Safe Haven: Caring for victims of sexual assault during COVID-19
Written by: Nicki Watson, RN, BSN, SANE-A, emergency department, Mount Nittany Medical Center
One in 5 women and 1 in 38 men will have experienced attempted or completed rape at some point in their life, according to the Centers for Disease Control and Prevention.
Sadly, most attackers are someone known to the victim, such as a friend, current or former intimate partner, coworker, neighbor or family member. In fact, according to the Rape, Abuse & Incest National Network, 8 in 10 victims of sexual assault know their attacker.
People of all ages, gender, races, religions, incomes and ethnicities can experience sexual violence. And even through the COVID-19 pandemic, Mount Nittany Medical Center’s emergency department is caring for the needs of sexual assault patients.
Because of these staggering statistics, all registered nurses at Mount Nittany Medical Center are trained as sexual assault forensic examiner nurses. This helps to ensure that victims have a safe place to go if they’ve experienced assault. And while COVID-19 has delayed annual sexual assault training to newly hired emergency department nurses, current staff is able to fulfill sexual assault patients’ unique needs. Regardless of the time of day, a trained registered nurse is available to provide care for a victim of sexual assault.
In addition to SAFE nurses, Mount Nittany Health has several nurses who have received advanced training in pediatric sexual assault. This team works closely with Mount Nittany Health’s Children’s Advocacy Center.
The sexual assault nurse is part of the Sexual Assault Response Team. The nurse is one of three essential members of the team that includes law enforcement and Centre Safe.
Coronavirus has changed how health care is delivered in any setting. Despite the challenges of the past year, we continue to strive to provide the highest quality care to all patients. This is especially important when caring for victims of sexual assault. We are interacting with these patients during the most stressful and traumatic time in their lives. It is vital that we meet the physical and emotional needs of this vulnerable population, while taking all necessary precautions to prevent the spread of COVID-19.
In addition to making sure the individual is not experiencing any physical pain or injury, evidence of the assault can be collected if the attack happened within the last 96 hours, and prophylactics may also be given to prevent pregnancy, sexually transmitted infections and HIV.
When a patient arrives at the emergency department, staff perform all of the necessary COVID screening procedures and immediately isolate patients with COVID symptoms. One visitor is allowed with the patient for moral support, provided they have no COVID symptoms.
With COVID protocols in place, members of the SART team are also screened before entering the emergency department, masks are required and social distancing is implemented whenever possible. To decrease unnecessary risk of COVID exposure, Centre Safe has supplied the medical center with two new iPads. The iPads allow Centre Safe to offer education and emotional support to patients while still keeping themselves at a safe distance.
COVID has presented several challenges when providing care to our patients, and victims of sexual assault are not exempt from these. However, Mount Nittany Medical Center, law enforcement and Centre Safe are working together to meet these demands and continue to provide excellent care to victims of sexual assault.
Sexual assault is never the victim’s fault, and the caregivers at the Medical Center are most concerned with the patient’s safety and wellbeing.
If you or someone you know has experienced dating or domestic violence, sexual assault or stalking, help is available 24/7 for women, men and children. Call Centre Safe at 814-234-5050 or toll-free at 1-877-234-5050.
Nicki Watson, RN, BSN, SANE-A, is a registered nurse and sexual assault nurse examiner for adults and adolescents in the emergency department at Mount Nittany Medical Center.
What we know about the Johnson & Johnson COVID-19 vaccine
Written by Ashley Kader, PharmD, BCPS, manager, pharmacy, Mount Nittany Medical Center
Many of us are being vaccinated, or are already fully vaccinated, against COVID-19. By now, we’ve all heard the names of the three available vaccines: Pfizer, Moderna, and Johnson & Johnson (J&J). You may also have heard the J&J vaccine referred to as Janssen. Janssen is J&J’s pharmaceutical division, which developed this vaccine. J&J/Janssen is the newest vaccine to come onto the scene, and unlike Pfizer and Moderna, which require two doses, J&J/Janssen is the first authorized vaccine that requires only one dose to help prevent severe illness from COVID-19.
What about the efficacy of the J&J/Janssen vaccine? In an ongoing multi-country clinical trial, the vaccine has been shown to be 77 percent effective in preventing severe/critical COVID-19 illness at least 14 days after vaccination, and 85 percent effective in preventing severe/critical COVID-19 occurring at least 28 days after vaccination. More importantly, the vaccine efficacy for COVID-19-associated hospitalizations and death was shown to be 100 percent.
The J&J/Janssen vaccine has some significant advantages over the Moderna and Pfizer vaccines. It doesn’t require freezer temperatures for storage and can be stored for up to three months at normal refrigerator temperatures, so it's easier to distribute to more places. In addition, being fully vaccinated after one dose is a welcome convenience for those who don’t like needles or have concerns about returning for a second shot.
Although it can be tempting to compare the three vaccines to determine which one is “best,” it’s impossible to make an accurate comparison because the vaccines haven’t been tested head-to-head. What is most important is that all three vaccines are effective in preventing the most severe COVID-19 outcomes, including hospitalization and death.
It is interesting to note that the J&J/Janssen vaccine employs a different technology than the Pfizer and Moderna vaccines use. The latter two vaccines are made using messenger RNA, or mRNA, a technology that delivers a small piece of genetic code to cells—a sort of recipe for making the surface protein, or spike protein, that is unique to the virus that causes COVID-19. After the protein is made by our cells, it activates our immune system, teaching it to recognize the spike protein as foreign and to develop antibodies to fight it. Our immune system is then ready to protect us against future infection.
The J&J/Janssen vaccine, which is known as a viral vector vaccine, uses a different approach to instruct human cells to make the spike protein. It uses a naturally occurring human adenovirus, a virus that causes common colds, which has been engineered to be a delivery vehicle for the genetic material of the spike protein. The adenovirus is engineered in a way that makes it unable to replicate within humans. Once the adenovirus enters the human cell, the cell uses the genetic material to make spike proteins, which then trigger an immune response in the same way that the mRNA vaccines work.
