In Episode 25 of Dr. Dave On Call, we discuss the neurological effects of COVID-19 with Neurocritical care specialist, Dr. Eric Liotta of Northwestern Medicine.

Many individuals who have experienced COVID-19 have encountered neurological symptoms. For example, loss of taste and smell have been pathognomonic for the disease. However, many patients have experienced other neurological symptoms such as stroke, malaise, numbness, "brain fog", weakness, etc.

We have received much feedback from our listeners regarding their neurological symptoms and thought it would be best to discuss these symptoms with a Neurological specialist, Dr. Eric Liotta. Dr. Liotta is Assistant Professor of Neurocritical Care and Surgery at Northwestern Medicine, Feinberg School of Medicine. He has been on the front lines of the COVID-19 pandemic, treating severely ill patients in the Neurocritical ICU. Further, he has had the opportunity to follow both severely and mildly ill patients in his clinic throughout the pandemic and has valuable insight into the neurological sequelae of COVID-19. We are honored to speak with him.

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In Episode 24 of Dr. Dave On Call, we discuss sleep and COVID-19 with sleep specialist, Dr. Beth Malow, Director of the Vanderbilt University Sleep Division.

Many individuals suffer from sleep disturbances. Sleep is critical to physical health, our immune system and a key promotor for our emotional and mental health. Adequate sleep can help combat stress, depression and anxiety.

The COVID-19 pandemic has provided a "perfect storm" to cause sleep disturbances. Our routines have been disrupted, increase in anxiety/worry, depression, isolation, combined with greater family and work stress. Not to mention all of the excess screen time.

We are privileged to discuss the COVID-19 pandemic and how it is affecting our sleep with Dr. Beth Malow, who is a Professor of Neurology and Pediatrics at Vanderbilt University Medical Center. She is also the Director of the Vanderbilt Sleep Division and has tremendous experience treating both children and adults with sleep disorders.

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In Episode 23, we discuss the importance of wearing a mask after being vaccinated.

A mask is the single most important mitigating technique to prevent the spread of COVID-19, even after being vaccinated. There are 3 central reasons to continue to wear a mask after being fully vaccinated. There are many variants circulating throughout the US, and as predicted the UK variant will be the dominant mutation in the US very soon. Some variants like the South African and Brazilian variant, the vaccine is less effective as protecting ourselves. Therefore, in order to decrease the ability for these variants to spread, we must continue to wear masks after being fully vaccinated.

The vaccine does not necessarily protect you from experiencing COVID, it will likely help reduce symptoms. By wearing a mask, you could prevent spreading COVID to other populations who have not been vaccinated yet.

Finally, a mask can help prevent the spread of other respiratory droplet illnesses like the influenza that are more common during cold/flu season. We have seen during this Winter 2020, a dramatic decrease in the prevalence of influenza, a large part due to the general population wearing masks.

It is extremely important to wear a mask during the pandemic, especially after being fully vaccinated.

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In Episode 22 of Dr. Dave On Call, we discuss the COVID-19 variants and the effects on vaccine efficacy with Dr. David Montefiori.

Dr. Montefiori is Professor and Director of the Laboratory for AIDS Vaccine Research at Duke University Medical Center. During the COVID19 pandemic, Dr. Montefiori and his colleagues were one of the first scientists to warn about COVID-19 variants.

As COVID-19 cases rise, the virus has more opportunity to mutate. Most mutations will be small and have no evolutionary benefit. However, some mutations will cause COVID-19 to adapt, increase its survival to infect others. There are many geographic mutations (i.e. UK, Brazil, South Africa) occurring in the world that result in COVID-19 adapting to improve its survival. These mutations are causing COVID-19 to be easily spread and effect the efficacy of the COVID-19 vaccines.

We discuss with Dr. Montefiori how viral variants occur, the status of the COVID-19 variants and how they are affecting the efficacy of the COVID-19 vaccines. More importantly, we discuss the future of possible variants and how we can plan accordingly.

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In Episode 21 of Dr. Dave On Call, we revisit pediatric mental health during the COVID-19 pandemic. We welcome back Child-Adolescent Psychiatrist, Dr. Karen Pierce.

