Last year, we provided 528,985 diapers to help parents keep their children clean, dry, and healthy.

Dileymis and Ariel are loving parents who are struggling to stretch their budget with the soaring cost of food, gas, and more. Having a 10-month-old means that Dileymis can’t return to work or pursue her dream of becoming a paralegal just yet. The family of five receives some SNAP benefits but depends on Ariel’s income as a painting contractor. When their budget is stretched too thin to afford diapers, she visits Whole Family Health Center’s Diaper Pantry in Fort Pierce that is stocked with diapers and baby items by Treasure Coast Food Bank through the Happy Baby Diaper Pantry Program. Diapers are an expensive necessity for a family with little ones, so Dileymis was thrilled to learn more of their limited income could go toward groceries, rent, and bills instead of diapers.

Read the full report at Treasure Coast Food Bank – 2022 Annual Report

The post Happy, Healthy Babies appeared first on Whole Family Health Center.

We are excited to announce our 11 finalists.

For the 2022 – 2023 membership year, five $100,000 grants will be awarded. Voting begins soon.

ANNOUNCING THE IMPACT 100 INDIAN RIVER

2023 GRANT FINALISTS

Ballet Vero Beach

  Fellowship Initiative for Dancers Expansion

Bike Walk Indian River County

     “Wheels on Wheels” Initiative

Indian River County Healthy Start Coalition

     Fatherhood Initiative Indian River County

Junior Achievement of the Palm Beaches and the Treasure Coast

     Junior Achievement: From Youngsters to High School Graduates

McKee Botanical Garden

     Nurtured by Nature – Welcome to McKee Botanical Garden

Senior Resource Association

     Meals on Wheels Waitlist Relief

The Gifford Youth Orchestra

     Audio, Recording, and Communications Studio

The Learning Alliance, Inc.

     Moonshot Lab School and Hub for Teacher Training

The Source

     Dignity Wellness Program

Vero Beach Theatre Guild

     Theatrical Learning Center (TLC)

Whole Family Health Center

  Expanding Access to Care: WFHC Mobile Medical Office

*****

2023 Annual Meeting

April 12, 2023

4:00 – 6:00 p.m.

(Registration begins at 3:30 p.m.)

Oak Harbor Club

4755 S. Harbor Drive

Vero Beach, FL 32967

Each of our grant finalists will present their projects and you will have the opportunity to vote in person.

The post 2022 – 2023 Impact 100 Grant Finalists!!! appeared first on Whole Family Health Center.

Two-Drug Regimens in the Real World: Efficacy of DTG/3TC

Gerald Pierone, Jr., M.D., the medical director of the Whole Family Health Center in Vero Beach, Florida, shared data on real world effectiveness of fixed-dose dolutegravir/lamivudine (DTG/3TC) as a two-drug regimen compared with common three-drug regimens among virally suppressed, treatment-experienced PLWH.

A coformulation of dolutegravir (DTG, Tivicay), a first-generation integrase inhibitor, and lamivudine (3TC, Epivir), a venerable NRTI, was approved by the FDA in April 2019 under the brand name Dovato. DTG/3TC is listed within U.S. HIV treatment guidelines as a recommended first-line treatment regimen in individuals who do not have a very high viral load, are not coinfected with hepatitis B, and for whom reverse transcriptase genotypic resistance testing results are available.

The study by Pierone and colleagues extended from May 1, 2019 (i.e., after DTG/3TC’s approval) through Oct. 31, 2020, with follow-up until April 2021. Patient records, drawn from the OPERA longitudinal database, included virally suppressed PLWH (in this study, that was defined as less than 200 copies/mL) who had switched from their prior regimen to one of three alternatives: DTG/3TC; a three-drug regimen containing dolutegravir (“DTG 3DR” for short); or a three-drug regimen containing bictegravir (“BIC 3DR” for short), a second-generation integrase inhibitor contained within the FDA-approved combo pill bictegravir/emtricitabine/tenofovir alafenamide (a.k.a. Biktarvy).