It’s important to note that none of these vaccines contain the virus that causes COVID-19 and they cannot give you COVID-19.
Common side effects of the J&J/Janssen vaccine include injection site pain, headache, fatigue and muscle pain. These have been found to be more common in those 59 years and younger, compared to older recipients.
We now have three highly effective COVID-19 vaccines authorized by the FDA, and it’s important to get whichever one you can as soon as you’re eligible. The longer you go unvaccinated, the longer you're at risk of contracting a severe COVID-19 infection. The bottom line is that the J&J/Janssen vaccine is safe and effective, and its recent approval will help further increase the nationwide supply of vaccine. These vaccines provide us the hope we need to stop the COVID-19 pandemic
Back to (in-person) school anxiety
Written by Linda Kurtz, MD, FAAP, pediatrics, Mount Nittany Physician Group
A return to in-person learning during the COVID-19 pandemic can be an exciting time for kids as well as parents, although transition from learning at home to returning to the classroom can cause anxiety.
For some children, the excitement of going back to school after so many months at home will outweigh any anxiety about returning to in-person education. But many children who are heading back to the classroom might feel nervous about not only being separated from their families after months of togetherness, but also leaving the safety of home isolation during the pandemic.
When you think about the messages we’ve all heard and internalized over the past year—“don’t get too close to other people, avoid large groups, keep your mask on, wash or sanitize your hands”—it’s understandable that kids might have questions and fears. Are we sure it’s safe to go back? Are other people safe? These are realistic fears that even adults contemplate.
The following are a few tips parents can do to prepare their child emotionally for returning to school:
Validate kids’ feelings. If your child is telling you they’re worried or stressed about going back to school, validate their feelings. Give them the opportunity to express their feelings. Explain to them that any worry they have is important and that no worries are silly.
Set the tone. It’s important to stay calm and answer kids’ questions even if you’re struggling with your own anxieties about your children returning to school. If children have questions you can’t answer, you can say, “That’s a really good question. I’m not sure of the answer, but let’s try to find out.” Your pediatrician can be a good source for answering those questions. Reducing unknowns and working together to ask and answer questions can help kids (and you!) stay calm.
Help kids think positive. Help kids stay positive by encouraging them to talk about the good things about attending school in person: easier to pay attention, less boredom, and seeing their friends.
For younger kids worried about separation, it can be comforting to know what you will be doing while they’re away and that they will see you again later. You can say: “After you leave for school, I’m going to the grocery store. What do you think I will show you in the refrigerator later?”
Practice separating. Start small and gradually build tolerance for more and more independence. Your child could be playing in their room while you’re in the kitchen cooking dinner, or they could stay with another caregiver while you’re out running errands. Those types of small things help build tolerance for a bigger separation.
For younger kids, transitional objects can be helpful. A transitional object can be anything that helps your child feel connected to you when you’re apart—a button, a pebble or shell, or a handkerchief. A small piece “of home” your child can keep in their pocket or backpack can help them feel more secure.
Have a routine. Making sure that your child has a predictable routine leading up to school can reduce uncertainty and help kids, especially younger ones, feel less anxious. For example, “At drop-off, Daddy will give you a hug and a kiss, and then wave to you after you get out of the car.”
Emphasize safety measures. Reassure kids that they wouldn’t open the school unless they were going to be really careful. While we can’t promise our kids that we won’t get sick, we can express confidence that the schools have done everything they can to minimize risk and keep everyone safe.
Linda Kurtz, MD, F.A.A.P, is a provider with Mount Nittany Physician Group Pediatrics. Dr. Kurtz sees patients at the Mount Nittany Health – Boalsburg location.
The COVID-19 vaccine and mammograms: What you need to know
Written by Allison Yingling, MD, radiology, Mount Nittany Health Breast Care Center
As more and more people are able to get COVID-19 vaccinations, a concern has emerged that side effects from the vaccine could mimic a sign of breast cancer on a mammogram. Specifically, the vaccine that prevents COVID-19 can cause swollen lymph nodes under the arm where the shot was given.
Cause and effect
Lymph nodes are part of the body's germ-fighting immune system, and swelling in the lymph nodes after a COVID-19 vaccination is a sign that the body is doing what it’s supposed to do: responding to the vaccine and building up defenses against the virus.
Breast cancer also can cause swelling under the arm if cancer cells have spread to the lymph nodes. So having a mammogram soon after vaccination may produce a “false positive” and cause unnecessary worry about swollen lymph nodes.
For that reason, it’s important to consider the timing of a mammogram if you qualify for the COVID-19 vaccine.
Timing is everything
If possible, to avoid unnecessary worry, you should schedule any routine breast screening before getting the COVID-19 vaccine.
If you’ve already received the vaccine, consider scheduling your routine screening mammogram for at least four to six weeks after your second vaccine dose. This will reduce the chances that any swollen lymph nodes from the vaccine will be detected on your mammogram.
But if you recently received the vaccine and have a mammogram scheduled in the near future, you don’t necessarily need to reschedule. You can keep your mammogram appointment—just be sure to tell the mammogram technician about your vaccination, the date it occurred, and which arm was affected. This information will be helpful for understanding the mammogram images: If lymph node swelling is found, the radiologist who interprets your mammogram images will consider your recent vaccine when recommending whether additional imaging or follow-up is needed.
Don’t delay care
It’s important to differentiate between screening mammography and diagnostic mammography. Screening mammography is performed routinely to detect breast cancer in people with no apparent symptoms. Diagnostic mammograms are used after suspicious results are found on a screening mammogram or after you detect anything of concern. Diagnostic mammograms should never be delayed: If you find a suspicious lump or unusual changes in your breast, you should call your doctor and continue with a diagnostic mammogram, regardless of when you get your vaccination.
If you skipped your mammogram last year because of the pandemic, it’s more important than ever to make and keep that appointment. The bottom line is that the COVID-19 vaccine is vital to helping our community reduce the spread of this virus, and regular screening mammograms are the single most important way for detecting and treating breast cancer early. You can protect your health and wellbeing by paying attention to the timing of both of these important health measures.
