July 9th, 2021
Edition #125 – est 3/2020

This week’s Bulletin discusses how to avoid heat injuries during these extremely hot and humid summer days along with the latest updates on COVID-19:

The summer heat can make outdoor activities not only miserable but dangerous. Prolonged exposure to high temperatures can raise the risk for heat injuries such as heat cramps, heat exhaustion and heat stroke. Fortunately, these injuries are preventable. Here are some steps you can take to stay healthy during the dog days of summer.


  • Drink plenty of cool water, even if you’re not thirsty. Try to drink at least a glass of water every hour.
  • Wear clothing that’s lightweight, light-colored and loose fitting as well as sunglasses and a wide-brimmed hat.
  • Apply a sunscreen with an SPF 30 about 30 minutes before going outdoors. Reapply as needed.
  • Plan your strenuous activities for early morning or early evening when the temperatures tend to be cooler.
  • Take breaks if you’re outside. If you feel you’re getting too hot or breathing heavily, find a shaded area or go indoors.
  • Pay attention to the signs and symptoms of heat cramps, heat exhaustion and heat stroke below….


Heat cramps are painful, intense muscle spasms usually brought on by exercising in hot environments. Heat cramps are associated with dehydration and loss of electrolytes. Cramping can occur anywhere but is most often felt in calves, arms, abdominals and back. If you’re experiencing heat cramps then your body is telling you to cool down and rest. Have an electrolyte drink like gatorade. If possible, gently stretch the cramping muscle groups. Refrain from physical activity for several hours. If you don’t feel relief from the cramps within an hour, call your doctor.


Heat exhaustion is a sign that your body is overheating. It’s usually caused from exposure to extreme heat or performing physical activity in high temperatures. Symptoms usually include heavy sweating, faintness, dizziness, fatigue, a weak but rapid pulse, low blood pressure upon standing, muscle cramps, nausea and headache. If you think you’re experiencing heat exhaustion, stop your activity, move to a cooler place, rest with your legs/feet slightly elevated, drink cool water or a sports drinks and sponge cool water on your skin. If the signs and symptoms persist beyond an hour or worsen, contact your doctor. If you become confused or agitated, lose consciousness or are unable to drink, seek medical attention immediately. 


If your body continues overheating, you risk heatstroke — the most serious form of heat injury. Symptoms include a very high body temperature (104° F using a rectal thermometer), nausea or vomiting, flushed skin, rapid heart rate, rapid breathing, headache and altered mental state. If you (or someone you know) has symptoms of heatstroke, get into the shade or indoors. Seek immediate medical attention. While you’re waiting for help to arrive, help the body cool down by sponging cool water on it and placing ice packs on the head, neck, under arms and groin. Untreated heatstroke can lead to organ damage and possibly death.


Even if you’re not dealing with a heat injury, cool down with a cool shower. And drink plenty of fluids, including sports drinks containing electrolytes to replace salts and minerals lost while sweating.

The most important things you can do to prevent heat illnesses are to stay hydrated and limit your time in the sun. According to the American College of Emergency Physicians, each year about 400 deaths and thousands of emergency department visits are caused by heat illnesses. While infants and people 65 and older are most at risk for a heat related illness, it can affect anyone, even exercise enthusiasts


  • Federal Data
  1. According to the CDC, as of Wednesday, July 7, Pennsylvania has administered first doses of vaccine to 63.3% of its entire population, and the state ranks 9th among all 50 states for first doses administered by percentage of population.
  2. According to the CDC, as of Wednesday, July 7, 60.8% of Pennsylvanians age 18 and older are fully vaccinated while 76% have received their first dose.
  3. According to the CDC, as of Wednesday, July 7, Pennsylvania ranks 5th among all 50 states for total doses administered.
  • State Data
  1. Vaccine providers have administered 11,800,591 total vaccine doses as of Thursday, 7/8
  2. 5,472,507 people are fully vaccinated; with a seven-day moving average of more than 13,100 people per day receiving vaccinations.
  3. 1,305,620 people are partially vaccinated, meaning they have received one dose of a two-dose vaccine.
  • Teenagers have figured out how to use soft drinks and fruit juices to fake a positive COVID-19 test, and the authors of a new study warn schools and other groups to be aware. As of July 1, videos uploaded to social media under the search term #fakecovidtest, featuring young people applying various liquids to rapid antigen COVID-19 tests, had been viewed millions of times, according to the British news website inews.co.ukThat report, and others, prompted University of Liverpool researchers to study the effects of applying soft drinks and artificial sweeteners to the test swabs.10 of 14 soft drinks produced positive or weakly positive results, with no apparent link between the test results and the soft drinks’ ingredients.
  • Studies have shown that, since early May, nearly every hospitalization and death from COVID-19 has occurred in unvaccinated Americans. The president said that his administration will be working throughout the summer to “wind down” mass vaccination sites, while increasing vaccine access and uptake in a more targeted way, focusing on five key strategies:
  1. Implementing a “door-to-door” education campaign
  2. Renewing efforts to bring vaccines to more primary care doctors
  3. Strengthening its approach to getting vaccines into the hands of pediatricians
  4. Making the vaccine available to workers by launching vaccine clinics at work sites
  5. Expanding the number of mobile clinics at festivals, sporting events, and places of worship
  • The Oakland Zoo has begun a vaccination program to inoculate its highest risk animals from COVID-19 with an experimental vaccine that has been authorized by the United States Department of Agriculture (USDA). They received its first shipment of the experimental vaccine developed by veterinary pharmaceutical company Zoetis and began to give doses to its tigers, black bears, grizzly bears, mountain lions and ferrets. The zoo next plans to give doses to primates, including chimpanzees, as well as fruit bats and pigs. A COVID-19 vaccine is not needed in pets or livestock at this time. The experimental vaccine has been authorized for use on a case-by-case basis after the San Diego Zoo requested help in January following an outbreak of COVID-19 among the zoo’s great apes.
  • Johnson & Johnson announced data that demonstrated its single-shot COVID-19 vaccine generated strong, persistent activity against the rapidly spreading Delta variant and other highly prevalent SARS-CoV-2 viral variants. In addition, the data showed that the durability of the immune response lasted at least eight months, the length of time evaluated to date.
  • An Israeli study shows that the Pfizer vaccine is still extremely effective protecting you from the Delta variantThis vaccine is 94% effective at preventing severe disease and hospitalization from the Delta variant. It’s also 64% effective at protecting you from any Delta variant infection. Most of the Delta variant infections are found in the unvaccinated population.


