By Dr. Anthony Policastro

To me Christmas has always represented a time for family. When I was growing up my dad had a Santa Claus outfit and bag full of presents that he would bring for us.

When I was older we still gathered around the dinner table with relatives. Dinner started at 2 p.m. with antipasto. At 4 p.m. the lasagna, salad and bread was served. We waited until 5:30 p.m. for the main course with the trimmings. Then it was dessert at 7 p.m. followed by nuts and fruit at 8 p.m. 

It allowed us to all be together for the entire day. That taught me the importance of family at Christmas. Once Joan and I got married we spent Christmas morning with her family and then headed back for the 2 p.m. dinner cycle to begin.

Even after  I started my residency in Boston, I had to contend with night call every second or third night. That meant that the only way to get home for Christmas was to be on vacation. I made a trade with the Chief Resident each year.

I agreed to make out the entire year’s call schedule for all 27 residents as long as I got to take vacation at Christmas. That worked for her. This was clearly pre-computer days. So it clearly meant work for me.

I managed to get leave at Christmas time for all 20 years in the Air Force. That even meant flying home for Christmas the two years I was in England. All of my other assignments were on the East Coast so I was able to drive home to my parents’ house for Christmas dinner.

The tradition kind of continued when my two daughters got married within five weeks of each other in 1996. We agreed that we would do Thanksgiving as a family one year and Christmas the next. 

This is a Christmas year. So on Christmas Day all three daughters, three sons-in-law and 10 grandchildren will be together. And as you might have guessed, dinner will start at 2 p.m. with a prayer of Thanksgiving for us all being together. As you might expect we will then have antipasto followed by lasagna.

I have written about the importance of Christmas and family in the past. The point at that time was to make sure any long standing family disagreements got buried. Someone has to take the first step. Family is forever. If you are estranged from a family member, maybe this is the year for that step to be taken.

You might remember the scene from Home Alone where Kevin convinced his neighbor to call his son. That was all it took for them to spend Christmas together.

Perhaps you can join with all of us that get to spend the Christmas holidays with our family this year with your family as well.

COVID update- The number of new cases nationally rose from 834,000 last week to 964,000 this week. Sussex County cases rose from 1,004 last week to 1,145 this week.

One current question is related to how much protection the vaccines offer against the Omicron variant. It is clear that booster doses of vaccine offer significantly more protection than the basic two doses do.

England has had at least seven deaths from the first 25,000 cases of Omicron. Some of those 25,000 patients are not yet better so the figure may go up. If you do the math, it means that so far deaths are about one out of every 3,500 cases there. That is a higher mortality rate than Japan, Pakistan and Bangladesh have had through the entire pandemic to this point.

As I have said all along, the natural history of this disease means that people will either get vaccinated or get infected. It is likely that this surge will infect just about all the remaining unvaccinated individuals. 

Evolution is about survival of the fittest. That is why the virus keeps mutating. It is the only way for it to survive. In order to defeat it, humans need to evolve in their approach. 

We have not done that too well. People still behave like they did when the virus first appeared. They still behave like they did when it surged last winter. They still behave like they did with the Delta surge. The virus is acting like all things in nature. It adjusts to survive. We are not quite as flexible. That is why it survives better than we do.

There has been much written about people needing to get vaccines after having natural COVID-19 infection. What has not been in the news is related to those who get a breakthrough infection after getting vaccine. 

The immune system behaves in a logical manner. When you are exposed to something, you make antibodies to it. Thus, a vaccinated individual exposed to COVID-19 naturally should have a boost in antibodies. That is true whether they actually develop a breakthrough infection or not.

A study out of Oregon supports this. They looked at 26 staff members at the Oregon Health and Science University. All of them had been fully vaccinated and then had a COVID-19 breakthrough infection. Antibody levels increased by an average of 1021 percent. This is consistent with the delayed immunity anamnestic response that I have so frequently spoken about.

The CDC has expressed concerns about a rare side effect of the Johnson and Johnson vaccine. It only occurs in one out of 100,000 individuals. The feeling is that level is high enough to suggest other vaccines be used. Those who have received Johnson and Johnson vaccine should receive a booster dose with one of the mRNA vaccines.