Allison Yingling, MD, is a provider at the Mount Nittany Health Breast Care Center. Dr. Yingling received her medical degree from Jefferson Medical College in Philadelphia, Pennsylvania, completed her internship at the Reading Hospital and Medical Center in Reading, Pennsylvania, and completed her diagnostic radiology residency at George Washington University Medical Center in Washington, D.C. Dr. Yingling is fellowship trained in breast imaging and intervention from George Washington University Medical Center and is a member of the American College of Radiology.
Community pulls together to get people vaccinated
When statewide vaccine shipment delays threatened to hinder delivery of vaccines for local community members, area healthcare providers worked together to ensure that already scheduled second-dose appointments were not delayed.
More than 1,000 individuals were scheduled to receive second doses of Moderna and Pfizer vaccines during Centre Volunteers in Medicine’s (CVIM) mass vaccination clinic scheduled this past Saturday, February 27. With recent distribution delays from the Pennsylvania Department of Health (DOH), CVIM was in danger of having to postpone its second-dose appointments last weekend. This would have required the rescheduling of these appointments in order for community members to receive their second dose of vaccine within the allotted time period directed by the Centers for Disease Control and Prevention. Working closely with the DOH, Mount Nittany Health offered to temporarily divert its weekly vaccine allotment to CVIM in order to provide the organization with the needed doses to hold Saturday’s clinic.
“This is just another example of our long standing support of CVIM and its role in serving our community,” says Mount Nittany Health Executive Vice President of Patient Care Services and Chief Nursing Officer, Dr. Tiffany Cabibbo. “We worked with CVIM to get them the vaccines they needed while working with DOH to ensure our replacement vaccines were delivered quickly. We were able to swiftly adjust our planning to best care for our community, as we’ve done throughout the pandemic.”
"We are truly a community, and this step by Mount Nittany Health illustrates the best of that. Working together for the greater good is what gives the Centre region its neighborhood feel. It’s this kind of caring and compassion that will allow us to overcome the many devastating effects of COVID-19 and return to some sense of normal,” shares Senator Jake Corman.
Adds Margaret Gray, Centre County Government Administrator, “Serving the community is the hallmark of Mount Nittany Health and Centre County values the significant role they have played in not only delivering vaccines to our residents but in their exceptional efforts to work in partnership with other organizations. Assisting Centre Volunteers in Medicine with securing vaccine doses exemplifies this commitment and highlights the importance of working together in the best interest of the community at large.”
Mount Nittany Health transferred several hundred doses of Moderna vaccine to CVIM and arranged for a tray of the Pfizer vaccine – containing more than 1,000 doses – to be transferred to the organization so that its weekend clinic would not be impacted. The DOH then scheduled an order of replacement Pfizer doses to be delivered to the hospital on Monday.
“We at CVIM cannot thank Mount Nittany Health enough,” says Cheryl White, executive director, Centre Volunteers in Medicine. “Because of their willingness to work with us, we were able to keep 1,200 second dose appointments on Saturday. We look forward to continuing to partner with Mounty Nittany Health as we work to vaccinate the community. Their legacy of giving in this community really is paramount, especially when it comes to CVIM.”
The COVID vaccine, staying healthy, and emergent care during the pandemic
Written by Brian Newcomb, MD, department chair, Mount Nittany Medical Center Emergency Department
COVID-19 vaccine distribution roll outs bring with them a huge sense of relief that there is an end in sight to the current pandemic. However, we can’t let down our guard just yet. As we get vaccinated, it will take time for each of us to individually develop immunity to COVID, thus, it will take time for our community to develop herd immunity. I urge you to please get vaccinated as soon as you are able, and remember that it is equally important to continue to practice infection prevention measures such as social distancing, masking and frequent hand washing.
Studies suggest that once you have had the two vaccine shot series – either Pfizer or Moderna – the vaccine is about 95 percent effective at protecting you against COVID. This means that there is a slight possibility for you to get COVID during your vaccination series, and possibly even after you are fully vaccinated. Additionally, while the vaccine may protect you from manifesting the disease, it is still unknown whether it prevents you from spreading an asymptomatic infection to others. The bottom line is, everyone, regardless of whether they have had the vaccine, must continue to practice good infection control. Together, with the vaccine, this gives you the best tools for stopping the spread of the virus.
For the most up-to-date information on the COVID-19 vaccine, visit mountnittany.org/coronavirus.
Getting the care that you need
As we continue to navigate life with COVID-19, we understand that the need for urgent and emergency care doesn’t go away in the midst of the pandemic. If you have an emergent life threatening condition such as chest pain, difficulty breathing, weakness, or traumatic injuries, please call 9-1-1 or come see us in the Mount Nittany Medical Center’s emergency department. We are standing by, ready to treat all of your urgent and emergency healthcare needs. We continue to take extra measures to ensure the safety of patients, staff and providers, including masking, visitor limitations and enhanced cleaning measures.
In an effort to improve access and convenience as well as serve patients who may still be hesitant to come in for services, Mount Nittany Medical Center also offers 24/7 virtual ER visits, with no appointment needed. Virtual ER visits offer a safe, convenient option for common urgent care needs. Virtual ER visits are available to both new and existing patients of all ages for common acute conditions such as urinary tract infections, seasonal allergies, pink eye, upset stomach, rash/skin issues and other urgent care needs. Additionally, the emergency department can screen for COVID symptoms and, if the care provider recommends it, order an outpatient COVID test to be scheduled at your convenience through the Medical Center’s drive-through test collection site.
It’s important to understand that virtual visits are not recommended for life-threatening or disabling conditions. If you believe you or a loved one is having a medical emergency, please call 9-1-1 or seek care at your nearest hospital.
To start a virtual ER visit, go to mountnittany.org/virtualER, click the link for “Start Virtual ER Visit,” and follow the prompts. After discussing your concern, you and your provider will determine the appropriate treatment or next steps, which may include calling in a prescription to your pharmacy. If your case is too complex for an emergency telehealth visit and warrants a more detailed work-up and treatment, your provider may recommend that you come to the emergency department in person for further evaluation.