Dr. Pierce is a Clinical Associate Professor of Child Psychiatry at Northwestern University. She is a Distinguished Life Fellow of the American Academy of Child and Adolescent Psychiatry and the American Psychiatric Association. She is currently in private practice in Chicago, Illinois.

The research demonstrates that COVID-19 is affecting the mental health of children and adolescents at an alarming rate and that depression and anxiety are becoming even more prevalent.

We are seeing these staggering effects of the pandemic on pediatric mental health all over the world. For example, a survey of 1143 parents measuring the effects of the lockdowns in Italy and Spain, nearly 86% reported changes in their children such as difficulty concentrating and spending more time online and asleep, and less time engaging in physical activity. In China, a study of 2330 schoolchildren found that the rates of anxiety and depression has risen during the pandemic. In the United States, the proportion of Emergency Department mental health–related visits for children aged 5–11 and 12–17 years increased approximately 24%. and 31%, respectively when compared to 2019.

It is imperative that we monitor indicators of children’s mental health. We must encourage appropriate coping mechanisms to facilitate resilience. Importantly, we must expand access to critical mental health services to support children’s mental health during the COVID-19 pandemic.

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In Episode 20 of Dr. Dave On Call, we discuss the reported 95% effectiveness for the experimental COVID-19 vaccines.

There are currently 2 vaccines by the companies Pfizer and Moderna that are reporting 95% effectiveness, an impressive number. Both companies have applied for Emergency Use Authroization to the FDA for approval.

Today we are going to discuss the press released data. Of note, this information has yet to be submitted for peer-review. For the purposes of this episode, we will focus on the Moderna data as it is very similar to the Pfizer data.

In addition to discussing the reported 95% effectiveness data, we will also use the reported data to answer the following questions:

1)  Does the COVID-19 prevent contracting the disease altogether?

2)  Does the COVID-19 vaccine prevent clinical disease?

3)  Does the COVID-19 vaccine prevent serious disease?

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In Episode 19, Dr. Dave On Call-Quick Hits, we discuss the flu vaccine and if it can give you the flu.

The seasonal flu vaccine is an important first-line defense to protect humans again the influenza virus. This year, it will be especially important to receive the flu vaccine during the COVID-19 pandemic.

How do flu vaccines work? They cause antibodies (proteins) to develop in our bodies about 2 weeks after vaccination. These antibodies provide protection against the influenza strains contained in the vaccine.

The CDC recommends that people ages 6 months and older to receive the seasonal influenza vaccine each season. There are many different types of flu vaccinations available for the general public, please ask your health care provider which specific type of vaccine would be suitable for you.

Can you get the flu from the flu vaccine? The answer is no. However, there are several reasons why someone could encounter flu-like symptoms after receiving the flu vaccine. First, someone could become ill from other respiratory viruses beside influenza, like the common cold (rhinovirus). Second, someone may have been exposed to influenza shortly before being vaccinated, and not enough time for antibody production to develop immune protection. Third, a person may be exposed to a type (strain) of influenza that was not included in the flu vaccine. Finally, in rare instances, a person does not develop appropriate antibodies to prevent influenza infection.

Do your part and help prevent the spread of influenza, get a flu shot, it could save your life and the life of others!

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In Episode 18, we begin Dr. Dave On Call-Quick Hits and discuss the purpose of a Stay-At-Home Order.

In the United States, we are recording about 150K COVID-19 cases on a daily basis, and in the next month or so, we should likely be over 200K daily. In addition, our average hospitalizations around 50K admissions throughout the country. Obviously, there are places in the US that are faring better and some worse than other places. North and South Dakota, Wisconsin and Illinois are faring poorly, whereas some areas in the Northeast are doing a little better.

As cases are rising so quickly and community spread is so rampant, more talk of “shutting down” or enacting “Stay-at-Home order” becomes more apparent in the media and even during public health official briefings.

We discuss the central thesis behind a Stay-At-Home Order and why they will likely be needed in some areas of the United States as the COVID-19 pandemic worsens during the Fall 2020 season.

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