Johnson & Johnson

It’s been a year since the coronavirus (COVID-19) pandemic shocked the United States and the world, but brighter days are seemingly ahead, thanks to the ramp up of vaccinations combined with other established health and safety protocols.

Dr. Javier Gonzalez, a board-certified emergency department medical director with AdventHealth Dade City and AdventHealth Zephyrhills, for one, is cautiously optimistic that a sense of normalcy could arrive by summertime.

That’s assuming that surging COVID-19 virus variants don’t “get crazy” and force the population to get revaccinated, he said.

“Hopefully we’ll get through this in July when we’re supposed to be majority vaccinated, so hopefully this won’t last long and we’re in the final stretch,” Gonzalez said. “As soon as we can get everybody vaccinated, the easier it will be for all for us to go back to a normal time again.”

Gonzalez was the featured guest speaker during The Greater Zephyrhills Chamber of Commerce March virtual business breakfast meeting.

Gonzalez — also certified as a diplomate with the American Board of Toxicology — spent the bulk of his 45-minute informational talk discussing the various COVID-19 vaccines available and the science behind them.

The health care leader explained the “whole goal” of the vaccines is not necessarily about not getting COVID-19, but rather to mitigate or prevent serious complications or death from the virus.

He put it like this: “People think the goal of the vaccine is, ‘I don’t want to get the disease.’ No, the purpose of the vaccine is not getting the complications. So, the endpoint really should be, ‘Am I going to get sick enough that I’m going to go to the hospital, or am I going to die from COVID-19?’ That’s what you’re trying to prevent, just like the flu vaccine. Most people can get the flu even if you’re vaccinated, but you don’t want to die from the flu, you don’t want to get the pneumonia complications.”

Gonzalez detailed how vaccines are designed to introduce some of the viral genetic material into the body so antibodies can be developed, “which is the key to help you fight the virus in the future.”

He shot down myths that the authorized COVID-19 vaccines may somehow change or interact with a person’s DNA in any way, explaining how the vaccine is delivered into cell’s cytoplasm, not the nucleus.

Said Gonzalez, “I know a lot of people are concerned it’s messing with our DNA. It doesn’t; it stays outside the nucleus of our cells, so it doesn’t go into where our DNA is…”

He touched on the efficacy of the various types of available vaccines, too.

He mentioned both the Pfizer and Moderna mRNA vaccines have shown to be about 95% effective in preventing COVID-19 infections for the general population, while the AstraZeneca and Johnson & Johnson viral vector vaccines have come in at 72% and 70%, respectively.

For comparison, the annual flu shot is about 40% to 50% effective in preventing influenza, he said.

The notable piece, Gonzalez emphasized, is the four COVID-19 vaccines are proven 100% effective in preventing hospitalizations and deaths related to the virus.

“Don’t be discouraged by these (efficacy) numbers,” he said. “Look at the flu vaccine. We get it every year, and it’s only 40% to 50% effective, but (lack of) hospitalization and death is the important factor here. I don’t care if I get COVID, as long as I don’t die from it.”

With that, he encouraged people to go ahead and get the single-dose Johnson & Johnson vaccine, if eligible to do so.

Said Gonzalez, “Is Johnson & Johnson weaker? Yeah, it’s weaker for you not to get COVID, but it’s going to prevent me from going to the hospital and dying from it, so if you are eligible to get the Johnson & Johnson vaccine, then by all means, please get it.”

Gov. Ron DeSantis expanded the groups eligible to receive the COVID-19 vaccine in Florida, as of March 15, to include those age 60 or older.

Eligibility continues to evolve, so be sure to check for the latest information on state or local health department websites.

Gonzalez, who’s been vaccinated himself, acknowledged experiencing some pain in the injection site.

He knows others have experienced headaches, fatigues and muscle aches for 24 hours to 48 hours — not dissimilar to flu shot symptoms.

He recommended taking Tylenol for relief post-injection. “When you get a side effect from the flu vaccine, most likely you’ll probably get it from COVID-19 (too),” Gonzalez said.

Serious side effects like anaphylaxis are rare, with less than a 0.1% reported, he said, adding, “We haven’t seen any deaths from people getting COVID vaccines.”

Meantime, as others wait to get vaccinated, Gonzalez emphasized continuing proper mask-wearing in public spaces.

