Dr. Keith Roach

DEAR DR. ROACH: No wonder COVID-19 doesn’t go away — people don’t seem to take it seriously anymore. I work with someone who tested positive for COVID, spent one day out of work, and then came back the very next day with “casual” use of a face mask. I work in direct contact with customers for about 30 minutes each. One of them said their spouse tested positive, yet they weren’t even wearing a mask, even though they were exposed.
Masks may not fit perfectly, but still, at least they would try to use them or stay home. Many times, I have come in contact with someone who says, “I still test positive for COVID, but I don’t feel sick.” And, they no longer decide to take precautions. They’ll say, “But I’ve had all my shots,” or “I’m OK, just tired all the time.” Am I right here? — Anon.
ANSWER: While it is true that the CDC has relaxed their recommendations about COVID-19 prevention using face masks, there are still about 300-500 Americans dying per day of COVID-19 at the time of this writing. Most of the deaths are occurring in people who are unvaccinated (an unvaccinated person is 16 times more likely to die of COVID than a person with at least two boosters) or people who have severe problems with their immune system (due to medical conditions or medications to suppress the immune system).
The recommendations are clear: If you test positive for COVID-19, you should stay home for at least five days and isolate from others in your home. Regardless of when you end isolation, avoid being around people who are likely to get very sick from COVID-19 until at least day 11. You should wear a high-quality mask until day 10. People who have definitely been exposed are potentially highly infectious even if they don’t have symptoms, and they should either stay away from people or at least wear a high-quality face mask.
As the weather turns colder and less humid, it is likely that rates of infection will once again rise: I recommend getting the new, bivalent booster shot if you are eligible.
DEAR DR. ROACH: Can you comment on why Voltaren gel is not recommended for use in the neck and shoulder area? All I could find online is that it hasn’t yet been tested for that. — J.M.
ANSWER: Diclofenac (Voltaren) is an anti-inflammatory medication that may be taken by mouth, or used topically in a gel. It’s a potent medication that is very effective for many people and is often used for arthritis pain. For superficial joints — like hands, wrists and even knees — it can be very effective. However, the joints of the cervical spine in the neck, and most of the shoulder joint, are deeper than the Voltaren can penetrate. Voltaren is not appreciably absorbed into the blood, so all of its actions are local.
It’s very safe, so you can certainly try it to see if it will work. If your pain is being caused by a more superficial source, it may well give you relief. However, since there is no indication for neck and shoulder pain, insurance may not cover it.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
(c) 2022 North America Syndicate Inc.
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