The researchers analyzed records of 8,037 PLWH fitting these criteria. The population was relatively diverse: 19% women, 35% Black, and 26% Latinx, with 54% of patients living in the U.S. South. The vast majority of patients were prescribed BIC 3DR, but notably, the proportion of Black patients and southern patients was highest in the subgroup that was prescribed DTG 3DR.

They found that, after a median of 13 to 16 months of follow-up (varying by study arm), virologic failure rates were low across all regimens—but only DTG 3DR was associated with a statistically significant increase in the risk of virologic failure relative to DTG/3TC (hazard ratio 5.21; 95% CI 1.85 to 14.67). BIC 3DR trended toward an increased risk, but fell short of statistical significance (HR 1.39; CI 0.61 to 3.17).

Discontinuation rates were higher for the DTG 3DR cohort (24.9 per 100 person-years) than the DTG/3TC group (17.7 per 100 person-years) or the BIC 3DR group (8.3 per 100-person years), amounting to a 69% greater discontinuation risk compared to BIC 3DR. Discontinuers on any combination were highly likely to be virally suppressed at the time of discontinuation (96% on DTG/3TC; 94% on BIC 3DR; 93% on DTG 3DR), and those discontinuations were unlikely to be due to adverse events or side effects: only 3% experienced adverse events with DTG/3TC, 4% with DTG 3DR, and 7% with BIC 3DR. The most common reason for DTG 3DR discontinuations was regimen simplification (21%); no reason was given for more than half of the discontinuations in each cohort.

Pierone concluded by saying that, because discontinuations were not attributed to the treatment, and because virologic failure was rare after switching to DTG/3TC, DTG 3DR, and BIC 3DR, all combinations showed high levels of suppression and tolerability.

Read the full article at https://www.thebodypro.com/article/idweek-2022-new-hiv-antiretroviral-therapy 

The post Two-Drug Regimens In The Real World: Efficacy Of DTG/3TC appeared first on Whole Family Health Center.

According to Indian River Insights, 12% of Indian River County residents do not have health insurance. Whole Family Health Center provides access to affordable quality healthcare by caring for uninsured and underinsured individuals in Indian River County. In 2021, their Behavioral Health Clinic saw 1,151 unique patients: 524 pediatrics and 627 adults. In February 2021, an expansion of the Behavioral Health Clinic was completed. The new expansion allowed for a 48% increase in Vero Beach Behavioral health visits as well as a bigger space to help protect residents against the COVID-19 virus. By putting in extra time on weekends, the organization was able to administer well over 31,000 vaccines to Indian River County residents.

Weekly Insights works in conjunction with Indian River Indicators. Indian River Indicators was launched in June 2021 and originated after the completion of the 2019 Indian River Community Needs Assessment. It provides key data and information about our community that is updated annually and can be used to support and sustain proven programs. It can also be used by community leaders to develop policy, promote promising practices and inspire innovation that can lead to solutions to persistent community challenges. Indian River Community Foundation holds monthly informational sessions to introduce the community to this new resource. The next session will be held on Tuesday, March 1st at 4pm via zoom. Please email Foundation Coordinator, Chiaka Nwosu, at chiaka@ircommunityfoundation.org to attend a session.

To learn more visit www.ircommunityfoundation.org and click “Indian River Indicators” or contact a member of the Community Foundation’s team at 772.492.1407.

The post Weekly Insights: Whole Family Health Center appeared first on Whole Family Health Center.

“Dr. Pierone is a community treasure,” says Brian Kroh of Vero Beach. “He is passionate about improving the lives of everyone he encounters, regardless of their lifestyle or financial status. He treats people locally, regionally, and in other countries with a drive to make people’s lives better.”

