You are trying to tie your shoelaces quickly and it's not working out for you; slow down, and it's a perfect tie. Have you ever been late to something important and get pulled over for speeding? Being in a hurry can slow you down. You may have heard this saying from the Navy SEAL ethos: slow is smooth and smooth is fast. SEALs train with this philosophy. That’s how movements and behaviors become muscle memory – something imperative in high-speed combat situations.

For important decisions, take your time to get the facts, check the facts, and move in a determined and smooth manner in all you do; this is the fastest way to get a good outcome. This idea may have evolved from a famous quote by Napoleon: "Dress me slowly that I am in a hurry." The concept is that sometimes, the best way to go fast is to do things slowly, but very well. Wyatt Earp knew this: "Fast is fine, but accuracy is everything." You need to take your time in a hurry.

And so it is, as we look at all we have learned and continue to discover about COVID-19.

Fall Update:

COVID Uptick

When kids go back to school, just like the past 2 years, we see an uptick in cases. There are currently multiple strains. XBB.1.5, an Omicron subvariant, was the predominant strain in June and July, and this strain is the target of the booster shots formulated for the fall. However, new variants, EG.5, "Eris" and BA.2.86, "Pirola", have emerged. It is thought, but not certain, that this new booster will have some activity against these. As I have said before, we are going after a moving target.

Process this: COVID-19 is a contagious, generally mild, illness for otherwise healthy people. If you have had COVID, and over 80% of the population has, either knowingly or unknowingly, this is your best immunity. And if you have been previously vaccinated with the primary series plus one booster, the benefit of taking the Fall booster is marginal, at best.

Fall Boosters

There is a meeting scheduled for tomorrow, September 12, of the Advisory Committee to CDC (ACIP); let's see what they say. There will be 2 mRNA vaccines: Moderna and Pfizer. I favor neither; their safety profile and efficacy track record can only be justified for high-risk people.

Remember, these vaccines give you messenger RNA that enters into many body cells and tells the ribosomes within the cells to make an identical protein to the spike on the virus. Once made, the protein presents to the immune system and you then make an antibody and T-cell response. The mRNA instructions in most people are short (one transcription), but in some people, the spike production continues, and with it, some people accumulate the spike protein, which has broad-ranging inflammatory effects on the body.

The protein sub-unit vaccine made by Novavax is my choice if you take a booster, which again, may not be needed if you are otherwise healthy and particularly if you have been vaccinated and had COVID. This is a safer, tried and true vaccine, which contains the protein spike antigen and an adjuvant; this stimulates your body to rapidly respond to the antigen. It is safer and the protein has a known decay rate. In other words, it will stimulate your immune system so your defenses are up but will degrade naturally over a short period of time.

By the way, Paul Offit, MD, a respect vaccinologist who I interviewed on my Columbia Association podcast last fall, Finding Your Wellness (click here), is NOT getting a booster (click here), nor am I.

Although I am not a pediatrician, common sense tells me that healthy children should not be vaccinated. The vaccine risks, such as myocarditis, are higher than the mortality from the illness.

Flu Vaccine

Yes, get your flu vaccine after September 15 and no later than November 15. It's available everywhere and most insurance will cover it.

I don't want to overwhelm you with too much information, so stay tuned for more comments and information on Paxlovid, masking, and the new RSV vaccination.

Walk with a Doc

This Saturday, September 16, from 9:00am - 10:00am, my friend and colleague, Dr. Joe Layug, will lead the Walk with a Doc. It meets at the People Tree (near the former entrance to Clyde's Restaurant and the Fountain). It's a fun activity at the Lakefront in Columbia sponsored by the Columbia Association.

Walk with a Doc is a worldwide walking program for anyone interested in taking steps for a healthier lifestyle. We take a few minutes to learn about a current health topic, then take a walk around beautiful Lake Kittamaqundi. It's a great way to get out, get active and enjoy all the benefits of walking. There is additional time for conversations and questions while we walk.

So consider coming this Saturday at 9am as a great way to start the day. We plan to do this walk on the 3rd Saturday of every month from September through June.

On a musical note: Smooth, by the legendary Santana:

On a somber note:

On this, the 22nd anniversary of 9/11, "let us remember the heroes who stepped forward - the patriots, but we also remember the unity that rippled through our nation following that tragedy. Instead of focusing on the division, the differing opinions, the opposing beliefs, we hope you will also remember the potential we have when we support each other and come together as one nation, under God, with liberty and justice for all." - author unknown.

As a reminder, I'm no longer sending out daily updates and instead, I'm updating you periodically. I continue to enjoy writing these updates. Initially, these were only sent to my patients, however, I've been humbled to learn that, through social media, these writings have been forwarded and re-forwarded to many. This has brought me great joy to know that this simple act of sharing facts, thoughts, opinions, and hopes has touched you in some way. Hopefully I've been able to reassure you, maybe make you smile and laugh, soothe your worries, and comfort you. And maybe, just maybe, I've helped you to be in the moment!

Reach out and stay connected. Be well. Feel free to forward this on.

HAO 24/7

Reach out. Stay connected. Stay home. Save lives. The power of one. Be well.

Feel free to forward this on: spread the word, not the virus.

HAO

24/7

Harry Oken, M.D.

Adjunct Professor of Medicine

University of Maryland, School of Medicine

Office 410-910-7500

Fax   410-910-2310 

Cell   443-324-0823