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At the beginning of the pandemic, there was real concern that being infected with COVID-19 was life-threatening. Back then, best protections were still unknown and unavailable. 

Now, with the omicron surge fading, we are in a much better position. However, we must remain alert for the emergence of new Variants Of Concern (VOC), as classified by the Centers for Disease Control and Prevention (CDC)

The good news is that tracking metrics have been put in place and many communities have come up with strong response plans to protect against infection and to institute early treatment.

Example: Los Angeles County's Post Surge Response Plan

The COVID-19 pandemic has had a devastating impact, particularly on poor and vulnerable communities. Because of that, Los Angeles County has put seven metrics in place to assess the status of COVID-19 in the community and to serve as the basis for decision-making. 

1. COVID-19 Variants

The goal is to have less than 5% new variants in tested samples. Currently, no VOC is beyond the 5% level. However, recent wastewater analyses are raising concerns. 

2. Emergency Room Visits

The goal is to have less than 5% COVID-19-related emergency room visits each week. Currently, this is at 4.3% which is still below 5% but will need close monitoring. 

3. Low-income Areas

In low-income areas, the goal is to have less than 100 cases per 100,000 population in poor areas.  Currently, there are 51 cases — a dramatic improvement from recent months.

4. Nursing Homes

Nursing homes have many vulnerable individuals in close contact and are considered as high-risk environments. The goal is to have less than 11 COVID-19 outbreaks every week; outbreaks currently number 4 a week. 

5. K-12 Schools

For K-12 schools, the goal is to have fewer than 4 outbreaks each week; there were 4 this past week

6. Homeless Shelters

Homeless shelters have the same goal as nursing homes: less than 11 COVID-19 outbreaks each week. Last week, 8 were reported. 

7. Workplaces

For workplaces, the goal is to have less than 100 outbreaks at work sites each week. There were 30 reported last week.

The above parameters help gauge the level of COVID-19 in the community and as you can see, there have been significant improvements in Los Angeles County. They illustrate the day-to-day challenges of monitoring on a global basis.

Response strategies and impact for myeloma patients

To respond to any increase in COVID-19 infections in the community, Los Angeles County also has a five-point plan.

Step 1

Workplaces are required to report 3 or more cases within a 14-day period.

Step 2

FREE COVID-19 testing is broadly available.

Step 3

A key goal, which is very important to myeloma patients, is to make helpful preventive and treatment options as available as possible — including Evusheld™ monoclonal antibody shots as a preventative, and Paxlovid™ as an early treatment option. The availability of these preventive and treatment options will increase in the coming months. 

Step 4

Vaccines: both mobile and fixed vaccination sites will be maintained on an ongoing basis. Again, this is very helpful for myeloma patients. 

Step 5

Surveillance is a key aspect because of concerns about new VOC. The intention is to analyze 15-25% of COVID-19 samples and also, to increase testing of wastewater samples. 

Right now, there is a definite concern because reports from both Europe and the U.S. indicate an uptick in COVID-19 cases in the past week, including the BA.2 variant and perhaps, the deltacron variant  — a mix of delta and omicron. 

There was a 48% increase in new cases this past week in the UK. In several locations in the U.S., there has been a 1,000% increase in COVID-19 found in wastewater samples.


Bottom line for myeloma patients

From what we have learned about COVID-19 — including monitoring, testing, and treatments which have been developed so rapidly— the outlook has dramatically improved for myeloma patients. If vaccinated and boosted, the risk of having severe COVID-19 is quite low. With the addition of Evusheld, a high-level of protection is feasible.
 
The main thing is to stay alert in your community. If COVID-19 metrics are increasing, be especially cautious during all situations of risk with groups, particularly indoors.

Masks remain a key line of defense for myeloma patients and are strongly recommended even if mask-wearing is not mandated. You can take maximum precautions to protect yourself and masks really work well in doing that. 

We are all hoping for a much better Spring and Summer. Staying safe is the best way to have opportunities to do more. Plan your vacation and travel when the situation is right. 

Be cautious, but there is no need to panic!


Image of Dr. Brian G.M. DurieDr. Brian G.M. Durie is the Chief Scientific Officer of the International Myeloma Foundation (IMF), serves as Chairman of the Board, and serves on its Scientific Advisory Board. Additionally, he is Chairman of the IMF's International Myeloma Working Group, a consortium of nearly 200 myeloma experts from around the world. Dr. Durie also leads the IMF’s Black Swan Research Initiative®.


 

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