“When I arrived in Vero Beach 25 years ago,” Kroh recalls, “I asked Hugh McCrystal, former chief of staff at Indian River Hospital, for a general practitioner recommendation. He said, ‘Give Gerry Pierone’s office a call. He is an extremely capable doctor about your age who you can grow up with.’ Following that advice, I was lucky enough to have both a family practitioner and a highly regarded infectious disease specialist to take care of my general health needs. 

“Little did I know at the time that 25 years later I would need Dr. Pierone’s infectious disease expertise when I contracted COVID-19. His medical acumen has been a vehicle for him to help make this world a better place. He does it with grace, confidence and compassion.”

Complete profile featured in the January 2022 edition of Vero Beach Magazine: https://www.verobeachmagazine.com/frontline-physician/

The post Frontline Physician appeared first on Whole Family Health Center.

Laurence Reisman | 01 Oct, 2021

But I’ve never heard Ramgopal or Gerald Pierone, an infectious disease specialist with offices in Indian River and St. Lucie counties, more optimistic about seeing light at the end of the dark COVID tunnel.

“Things are better,” said Pierone, who, like Ramgopal, since late 2020 has helped COVID-19 patients get better with infused monoclonal antibody treatments. “A few weeks ago, it was really bad.”

Maxed out on monoclonal antibodies

In late August before Florida Gov. Ron DeSantis opened state-run monoclonal antibody clinics, including one in Fort Pierce, Pierone’s clinic was so maxed out it was featured in a national medical blog.

“It was just out of control,” he said of the August barrage of cases, which consisted of 70% unvaccinated patients in worse shape than the 30% of vaccinated patients (often in their 80s with comorbidities). “We couldn’t get people in we wanted to get in.”

The good news: Monoclonal antibody infusions and injections, he said, reduced hospitalization and death by 70% and 80%. The bad news?

“It’s not a fail safe,” he said, noting vaccines are better options.

Volume at the clinic has slowed enough so it could start clinical trials for the next generation of infused or injectable monoclonal antibodies, which could be even more effective.

The game changer, however, is expected to be what Ramgopal dreamed of in February: antiviral pills that attack COVID-19 in a similar way monoclonal antibodies do.

While at least three pills are in the pipeline, Merck announced Wednesday its new oral drug worked against COVID variants and clinical trials would end in November.

COVID-targeted pills game changer?

“If they work, that’s going to be a game changer,” Pierone said. “It’s still very cumbersome and awkward to have to bring people in to give them either injections or infusions. If you can meet them at home with a pill like you would with somebody with bronchitis or whatever, that would be transformational.”

It’s good news even if cases are slowing locally.

“I think we’re through the worst of it,” said Pierone, noting he sees fewer adults, but more children testing positive. “Hopefully this downward trend will continue.

“Is it going to go away completely? No, because there are still people out there, delta is a highly transmissible variant, both for people who are fully vaccinated and for people who are unvaccinated.”

In fact, he said, about 30% of the COVID patients his Whole Family Health Center treats are vaccinated.

“They’re not dying sick (which vaccines are good at preventing), but they’re sick,” he said. “They can transmit it to their friends and family and whoever, so it’s still out there.”

Which is why he and Ramgopal urged, as they did when COVID retreated last winter and spring, for people to continue to socially distance, mask up indoors, avoid large gatherings and get vaccinated.

“Until we get rapid treatment that will kill the virus and stops the spread, that’s the strategy,” Ramgopal said.

Read the full article at: https://www.tcpalm.com/story/opinion/columnists/laurence-reisman/2021/10/01/treasure-coast-covid-experts-see-possible-end-sight-opinion/5915451001/

The post As COVID Cases Drop, Local Infectious Disease Experts Pierone, Ramgopal Weigh In | Opinion appeared first on Whole Family Health Center.

Gerald Pierone, MD, gets regular phone calls from COVID-19 patients and their family members, asking for a spot at his monoclonal antibody clinic in Vero Beach, Florida.

But as infections continue to surge throughout the state, the clinic is often full.

“We are just being inundated with COVID patients now because of this Delta surge,” Pierone, an internist and infectious disease specialist, told MedPage Today.