For less serious health concerns – for those who don’t prefer in-person visits at this time – we encourage you to try a telehealth visit health concerns. You can learn more at mountnittany.org/telehealth.
Whether your next visit is in person or online, please know that we look forward to serving you and keeping you and your loved ones safe and healthy.
COVID-19 and the flu: Similarities and differences
Written by Faoud Ishmael, MD, PhD, allergy & immunology, Mount Nittany Physician Group
As the COVID-19 outbreak continues to evolve, we are also in the midst of flu season. If you’re not feeling well, you might be wondering: Is this the flu, or is this COVID-19?
Both COVID-19 and the flu are contagious respiratory illnesses: They affect your lungs and breathing and can be spread to others. Although some symptoms of both diseases can look similar, they are caused by different viruses.
How are COVID-19 and influenza viruses similar?
Symptoms of both COVID-19 and the flu can range from mild to severe, and overlapping symptoms include fever, cough, runny or stuffy nose, headache, fatigue, and muscle/body aches. Both can also cause gastrointestinal symptoms like abdominal pain, nausea, vomiting and diarrhea.
Both viruses can be transmitted through personal contact, droplets, and surfaces. So the safety measures we’ve been practicing—such as hand washing or sanitizing, wearing a mask, physically distancing, and covering coughs and sneezes—are important actions we can all take to prevent infection.
How are COVID-19 and influenza viruses different?
The COVID-19 illness is characterized by fever, cough, and shortness of breath. Less common symptoms include aches, nasal congestion, and sore throat. Some early symptoms of COVID-19 may also include the loss of taste and/or smell, nausea, and diarrhea. Common flu symptoms include fever, aches, fatigue, cough and headache.
Flu onset can also happen quickly, with individuals typically experiencing symptoms one to four days after exposure to the virus. With COVID-19, symptoms appear an average of five to six days after exposure.
Those most at risk for severe influenza infection are children, pregnant women, elderly people, those with underlying chronic medical conditions, and those who are immunosuppressed. For COVID-19, the current understanding is that older age and underlying conditions increase the risk for severe infection.
Is it possible to have COVID-19 and the flu at the same time?
Because the flu and COVID-19 are caused by different viruses, it is possible to have both illnesses — as well as other respiratory infections — at the same time. Both can result in serious illness, hospitalizations, and even death, and having both at once could increase the chance of more serious outcomes, including pneumonia and respiratory failure. As well, experts believe there’s a good chance that getting infected with one can make you more vulnerable to getting the other—once you get sick, your body and immune system are weakened. That’s why it’s more important than ever to practice safety measures to protect yourself from infection.
If you develop symptoms that could be related to either the flu or COVID-19, you should call your doctor and isolate yourself from others until COVID-19 is ruled out. If you are unable to see your doctor, then it’s important to stay at home and isolate yourself for at least ten days and until your symptoms resolve.
Because vaccines offer the most effective protection against both the flu and COVID-19, it’s highly recommended that everyone (over six months of age) get a flu shot annually. Currently, the Pfizer BioNTech COVID-19 vaccine is authorized for those ages 16 and up, and the Moderna COVID-19 vaccine for those ages 18 and up. Most everyone is encouraged to receive the COVID vaccine as soon as they are eligible according to the Pennsylvania Department of Health’s distribution guidelines. Please consult your doctor if you have questions.
Faoud Ishmael, MD, PhD, is a board certified allergy and immunology physician with Mount Nittany Physician Group Allergy & Immunology, and offers particular expertise in allergy management and testing, including testing for allergies related to foods and medicines.
The science behind the masking
Written by By Philip Miller, DO, family medicine, Mount Nittany Physician Group
As the COVID-19 pandemic continues, even in the midst of vaccines beginning to roll out, it’s important that we all continue the safety measures we’ve been practicing. One of the most important of those safety measures is wearing a face mask.
COVID-19 spreads mainly from person to person through respiratory droplets that travel into the air when you cough, sneeze, talk, shout or sing. These droplets can then land in the mouths or noses of people who are near you or they may breathe these droplets in.
Masks are a simple barrier to help prevent your respiratory droplets from reaching others. Studies show that masks reduce the spray of droplets when worn over the nose and mouth. Masks also can prevent larger expelled droplets from evaporating into smaller droplets that can travel farther.
Early on when the Centers for Disease Control (CDC) recommended that everyone wear masks to slow the spread of COVID-19, a helpful phrase to remember was “My mask protects you, your mask protects me.” Evidence continues to show that masks help prevent the spread of COVID-19.
You should wear a mask even if you don’t feel sick. This is because studies have found that people with COVID-19 who never develop symptoms and those who are not yet showing symptoms can still spread the virus to other people. Wearing a mask helps protect those around you in case you are infected but not showing symptoms.
Because COVID-19 spreads mainly among people who are in close contact with each other, it’s especially important to wear a mask when you’re indoors with people you don’t live with and when you can’t stay at least six feet apart. And you should always wear a mask when caring for someone who is sick with COVID-19.
Choosing a mask
Although the purpose of wearing a cloth mask is mainly to protect others, it also protects you to some extent. How well it protects you from breathing in the virus depends on how tightly woven the fabric is, the number of layers of fabric, and how well the mask fits.
What kind of mask should you wear? The best mask is one you can wear comfortably and consistently. Fabric masks should be made of three layers of fabric: an inner layer of absorbent material such as cotton, a middle layer of non-woven non-absorbent material such as polypropylene, and an outer layer of non-absorbent material, such as polyester blend.
When choosing a mask, check for filtration, breathability and fit. Your mask should fit over your mouth and nose comfortably, and you shouldn’t have to be constantly adjusting it. Find a mask that fits closely over your nose, cheeks and chin. When the mask’s edges are too loose and they shift, air can penetrate through the edges. Masks with vents or exhalation valves aren’t recommended because they allow unfiltered breath the escape the mask. Surgical masks are generally more protective than cloth masks, and some people find them lighter and more comfortable to wear.
