Chief Medical Officer at Northwestern Medicine Central DuPage Hospital Dr. Kevin Most joins the Steve Cochran Show to discuss the rare skin cancer that claimed Jimmy Buffett’s life, what may have caused Mitch McConnel’s freezing episodes, and factors that may cause a mask mandate.

Dr. Kevin Most’s Steve Cochran Show Notes:

Covid cases rising:

• 2 weeks ago all 102 Counties in Illinois remained at low level for Covid hospital admissions
• Surveillance is now pretty much focused at wastewater detection
• That surveillance is showing moderate activity at all of the wastewater testing sites
• We have seen cases in the ER and Urgent Care Centers rising the past 2 weeks
• Some colleges are noticing increased cases, and we can probably expect that here as schools are back in session
• Cases in the hospital have risen as well
• The state of Illinois has 200,000 courses of Paxlovid that are part of the stockpile so still provided free of charge
• Those at risk including seniors and immunocompromised should be prepared to get the new Covid vaccine when it becomes available in the next few weeks.
• Continued focus on the new variant BA 2.86 and if the current vaccines will show protection against this strain.
• The known cases of this strain do not appear to be linked which leads us to believe it is more widespread than we thought.
• This is already been seen in over 10 countries
• Focus on this strain as we have great immunity currently from infections and vaccinations, but what is concerning is will it evade the protection we have
• We do not know a lot about this strain at this point but the high number of mutations is concerning
• Question is will it spread or die off without causing a problem
• We do not have any evidence that this strain is causing more severe illness or death, however hospitalizations are rising 

Masking again ???

• Other concern is if this becomes predominant and  runs thru schools and workplaces will we see people masking again
• With the concern that this strain may evade our immune system, it may be a good time for those over 65 or immunocompromised to wear masks again when in crowded environments
• Individuals who are immunocompromised may want to keep a N95 mask in the car, or somewhere easy to get to
• What will trigger wide mask mandates? Probably if we see a stress on the hospital systems which is doubtful as most individuals now have some immunity to protect from severe illness or hospitalizations

Covid Vaccines- Booster now or wait??

• Personal recommendation would be to wait for the fall booster to be available
• The new vaccine will be focused on the XBB strain, which is one of the 3 major strains circulating now
• New vaccine should be rolled out in the next 2 – 3 weeks and available widespread.
• I do not think you will see mandates for the booster, but many companies and industries will be making strong recommendations.

Vaccines- we have talked a lot about vaccines over the past 2 years. We have also talked about RSV over the past year.  Unique vaccine was approved last week, not unique about the vaccine, but more about the intent

• RSV is the leading cause of infections in children under 5 years of age, it is the most frequent cause of pneumonia in infants world wide
• We see over 2 million cases of RSV in doctors offices and it is thought that this may be about 50% of the actual number of cases as many do not see a doctor.
• Last year we had close to 100,000 hospitalizations for RSV in Children under the age of 5, and another 150,000 hospitalizations in adults over the age of 65
• Until May of  this year we had no vaccine for RSV, when the vaccine for RSV was approved for individuals over the age of 60, thus covering one of the groups of our concern
• This past week the FDA approved this same  vaccine with a unique focus on a population that can be severely impacted.
• The RSV vaccine approved last week was for women who are pregnant and between 32-36 weeks gestation.
• Are we concerned that the mother will get RSV??  —– No
• This vaccine is given to the mother, so her immune system can make antibodies to RSV, which she passes to the unborn child.
• The child when born now has the mothers antibodies to protect the baby from RSV infections from  birth to 6 months of age, the time they are most vulnerable to this contagious disease
• Newborns have a very limited immune system when born, they have WBC to fight infections but their supply of antibodies has not been built up, and the immune system is not ready to produce antibodies well
• Mothers who breast feed also pass important antibodies to the newborn, again giving them some protection