“These people are really sick,” he added. The majority of patients who show up to his clinic have been sick for at least 4 days, and may have a cough, shortness of breath, nausea, and headaches.

Often, these patients need more than just an infusion. Healthcare workers at Pierone’s clinic are managing patients with acute illness, and often administer nausea medication and IV fluids, or counsel patients on isolation and quarantine.

“It’s quite an operation for a small staff, to move these people through and take care of them,” Pierone said, adding that there are four providers. “Right now, we are all hands on deck.”

The clinic is one of many monoclonal antibody treatment centers in Florida that have seen a surge of patients as the Delta variant continues to spread. Gov. Ron DeSantis (R) has promoted the benefits of Regeneron’s monoclonal antibody treatment in preventing severe illness and hospitalization, and officials have ramped up the launch of new treatment sites. There are now 18 state-run facilities offering free monoclonal antibody treatments (though Pierone’s clinic is not one of those).

In November of last year, Pierone and his research team began enrolling patients in the NIH ACTIV-2 study, a clinical trial program evaluating the safety and efficacy of therapeutics for COVID-19. Pierone provided monoclonal antibody treatments at Whole Family Health Center, a multispeciality, community-based health center that he founded 30 years ago as an HIV clinic.

After a few months of doing research at his facility, Pierone opened a stand-alone clinic for patients with active COVID-19, which consisted of four exam rooms where he could provide monoclonal antibody infusions.

Patient volume picked up significantly as the Delta variant spread throughout Florida. In June, the clinic performed just two monoclonal antibody treatments. Treatments jumped to approximately 60 in July, and this month he has already treated 130 patients.

The small clinic maxes out at seeing 14 to 15 patients a day. Each patient’s treatment lasts about 2 hours, after they fill out paperwork, receive the infusion, and wait out an hour-long observation period.

Some of the patients who are treated in Pierone’s clinic are those who test positive for COVID-19 at his larger health facility. Others may be referred by local physicians, or call in to try to get a spot after hearing about the clinic through word-of-mouth.

Regeneron’s casirivimab/imdevimab (REGEN-COV) cocktail is authorized under emergency use to treat COVID-19 positive patients ages 12 and older who have a high risk of progressing to severe illness. Because the FDA has made the treatment criteria broad, the providers in Pierone’s clinic have had to triage whom they treat. They don’t say no to everyone, but often take the patients who are at the highest risk of getting really sick.

“It’s really frustrating, because we don’t have the capacity to treat as many people as we’d like to treat,” Pierone said.

Although the FDA recently expanded the use of casirivimab-imdevimab to include post-exposure prophylaxis, Pierone said his clinic cannot take patients in this category, because the facility is already overextended treating sick patients.

One of the reasons many of his patients are so sick, Pierone said, is because approximately 70% have not been vaccinated. He treats partially and fully vaccinated people as well, who are often older and at a higher risk of severe illness, but none of those patients have died from COVID-19. That’s not the case for the unvaccinated, however.

“The really sick patients are the unvaccinated,” Pierone said.

Recently, Pierone treated an unvaccinated, healthy 34-year-old patient. After the patient got infected, he received antibiotics and appeared to be doing well. But around a week after his symptoms started, the patient came into Pierone’s clinic with an oxygen level of 90%, and had to be admitted to the emergency room.

“That’s kind of a typical younger person,” Pierone said. “The first week they’re not that sick, then the immunity kicks in, the cytokine storm kicks in, and they get much worse.”

The problem is, it’s hard to tell who will progress to worse illness on the front end, Pierone added. While patients with comorbidities such as overweight and obesity, diabetes, or asthma typically have more severe illness, the disease course can be unpredictable. “You don’t know if this person is going to be fine, or if they are going to crash and burn,” Pierone said.