  • A new data analysis identifies clusters of unvaccinated people, most of them in the southern United States, that are vulnerable to surges in Covid-19 cases.  The five clusters are largely in parts of eight states (not the entire state) – Georgia, Texas, Missouri, Alabama, Arkansas, Louisiana, Oklahoma and Tennessee. Most of these states are currently seeing increases in Covid-19 cases. The five most significant clusters together include more than 15 million people. Of those, only 27.9% are fully vaccinated – far lower than the national rate of 47.6%. While the clusters do encompass some sizable cities, 92% of the counties in the clusters have a population of less than 100,000.
  • Unvaccinated clusters are worrisome because each time a virus spreads, it has an opportunity to learn how to mutate. The Delta variant has learned how to evade Covid-19 vaccines to a small degree, but our vaccines still offer excellent protection against severe disease and hospitalization. The fear is that the next variant might be able to outsmart the vaccine more thoroughly, causing problems even for parts of the country that have high vaccination rates.
  • The official global Covid-19 death toll has topped 4 million, about equal to the population of Los Angeles, according to data from Johns Hopkins University released late Wednesday. More than six months after vaccines became available, reported Covid-19 deaths worldwide have dropped to around 7,900 a day, after topping out at over 18,000 a day in January, The Associated Press reported.
  • A study was done to determine the proportion of the U.S. population who had an undiagnosed COVID-19 infection during the first wave of the COVID-19 pandemic.The study measured antibodies in participants who had not previously been diagnosed with a SARS-CoV-2 infection. The study found that by mid-July of 2020, 16.8 million people had an undiagnosed SARS-CoV-2 infection, almost five times the rate of diagnosed infections. This means there were 4.8 undiagnosed SARS-CoV-2 infections for every diagnosed case of COVID-19. This data suggest that a higher level of infection-induced immunity exists in the U.S. population than previously predicted
  • Anthony Fauci on Sunday said more than 99 percent of the 10,000 people in the US who died from COVID-19 in June were not vaccinated, calling the loss of life “avoidable and preventable.” As of Sunday, 67.1 percent of U.S. adults had received at least one COVID-19 vaccine dose, and 47.4 percent of the total U.S. population is fully vaccinated, according to the Centers for Disease Control and Prevention.
  • In a highly promising find, a study shows that nearly all cancer patients vaccinated against COVID-19 with mRNA vaccines developed strong immune response three to four weeks following their second dose. The results appeared in the journal Cancer Cell. Patients with hematological malignancies, such as myeloma and Hodgkin lymphoma, were less likely to respond to vaccination than those with solid tumors. For patients with cancer, two doses are very important for robust antibody response.
  • “As the Covid-19 pandemic fades, “some existing trends will remain,” said Jacqueline Gollan, a professor of psychiatry and behavioral sciences at Northwestern University’s Feinberg School of Medicine in Chicago. For example, the recent expansion and use of online shopping, telehealth services, hybrid work models and technology that allows virtual gatherings will endure. We’ll also be evaluating many of the lifestyle habits we’ve engaged in before and during the pandemic including fist bumping instead of handshakes, mask-wearing if you’re sick, homeschooling children and more frequent disinfecting of high use surfaces.
  • Pet cats and dogs often catch COVID-19 from their owners, a new study suggests. The study researchers found that, among the pets of people who had recovered from COVID-19, about two-thirds of cats and more than 40% of dogs had antibodies against the coronavirus that causes COVID-19. Fortunately, most pets that had coronavirus antibodies were asymptomatic or had mild symptoms. Cats appear to be more susceptible to COVID-19 than dogs. This may be because the virus binds more easily to the receptors on the surface of cats’ cells compared with dogs’ cells, the authors said. In addition, cats may be more likely to sleep near their owners’ faces compared with dogs, they said. No data suggests that pets can pass COVID-19 back to people, and the risk of this happening is low, according to the Centers for Disease Control and Prevention (CDC).
Enjoy healthy salads and smoothies delivered to you while you work at home!

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Please stay safe and be smart,
Dr Bralow

Dr. Vicki Bralow
834 South Street
Philadelphia, Pa 19147