For more than 100 years spring meant the beginning of the baseball season. The hopes and dreams of fans dominated the conversation and the airwaves. In 2021 however, America has turned to a different, more serious game. Our favorite teams are no longer the Mets or the Yankees or the Red Sox, but rather THE PFIZER's, THE MODERNA's AND THE J&J's. Instead of watching the standings of each of our baseball teams, we are anxiously watching the number of new cases and the number of vaccines administered daily. In this new game there should be only winners, no losers. However, watch out because there is a new team in the game, THE VARIANTS.
The key to turning the corner and heading home is the concept of herd immunity. This requires that we vaccinate all, if not most, of the population as soon as possible and continue to practice safety as suggested by the CDC until this game is over.
There is one problem however. Some of our teammates are refusing to play the game and follow the rules. Without everyone's participation Team America cannot win. The virus needs a host to mutate. Recently a patient who died of cancer, not COVID-19, but who was COVID-19 positive for 60 days was examined and an autopsy specifically looked at the nature of the COVID-19 virus that infected him. Much to the scientists' surprise, they found 6 different variants of the virus in the 1 patient, indicating that in the 60 days he was ill, COVID-19 mutated 6 times. Thus far in the laboratory, but not in humans, the variants seem to be inhibited by our current vaccines. But that is no guarantee that the next mutation will not change the game.
We Americans are all entitled to our own opinions and views. However, when the actions of an individual can negatively impact the health and well-being of another, the concept of freedom and autonomy must be re-examined. The fact that a significant percentage of Americans are not seeking vaccinations, a fact often correlated with political affiliation, is an example of this dilemma. A Democrat can infect a Republican as easily as the converse. COVID-19 does not vote or have a party affiliation.
There is increasing evidence that a fully vaccinated individual has a very low likelihood of infecting an unvaccinated individual. It appears that the virus does not linger long in an individual who has been vaccinated, and may be present an insufficient amount to infect another. Further studies so far seem to support this premise and soon we will have hard evidence.
In terms of mortality, obesity is the number one health issue associated with a higher rate of death from COVID-19. In countries with a high level of obesity the death rate is 10 times that of countries that do not have a similar problem. In the United States, obesity is the most common pre-existing condition that leads to death, followed by diabetes which is another condition that is diet related.
One of the negative side effects of the last year of our lockdown has been the observation by oncologists that patients coming in for breast cancer and colon screening and/or treatment have much more advanced diseases than seen previously. The one year delay in routine follow-ups has made the prognosis for many cancer patients significantly poorer. It is important that all of you receive your routine and frequent medical examinations. I have always stressed that prevention is the only way out of the conundrum of our health care disaster.
Yesterday on the news there was a 5 minute segment about dentistry and the fact that dentists across the country are noticing a marked increase in patients coming in with worn and fractured teeth often leading to the loss of single or multiple teeth. I have observed patients coming in with a significantly high number of fractured crowns and teeth, frequently followed by the extraction of teeth which cannot be otherwise saved. As I was writing this I had just completed removing a completely healthy tooth with no restorations in a 60 year-old woman. The clenching that she had engaged in over the last year put enough force on this tooth to cause micro fractures that led to pain upon biting and rendered the tooth non-treatable. This increase in clenching of the teeth and bruxism, a grinding of the teeth, not only can damage the teeth but can cause pain in the jaws. Earlier in the week, a woman who has been a patient for many years came in for an examination complaining of pain in her jaw. Interestingly enough, when she told her physician about it she was prescribed, sight unseen, an antibiotic. When she saw an Ear Nose & Throat physician, he prescribed her a steroid. When she came to my office it was clear to me that her pain on the side of her jaw was a muscle spasm. She is a severe clencher and has been under a great deal of stress this year. The ever repeating paradigm that if all you have is a hammer, everything looks like a nail. In any event, many adult patients require the fabrication of night guards, plastic appliances to keep their teeth apart when they sleep. This will prevent wear as well as fracturing of teeth, which in my own practice over the last number of years has become a leading cause of tooth loss.
On a final note, recently the AMA lowered the age for screening for lung cancer in current and former smokers. Prior it was age 55, but because the screening has been so successful, they have now lowered the age to 50. The criteria are that you smoked for at least 20 years, 1 pack a day, or if more than 1 pack a day less than 20 years. Numerous patients in my own practice and among my peers have had early malignancies detected and removed prior to symptoms. Lung cancer is most curable when it is detected and treated prior to symptoms.
White Plains Hospital, as I have mentioned before, has a program to screen patients with a low-level radiation CAT scan. They will accept your insurance and if you are not insured, the program was allowing the patients to be part of a study and avoid a fee.
Hopefully in the near future we will all be vaccinated and we can turn our attention to living a more connected life.
As always I appreciate your viewpoints.
Dr. Victor M. Sternberg, D.M.D.<br
By Westchester Center for Periodontal & Implant Excellence
March 29, 2021