Earlier this month, the CDC released new research that found wearing a cloth mask over a surgical mask offers more protection against the coronavirus, as does tying knots on the ear loops of surgical masks. The findings prompted updated guidance on how to improve mask fit as concerns over a number of new variants of the virus are emerging. For optimal protection, the CDC recommends making sure the mask fits snugly against your face and to choose a mask with at least two layers.
A current guide to masks, including how to select, how to wear and how to clean is available at cdc.gov.
No matter which mask you choose, the bottom line is that any mask that covers the nose and mouth will reduce the spread of the coronavirus. And remember, while wearing a mask, you should still keep physical distance from others.
Philip Miller, DO, is a provider with Mount Nittany Physician Group Family Medicine at its Green Tech Drive location.
How the COVID-19 vaccination works and who gets it when
Christopher Hester, MD, internal medicine and clinical director, primary care services, Mount Nittany Physician Group
Editor’s note: The COVID-19 pandemic is an evolving situation. The information below was up to date at the time of publication on February 1, 20201.
Now, more than ever, we need our community to come together to stop the spread of COVID-19. COVID-19 vaccines will help slow and prevent the spread of the virus to help keep our community safe. There’s a lot of information out there about the vaccines, their effectiveness and when they will be available for the general public.
Currently, there are two vaccines authorized and recommended to prevent COVID-19, which are Pfizer-BioNTech and Moderna. Large-scale clinical trials for additional COVID-19 vaccines are also in progress.
How the COVID-19 vaccine works
Vaccines are key to preventing diseases and saving lives. Vaccines strengthen the immune system by inducing our bodies to build cells that will remember how to fight an infection. The COVID-19 vaccines can help prevent you from getting COVID-19, or if you do get the virus, can help prevent you from getting seriously ill or developing severe complications. The Pfizer-BioNTech COVID-19 vaccine and the Moderna COVID-19 vaccine require two shots in order for the vaccines to work and be most effective. The second dose is given three to four weeks after the first dose, depending on the vaccine. Both vaccines are estimated to have a 95 percent effectiveness rate after two doses. It takes time for your body to build up protection after a vaccination, so it may take a couple of weeks after receiving the second shot before your body builds up protection against the virus.
Keep in mind, the COVID-19 vaccines are a tool to help us fight off the virus, but they are not a cure. Experts will continue to learn more about the protection that the vaccines provide. To protect yourself, your loved ones and our community, it is crucial that we continue to follow the Centers for Disease Control and Prevention guidelines and everyday precautions, including wearing masks in public, maintaining social distancing of at least six feet, cleaning frequently touched surfaces and objects, staying home if you are sick and performing hand hygiene frequently. Getting vaccinated and following the CDC’s recommendations will offer the best protection from COVID-19.
COVID-19 vaccine distribution
Due to current limited vaccine supply levels, not everyone can be vaccinated right away. The Pennsylvania Department of Health has a three-phase approach to distribute COVID-19 vaccines based on CDC guidelines. Phase one focuses on reaching critical populations including health care personnel, emergency medical services, residents and staff in congregate settings and other essential workers. Once a large number of doses are available, we can move to phase two, which will expand to include vulnerable populations and those who may be at high risk. Once there are sufficient supplies, phase three will expand to the general public.
Over the next several months, the COVID-19 vaccine supply levels are projected to increase, which will allow vaccinations to be expanded to ensure the entire population has access to them.
To stop this pandemic, it is important that we continue to work together and use the resources we have available to prevent the spread of COVID-19.
For the most up-to-date information on Mount Nittany Health’s approach to COVID-19, including the latest COVID-19 vaccine news, visit mountnittany.org/coronavirus.
Your COVID-19 vaccine questions answered
Written by Faoud Ishmael, MD, PhD, allergy & immunology, Mount Nittany Physician Group
Editor’s note: COVID-19 vaccination information is rapidly changing. The information contained within this article is current as of (date sent to press).
As Pennsylvania continues to roll out plans for distribution of both the Pfizer BioNTech and Moderna COVID-19 vaccines, many questions remain regarding the vaccines themselves, as well as, availability within our local communities. Below is a list of questions and answers to some of the most common inquires that I receive as a physician with Mount Nittany Physician Group that I hope will help to arm readers with the information they need.
Q: Why should I get the COVID-19 Vaccine?
A: The COVID-19 vaccines are tremendous scientific achievements and are the best way for us to return to normal life. However, many people are nervous about getting the new vaccine. These vaccines are both safe and effective, as I’ll outline below.
Q: What is RNA and how does the vaccine work?
A: RNA is a type of nucleic acid that SARS-CoV-2 uses to carry its genetic information. It is a blueprint to produce proteins that form the virus particle. Both of the FDA-approved COVID-19 vaccines contain a small piece of SARS-CoV-2 RNA encased in a lipid particle. When injected into the body, these particles are taken up by immune cells, the viral spike protein is produced, and our immune system produces antibodies and other immune cells that specifically recognize it. This process mirrors exactly what happens when the virus infects our body, but the vaccine cannot cause infection as it does not contain the actual virus. A second booster vaccine makes the immune response even stronger. If we are exposed to the virus, our immune system now has all the tools needed to rapidly clear it.
Q: What is herd immunity and how does it relate to the vaccine?
A: Herd immunity refers to how many people in the population need to be immune to the virus to prevent it from being spread. The more contagious the virus, the more people need to have immunity to prevent transmission. For COVID-19, 50 to 70 percent of the population needs to have immunity to achieve herd immunity. This number may change as we learn more about the virus, and it may be higher if more contagious strains emerge, such as the U.K. variant, now beginning to appear throughout the United States.
Some people have proposed letting COVID-19 run its course to achieve herd immunity, but this could result in more than two million deaths in the U.S. The only safe and effective way to achieve herd immunity is through vaccination, and we need to vaccinate the majority of the population to be successful.
Q: It seems like these vaccines were rushed to be developed. How do I know that they are really safe?
A: Many people are concerned about vaccines in general, as there are misconceptions that these are not safe because they are artificial, lab-made constructs. Because this vaccine mimics exactly what the virus does in our body, but in a way that infection is not possible, this is actually the most natural way to produce immunity. The vaccines were built on technology that has been used by scientists for over a decade, and were able to be developed because there was an unprecedented amount of global research devoted to this virus.