He underscored how it reduces risk of transmission or spread of respiratory droplets containing viruses, whether through breathing, talking, coughing or sneezing.

The medical professional admitted, like others, he doesn’t particularly enjoy wearing a mask, but illustrated the bigger picture at play: “I know it’s cumbersome, (but) it doesn’t take that long, you’re helping your neighbor, you’re helping yourself, so, it’s just easier to wear one, whether you believe in it or not, it doesn’t take much from somebody to wear a mask. Just cover your mouth and cover your nose, and be a good citizen with everybody else.”

Improved COVID-19 treatment options
From an encouraging standpoint, inpatient and outpatient COVID-19 treatment options have improved greatly since the pandemic’s onset, Gonzalez observed.

Inpatient hospital care options include anti-virals like remdesivir, similar to Tamiflu to fight influenza; steroids like decadron, given to patients with low oxygen saturations; and convalescent plasma injections, whereby COVID-19 survivors’ antibodies are transfused into sick COVID-19 patients.

In the way of outpatient COVID-19 management, AdventHealth Dade City and AdventHealth Zephyrhills were some of the first hospitals in the health care system’s West Florida division offering monoclonal antibody infusion, Gonzalez said.

With monoclonal antibody infusion, synthetic antibodies created in a pharmaceutical laboratory are used to limit the amount of virus in the body, treating COVID-19 positive patients and preventing progression to more severe cases and symptoms.

The therapy requires an IV infusion at the hospital and takes about three hours, Gonzalez said.

“We got a lot of good feedback from patients that have received this,” he said, noting his parents and fellow physicians have received therapy at both facilities. “Within 24 hours they were miraculously better.”

Gonzalez pointed out this treatment was actually used to help President Donald Trump recover from the coronavirus, administered at Walter Reed National Military Medical Center, in Bethesda, Maryland.

Don’t ignore other health care issues
Even amid the pandemic, Gonzalez strongly advised people to not put other non-COVID-19-related health care issues on hold, or simply ignore new or persistent symptoms.

Hospitals have taken extreme measures to make sure that people with COVID-19 are held in separate locations, he said, so there shouldn’t be fear of visiting facilities to take care of other medical conditions — whether it’s diabetes, hypertension, or routine cancer screenings.

“Please keep your appointments for chronic disease management, especially if you’re taking medications,” he said.

The speaker noted how hospitals are reporting fewer heart attacks and strokes amid fear of COVID-19 —worrying doctors that patients are avoiding visits for health issues that require prompt care.

“Timing can be the difference,” he said. “If you wait too long (to seek medical care) you’re going to get more comorbidities and more risk for mortality or death.”

A seasonal virus?
At least one lingering question is whether COVID-19 will become a seasonal virus, like the flu.

Gonzalez said it’s “really a debatable question,” adding, “at this time, there’s no data suggesting it will be seasonal.”

However, the medical director explained because COVID-19 is virally enveloped, it’s more apt to survive and travel in cold weather.

Moreover, because sunlight is less intense in the wintertime, there’s less UV radiation light to kill the virus, he said.

Other concerning factors of the virus perhaps spreading more in the wintertime, he said, is a byproduct of people congregating in enclosed indoor spaces more often. There’s also risk of weakened immune responses as people have less Vitamin D amid less sunlight, he said, so supplements are recommended in wintry months.

Symptoms of Coronavirus (COVID-19)
Symptoms can range from mild to severe, and appear two days to 14 days after exposure to the virus that causes COVID-19.

• Fever/chills
• Shortness of breath
• Dry cough
• Loss of smell/taste
• Muscle aches
• Vomiting
• Diarrhea

Note: Seek medical care immediately if someone has emergency warning signs of COVID-19.

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Bluish lips or face

Source: Centers for Disease Control and Prevention

Five mistakes to avoid with your mask

• Not washing your hands
• Not covering your nose and mouth
• Touching or adjusting mask
• Masking too late, removing it too soon
• Reusing old/dirty masks

Source: Akron Children’s Hospital

COVID-19 general prevention measures

• Avoid sick individuals
• Socially distance at least six feet
• Wash hands for at least 20 seconds
• Disinfect high-touch and high-transit areas, such as elevators and stairwells
• Wear a mask in the community

Published March 17, 2021