Chief Medical Officer at Northwestern Medicine Dr. Kevin Most joins the Steve Cochran Show to discuss the gradual shift towards non-contact football summer camps, the new at-home lymes disease test kit, and he eases your COVID-19 vaccine confusion.
Dr. Kevin Most’s notes from the Steve Cochran Show:
CTE – Chronic traumatic Encephalopathy- new study- not the number of concussions, more important is the cumulative impact to the brain.
- New study released last Tuesday showed that the chances of CTE are not only related to the number of head impacts but also to the cumulative impact of all the hits.
- This was a study that reviewed 34 previous studies that looked at the number of hits and the impact of those hits measured by helmet sensors
- This looked back over 20 years and studied the 631 players who had donated their brain to these studies that were overseen by Boston University
- This study looked at what aspects of head hits most commonly contributed most to CTE progression
- They reviewed number of hits to the head, number of years played, and force of the hits
- Study found that the best predictor was the cumulative force of the head hits over the course of their career, not the number of concussions (which are very under reported or identified)
- The study reviewed 631 brains, of those 451 or 71%, had CTE
- The players who were estimated to have absorbed the greatest cumulative force had the most advanced CTE
- This reinforced that the concept of the impact of subconcussive hits, rather than number of concussions was the driving force behind the diagnosis and cognitive decline.
- The data collected was from college players as the NFL has not released its helmet sensor data
- The study looks at the number of hits and the force of the hits and them tracks the cumulative data
- Different players get hit in different areas of the brain, lineman take hits to the front of their heads, where quarterbacks take hits to the back of their head most often.
- This is leading to research on different helmets for different positions
- Future studies will look at the location of the hits and the impact
- More data will come out as helmet sensors become universally used.
- Many high schools going to low contact practice and well controlled contact practice.
- Helmet technology has certainly advanced to safer helmets, however players are bigger and faster and technology cannot keep up with protection from the force generated.
- Helmets have sensors for the force of the hit and some actually have EEG monitors, both are used to be more objective when a player needs to be removed form a game.
Covid Vaccines- Confused? You are not alone… Think back over the past 3 years- one shot or 2, age 16 or 18? Boosters for which strain? Who gets boosters, new booster this fall
- The Covid virus is first noted in a patient in December of 2019
- In January of 2020 the first case is found in Seattle, Washington, a few days later the first case was noted in Illinois
- The Covid Virus was genetically sequenced shortly after it was identified, this allowed for vaccine research and trials to begin
- The original vaccine was produced in record time using newer technology, and approved for individuals over the age of 18. Confusion/concern- made too fast
- Original Covid Vaccine was produced using the original strain of Covid ( SARS-VoV-2)- released December 11, 2020, Pfizer and Moderna
- This was a 2 shot series, released under an emergency authorization
- A month later J and J Covid vaccine gets released as a single shot for those over the age of 16, some skeptics about this, but shortages promoted it Confusion- why only one shot
- Shortly after that Pfizer vaccine is approved for children aged 12 and over, then follows up with an approval for 6 months to age 12. Confusion/ concern- enough research done on kids with new vaccine?
- Moderna vaccine gets approved for 6 months to age 11
- Fast forward to August of 2022, Moderna and Pfizer get approval for new booster based on BA4 and BA5 strains, the predominant strains at that time. Confusion/Concern- will we need boosters for all variants
- Booster is approved as a single shot for those 18 and older to be given at least 2 months following the completion of the primary series.
- UK and Canada approve 2nd booster for those over age 65, XXXXX Date, US is silent. Confusion/concern- why are they doing a second booster and we are not
- US approves 2nd dose of Covid booster April, 2023, for those over 65 or immunocompromised. Booster is still BA4 BA5 based
- US no longer gives original Covid vaccine to those who have not been vaccinated, now move to “Booster” vaccine as the standard
- News out now, this fall there will be a new Covid Vaccine using the predominant strain at this time XBB
- This will be recommended for all this fall along with your annual flu vaccine. Confusion/Concern- will insurance cover the cost as it is not government stock
- Will we need another booster in the spring? Confusion/Concern- we seem to need a booster 6-8 months after our last shot, will this happen again?
Home test for Lyme disease
- One great thing that came out of covid was the advancement of testing in the home for the disease.
- We saw earlier diagnosis made with less hassle and cost
- Now we are seeing how that is being advanced
- Home test for Lyme Disease is in the research phase.
- Hopefully faster identification will lead to earlier treatment , thus preventing any long term consequences from the illness
- Currently we use blood tests looking for the bodies response to the infection, we look for antibodies to the bacteria.
- Unfortunately the body may take a couple weeks to make enough antibodies to be at a level that we can identify them
- Now we have home tests where a patient can prick their finger and send a drop of blood and sent that to a lab, this still may not be positive for weeks and has a turnaround time of 3-5 days
- This delay in antibody detection allows the bacteria to spread throughout the body
- Test #1-Work is now being done with a simple urine test that will identify small portions of the bacteria within hours after the infection begins. Virginia Tech
- Test #2- is even faster. It is a sticker that is applied to the skin immediately after the tick is removed, and if the tick was infected with the bacteria for Lyme disease, the sticker will change colors
- Both of these are a couple years away, however it is showing that we will be doing more in home testing and hopefully quicker diagnosis at a lower cost