We have data from well-conducted, large studies (with more than 70,000 total participants) as well as vaccinations from millions that have already received this vaccine worldwide. As almost all adverse vaccine reactions occur within a few days to eight weeks of injection, we have enough data to prove that the vaccine is safe.
Q: What are the side effects?
A: The most common side effect is a sore arm for 24 to 48 hours. Some people can develop a fever, swollen lymph nodes, generalized muscle pain or fatigue. These side effects are generally mild and not unexpected. They indicate that our immune system is activated.
Q: I have a history of food or drug allergy. Should I be worried about an allergic reaction to the vaccines?
A: The risk of allergic reaction is very low. Twenty one allergic reactions have occurred in the first 1.85 million vaccine doses (about one in 100,000 injections). In general, patients with a history of previous allergic reactions to foods or medications may safely receive the vaccine, but would need to be observed for 30 minutes after administration. The suspected allergen is polyethylene glycol, a common ingredient in many different medications, household products, and some laxatives. Patients with an allergy to polyethylene glycol can be evaluated and tested in our allergy clinic.
Q: I am healthy and have a low risk of severe COVID-19. Why should I be vaccinated?
A: COVID-19 is unpredictable and can be severe in any age group. Even if you get a mild infection, you will infect other people. The vaccine protects not only you, but your family, people with immune deficiencies or cancer and others who may not be able to mount a response to the vaccine. We all want to go back to pre-pandemic life, but things cannot go back to normal if only some people choose to be vaccinated. Everyone needs to do their part to not only be vaccinated, but to encourage their family and friends to do the same.
Q: When will the vaccines be available to the general public in Centre County?
A: As most people know, COVID-19 vaccines are being distributed to Pennsylvanians in a phased approach. Centre County is currently in the first of those phases, Phase 1A. It’s important to understand that the Pennsylvania Department of Health (DOH), as the state's public health agency, is the lead in terms of moving from one vaccination phase to the next. As information is finalized on additional vaccine allotments and the status of the DOH phased rollout process, Mount Nittany Health will keep the communities we serve informed.
DOH will continue to provide updates on where vaccines are being distributed across the commonwealth on health.pa.gov, and Mount Nittany Health share this information as it becomes available at mountnittany.org/coronavirus.
Mount Nittany Health also encourages patients to sign up for its Patient Portal at mymountnittanyhealth.com, an online tool where they can communicate with their provider about the COVID-19 vaccine.
Faoud Ishmael, MD, PhD, is a board certified allergy and immunology physician with Mount Nittany Physician Group Allergy & Immunology, and offers particular expertise in allergy management and testing, including testing for allergies related to foods and medicines.
Grocery list: How best to shop and what to have on hand during the COVID-19 pandemic
Written by Cara Dellegrotti, DO, family medicine, Mount Nittany Physician Group
During the COVID-19 pandemic, grocery shopping looks different. Many of us are trying to minimize trips to the grocery store, or using curbside pickup or delivery, to avoid possible exposure to the coronavirus.
When you do venture out to the market, there are actions you can take to be safe. Be sure to follow these safety measures before, during and after grocery shopping:
Clean your hands with sanitizer before entering the store.
Cover a cough or sneeze in your bent elbow or tissue.
Maintain at least a six-foot distance from others.
Wear a mask.
Once home, wash your hands thoroughly and also after handling and storing your purchased products.
It’s important to remember that there have been no confirmed cases of COVID-19 transmitted through food or food packaging. Fresh fruits and vegetables are part of a healthy diet and should definitely be on your grocery list! Wash fruits and vegetables thoroughly with clean water.
One way to minimize shopping trips, and to be prepared in case of quarantine, is to do a big stock-up trip to the supermarket. It’s a good idea to have enough nutritious foods and other essentials on hand to last for two weeks. Then, in case you need to self-quarantine or self-isolate, you’ll have the nutritious foods and other items you need at home.
How to stock a healthy pantry
When grocery shopping, focus on foods with a long shelf life. Of course, you’ll have to shop more frequently for things like fresh fruits and vegetables, milk and eggs, but having a good supply of staples on hand—including canned and frozen foods—will go a long way!
Any time you’re shopping for canned, frozen, or other processed foods, keep in mind to select low-sodium and no-added-sugar varieties.
Here are the basics you should have on hand:
Cheese (hard cheeses like cheddar and pecorino can last for a month)
Bread (bagels, rolls, tortillas, etc.)
Hot cereals (oatmeal or grits)
Cooking oils, such as canola and olive oil
Lean meat, fish, and chicken (stock up the freezer)
Canned or boxed broth
Canned tomatoes or tomato sauce
Canned fruits and vegetables
Frozen fruits and vegetables
Granola bars and protein bars
Frozen pizza or pizza crust
Baby food and formula
And don’t forget our furry friends! If you have pets, stock up on their food staples and other needs.
The medicine cabinet
If you must self-quarantine or self-isolate, make sure you have enough of any prescribed medications to last two weeks.
In addition to prescription medicines, pick up the following items (if you're running low) while you're in the pharmacy section of your grocery store:
Pain relievers – ibuprofen or acetaminophen
Children’s fever reducer (if there are kids under 12 in the family)
Cold and allergy medicines
Please keep in mind that the best defense is to continue recommended safety practices: hand washing or sanitizing, wearing masks, physical distancing, covering coughs and sneezes, and staying home when sick.
Being vaccinated against COVID-19 is also an important tool to help mitigate the spread of the virus. Mount Nittany Health is working closely with the Department of Health and has ordered additional quantities of the COVID-19 vaccine to expand our vaccination program to the recently added groups – anyone over the age of 65 as well as those between the age of 16 and 64 who have certain high risk conditions.
As soon as additional information on the health system’s vaccine supply for these groups is received from the Department of Health, updates will be posted online at mountnittany.org/coronavirus. If you are in this group, then please check our website regularly for more information, including a self-scheduling option.
