celebrates Milestone in New Desert Mission Construction

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In April 2021, NOAH broke ground on the new Desert Mission Health Center and on June 26, hit another major milestone in the project. Kitchell, the construction company building the more than 23,000 square foot health center, lifted the final steel beam to complete the structure. This “Topping Off” celebration signifies a major phase in the completion of the health center.

Desert Mission Health Center team celebrates the Topping Off of their new health center.

Members of the NOAH Desert Mission Health Center team, along with other NOAH staff and board members came to celebrate the progress of the new Desert Mission Health Center facility by signing the final beam and sharing heartfelt memories and excitement for the future of NOAH in the Sunnyslope community.

The new health center, located around the corner from the current Desert Mission Health Center, will be at 9015 N. 3rd St. in Phoenix. NOAH is committed to providing healthcare for all, and that principle will guide how NOAH will serve around 20,000 patients every year with comprehensive, equitable healthcare at this new location.

Desert Mission was founded in 1927 and has provided much-needed medical care and ongoing support to the Sunnyslope community ever since. Now two separate entities, the Health Center and the Food Bank, together the legacy lives on.

Construction is expected to be completed on the new Desert Mission Health Center before the end of 2021. For more up-to-date information about the progress of this project, visit DesertMission.NOAHhelps.org.  

Have a Summer Safe in the Sun!

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By Cassandra Altamirano | PA-C, MPAS

Summer is a time to have fun!

Many of us enjoy outdoor activities like swimming, hiking, biking, and running, but summers in Arizona are very hot!  This heat can be dangerous and can cause people to become very sick or even die. Being out in the heat too long can cause dehydration and symptoms of dizziness, headaches, light-headedness, and fainting. If your body reaches too high of a temperature it can even impact organs like your kidneys and brain. Every year, people end up in the hospital due to heat related illness. Have fun, but be sure to have a summer safe from heat illness.

Here are the signs and symptoms of heat related illnesses:

Recommended tips to have a summer safe in the heat and prevent heat-related illness:

Bring water 

  • Bring water with you everywhere you go. 
  • If you are outside in the heat stay hydrated! Drink at least 1 cup (8 oz) of water every hour even if you do not feel thirsty.

Wear sunscreen 

  • Wear at least 30 SPF sunscreen and remember to reapply every 2-3 hours especially if you are in the water. 
  • People often forget to apply sunscreen on wrists, tops of feet, backs of hands, ears, and nose. Don’t forget these areas!

Wear the right clothes

  • Wear a hat – a wide brimmed hat is best.
  • Wear sunglasses to protect your eyes.
  • Wear lightweight cotton clothing that covers your skin. 

Make safe choices

  • Avoid outdoor activities during the hottest part of the day, 4 a.m. to 7 a.m. is generally the coolest time.
  • If you are unable to avoid being out in the heat be sure to take frequent breaks to drink water and find shade to rest.
  • Check in on your elderly neighbors, family and friends, people from out of town or those that may be at high risk.

If you have more questions about heat and hydration safety, talk to one of NOAH’s providers today.