Cara Ricotta, DO, is a family medicine provider with Mount Nittany Physician Group.
Community donations support Mount Nittany Health's COVID-19 response
"We cannot express our gratitude enough for the compassion and generosity of our community," shares Simon Corby, executive director, Mount Nittany Health Foundation. The COVID-19 response fund, to date, has raised $176,361.40, and Mount Nittany Health is putting these generous gifts to work.
In particular, the fund supported the conversion of two units at the Medical Center into dedicated COVID-19 units to expand our capacity to care for COVID-19 positive inpatients. This includes creating:
A temporary anteroom for each unit dedicated for staff to put on and remove personal protective gear
Sealing all doors into the unit, including elevator entrances
Creating a negative airflow environment
Continuous airflow monitoring
These converted units serve forty-five patients and augment our permanent isolation rooms. Creating these dedicated COVID-19 units offers an additional effective infection control measure to meet the demand for COVID-19 positive inpatients.
The fund also supported the cost of construction for dedicated COVID-19 test collection sites at the following Mount Nittany Health facilities:
Blue Course Drive
Mount Nittany Medical Center
These test collection sites allow staff to conduct the nasal swabs necessary to test for COVID-19 without the individual ever leaving their car. This limits COVID-19 exposure for both staff and the person being tested. These drive-thru testing sites are the national standard for testing excellence as recommended by the Centers for Disease Control and Prevention.
"I'm particularly proud of our lab technicians, phlebotomy and support staff, who made these test collection sites a reality. We've conducted over 16,000 tests for asymptomatic patients alone," shares Kristin Klinefelter, manager, laboratory services, Mount Nittany Medical Center. "The laboratory team worked tirelessly to expand testing to ensure the fastest test results possible. When we first started testing, we had three laboratory options, and now we have nine, including in-house testing. This allows the staff the flexibility to determine the best and quickest option to receive COVID-19 test results," states Klinefelter.
The COVID-19 response fund was established to support the evolving needs of Mount Nittany Health during this pandemic. Mount Nittany Health continues to adapt and take enhanced measures to provide the care this community deserves, which is why the fund remains open. To learn more about the fund or make a gift, visit foundation.mountnittany.org.
Flu season amidst the COVID-19 pandemic
Written by Carrie Hanley, PhD, MPH, CIC, manager, infection prevention & control, Mount Nittany Health
As we continue to battle the COVID-19 pandemic, the onset of flu season makes it more important than ever to help contain the spread of both diseases. So far, the United States has been experiencing a milder flu season this year—a possible benefit of efforts we’re taking to prevent the spread of COVID-19. But even so, the flu is making its rounds.
COVID-19 vs. Influenza. What’s the difference?
Influenza (the flu) and COVID-19 are both contagious respiratory illnesses: They affect your lungs and breathing and can be spread to others. Although the symptoms of COVID-19 and the flu can look similar, the two illnesses are caused by different viruses.
Symptoms of COVID-19 and the flu can range from mild to severe, and overlapping symptoms including fever, cough, runny or stuffy nose, headache, fatigue and muscle/body aches.
But there are differences. Some early symptoms of COVID-19 may also include the loss of taste and/or smell, nausea and diarrhea, which are less associated with the flu. Flu onset can also happen quickly, with individuals typically experiencing symptoms one to four days after exposure to the virus. With COVID-19, symptoms appear an average of five days after exposure.
It’s also important to remember that because COVID-19 is such a new virus, we don’t yet fully understand the potential for long-term respiratory, and even heart damage once the virus itself has cleared.
Can you get both?
It is possible to have both illnesses — and other respiratory infections — at the same time. If you develop the symptoms that could be related to either the flu or COVID-19, you should call your doctor and isolate yourself from others until COVID-19 is ruled out. If you are unable to see your doctor, then it’s important to stay at home and isolate yourself for at least 10 days and until your symptoms resolve.
The importance of vaccines
Every year a flu vaccine is available starting in October. The flu shot is safe for almost everyone, including pregnant women, children over six months of age, older adults and people with underlying medical conditions. It’s especially important for vulnerable individuals to get flu vaccinations because it will decrease their risk of developing a severe case of the flu. If enough people get vaccinated, it can help prevent the spread of the flu in the community and alleviate the burden of an already overburdened healthcare system. If you haven’t already received the flu vaccine, it is not too late.
The good news is that a vaccine has also been developed against COVID-19. As it continues to roll out and become available to various populations, it will be important to be vaccinated against both the influenza and COVID-19 viruses.
And although we’ve been hearing it for many months, it remains critical to double down on the safety measures that can prevent the spread of both COVID-19 and the flu: hand washing or sanitizing, wearing masks, physical distancing, covering coughs and sneezes, and staying home when sick. The choices we make affect not only our own health but the health of others.
Carrie Hanley, PhD, MPH, CIC, is the manager of infection prevention & control for Mount Nittany Health.
Dealing with COVID fatigue
Written by Candace Good, MD, behavioral health, Mount Nittany Medical Center
For most of 2020, we’ve all been dealing with stress caused by the COVID-19 pandemic. We are tired of staying home, tired of wearing masks, tired of news of more cases and more deaths. This ongoing stress has led to a widespread emotional exhaustion that has been called “COVID fatigue." COVID fatigue is real, but it’s important to continue to follow health guidelines.
As we enter into the coldest months of the year and another surge in COVID-19 cases, we can’t afford to let our guard down and become careless about taking precautions: washing hands, wearing masks and maintaining physical distance.
One helpful way to fight COVID fatigue is to practice coping skills. Here are some tips for staying mentally and physically healthy as we wait out the pandemic:
Practice constructive thinking: When we can’t change the situation, we can adjust our thinking. Be compassionate with yourself and others. Remind yourself, “I’m doing the best I can.” Focus on controlling what you can control and what you can do to protect yourself and your family.
Exercise: Exercise is one of the best ways to release the energy that builds up from stress and worry. Take a walk through the park or your neighborhood. Do floor exercises to a YouTube video. Play with your kids outside. Even taking longer routes through stores or parking farther from your destination makes a difference.
Practice mindfulness: Mindfulness is cultivating an awareness of the present moment. It can be as simple as stopping and focusing on the task at hand, or on the natural world around you, or on your own breathing. Redirecting your focus to the now helps dispel anxiety about the future. Rather than projecting into the future or ruminating about the past, for now, just take life day by day.
Express yourself: By sharing how we’re feeling—whether through talking with a trusted friend, writing in a journal, or playing a musical instrument—we release the worry and stress that we’ve been holding in before it builds up to a traumatic level.
Watch what you’re watching: Although staying informed is important, inundating yourself with information can add to COVID fatigue. Consider limiting yourself to a few trustworthy news sources, as well as limiting the time you spend each day listening to news. Be especially mindful of social media, and don’t get caught up in arguing online.
Stay physically distant, not socially distant: The term “social distancing” is unfortunate because we need to stay connected socially, but distance physically. Use technology to stay in touch with friends and family. Even though it may not be a substitute for the real thing, it’s more important than ever that we stay socially connected.
Finally, it helps to remember that we have the ability to get back to all those things we’re missing—going out, visiting family and friends, eating in restaurants, and traveling—by following the health guidelines that will lead to the eventual end of the pandemic.
More than 700 Mount Nittany Health employees and medical staff sign letter to the community
As COVID-19 cases increase significantly in our community, Mount Nittany Health is taking actions to urge community members to practice behaviors, like wearing a mask and physical distancing, to help prevent COVID-19. To underscore the need for collective action, more than 700 Mount Nittany Health providers and staff signed an open letter to the community imploring them to stop the spread of COVID-19 by wearing a mask. Nurses, doctors, and employees from all departments across the system signed their names to the message. The health system shared the letter to the community through social media and publishing it in the Centre Daily Times on Sunday, December 20.
Just last week, Mount Nittany Health reached an all-time high of 53 COVID-19 inpatients ages 19 to 53. In response, the Medical Center moved to the next phase of its pandemic response plan. Due to the sustained high COVID-19 inpatients, at least half of planned elective surgeries and some other procedures will be rescheduled through January 11. Further reductions will be made if needed.
The dedicated and compassionate team at Mount Nittany Health is asking the community to rally together to wear a mask, avoid gatherings, wash hands often, and maintain social distancing. These small actions make a difference in stopping the spread of COVID-19.
Click here to view the open letter to the community.
Mount Nittany Health moves to next phase of its pandemic response plan
With the continuing high numbers of COVID cases in the community and in the hospital, Mount Nittany Health announced today that it is moving forward with additional surge planning measures as part of its pandemic response plan.
With the recent rise in COVID hospitalizations, health system clinical leaders have been managing the number of elective surgeries that require overnight stays on a day-to-day basis. Given the sustained high volume of hospitalizations, approximately half of these surgeries and some other procedures will be rescheduled through January 11, 2021. Daily monitoring will continue, with any further reductions made as needed. Depending on future trends, other services may also be adjusted as the health system balances care for COVID hospitalized patients and those needing other care.
“Health systems around the region and around the country are challenged by the increasing number of COVID-positive admissions,” said Nirmal Joshi, MD, chief medical officer, Mount Nittany Health. “This surge is affecting everyone’s ability – including ours – to provide care to their communities. Until vaccines are widely available to the community, which will take some time, we urge the public to abide by advice they’ve been hearing about mitigation: wear masks, wash their hands, avoid gatherings, social distance and stay at home as much as possible.”
“We also want to recognize our outstanding staff that is showing tremendous commitment and flexibility under very challenging circumstances. We are doing everything possible to manage our operations in a way that serves the community and provides as much support as possible for our frontline workers.”
There are currently 53 COVID positive in patients at Mount Nittany Medical Center, ages 19 to 95.
Life in a COVID unit
Written by Amber Shaw, BSN, CCRN, manager, critical care services, Mount Nittany Medical Center
When I see people out in the community not wearing masks, I wish they could see the COVID unit at Mount Nittany Medical Center. When I see pictures of a large group gathering or hear about someone going to a big indoor party, I wish they could see our COVID unit. I wish everyone who thinks COVID isn’t real or isn’t dangerous could spend a day in the shoes of one of our nurses.
In the spring, we were all waiting and preparing for a crisis that didn’t materialize as forecasts had predicted. This is different. Now, the crisis is here.
Picture this image: Nurses and others tending to COVID patients, all of whom are sick enough to require hospitalization, wearing full protective gear. Anyone who leaves the unit for a break or a meal has to take it all off and put it all back on again when they return. It’s exhausting. It’s stressful. It’s hard.
Many of our patients have trouble breathing. Most will recover, but some will not. Some will go home but continue to feel the effects for a long time afterwards. Some will be lost. And they will go through this without their loved ones near – seeing them only through video calls whenever that’s possible. We try to comfort them, to talk to them about their lives and their families, to hold their hands.
Despite all the precautions we take, members of our staff are susceptible to COVID as well. Staff members and their families worry about getting sick.
And when we go into work every day, we know it’s possible that CDC guidelines will have changed to address new information we’ve learned, and that we’re all going to have to adapt to new protocols that weren’t in place the day before.
When we go home, exhausted, our kids still need our help with schoolwork, someone still needs to make dinner and, of course, the bills still need to be paid. And we look at our families and hope we haven’t brought the virus home to them.
For anyone who thinks this isn’t real, let me assure you: this is as real as it gets. It’s relentless. Our health system has a plan, we are implementing it, we are doing our best to support each other just as we support our patients every day. We are determined to persevere, to be as relentless as the virus and to stick with this until we defeat it.
But no one should underestimate the toll it is taking.
Please, please, please help us. The holidays are around the corner and the number of COVID cases in our community is expected to remain high. Believe me, we want to be celebrating with our friends and relatives as much as you do, but some of our friends and relatives may not be here next year unless we reduce the spread of COVID.
So please take measures recommended by health officials. It’s simple.
Social distance. Avoid large gatherings. Stay at home as much as possible. Wash your hands. And please, wear a mask.