The ideal is to get people on monoclonal antibodies 3 days after symptom onset, Pierone said. But he estimated that only around 20% of patients come to the clinic within that early time frame. “The truth is, we end up seeing a lot of people on day 7, day 8, day 9, day 10,” he said.

What they are really doing for those patients is treating secondary bacterial infections, and administering corticosteroids. “We are helping people, in many cases, more by giving them dexamethasone and other adjunctive treatments, than we are by giving them monoclonal antibodies when they’re at that later stage,” Pierone said.

Of the four providers at Pierone’s monoclonal antibody clinic, he is currently the only physician, joined by nurses and a research assistant.

“I would say my staff is frazzled,” Pierone said. “I’m definitely developing some compassion fatigue. What we are doing right now, it’s not sustainable.”

State officials recently opened a large Regeneron monoclonal antibody site in Fort Pierce, which can treat more than 300 patients a day with subcutaneous shots. People 12 years and older who have tested positive for COVID-19, or have been exposed to an infected person, can walk in to receive treatment, with or without a provider referral.

“They are trying to very aggressively expand access to monoclonals,” Pierone noted. And he said that while wider access to these treatments may prevent future hospitalizations, “by far, the most important public health measure is getting people vaccinated.”

While DeSantis continues to expand access to monoclonal antibodies in Florida, he also continues to resist mask mandates in public schools, even for kids under 12, who cannot get vaccinated. The governor is currently entrenched in a legal battle over his authority to ban mask mandates in schools.

Pierone has reached out to other local hospitals and the health department to assess the outbreak. As he and his staff are drowning in patients, they are drowning too. Hospitals are still not performing elective procedures, and ICUs in the state are near capacity.

“Nobody is going to rescue us,” Pierone said. “We have to rescue ourselves.”

The post This Florida Monoclonal Antibody Clinic Is Maxed Out appeared first on Whole Family Health Center.

Jeff Powers has dealt with his share of bad luck: a bad bout of COVID-19 when no one even knew it was in town; a nerve disorder triggered by serious back surgery; and most recently, torn Achilles tendons that have left him in a wheelchair.

Powers is ready to end that streak. Last weekend, he became one of the first to 

get a vaccine booster shot against coronavirus.

As he wheeled up to the pharmacy of the Publix on Miracle Mile Sunday, it was the medication for the nerve disorder that earned him the right to the first COVID-19 booster shot the pharmacy had given out.

Eligibility is on the honor system – no doctor’s note required. “There wasn’t a soul there,” he said. “Even in the wheelchair, the whole thing didn’t take me 15 minutes.”

Powers was a hyper-athletic 60-year-old when he got very sick with what was apparently COVID-19 in early February 2020; he later tested positive for antibodies. “After that, I was panicked to get a shot when it came out,” he said.

Powers was able to get the COVID-19 vaccine early because of his nerve disorder, which requires heavy doses of corticosteroids that depress his immune system, putting him at high risk of severe COVID-19 disease.

Now with a booster, he more than meets the vaccine mandate for coaches of Float Hope, the Gifford-based swim school for economically challenged kids that he supports.

“We are strong on the vaccine,” he said, adding that all five of his own kids are vaccinated.

In the meantime, vaccine mandates are popping up at local clubs and businesses. John’s Island Club issued a mandate over the weekend that all employees must be vaccinated by October.

“The membership is all behind (general manager) Brian Kroh leading the charge,” said Powers, who lives in John’s Island. He said for several months, only vaccinated club members have been allowed to eat at Rafters, a casual on-site restaurant. John’s Island members have an “extremely high vaccination rate – 97 percent of those over 70,” he said.

Booster vaccinations got their first official approval – albeit only in certain cases – just a week ago when the FDA amended its emergency use authorization to include a third shot of the Moderna and Pfizer vaccines in people with compromised immune systems who may not get full protection from the two-dose regimen.

With vaccines in plentiful supply in the U.S., and the applicant’s word enough, the only hurdle in the two-page booster registration form is being able to check at least one box on the list of the CDC’s guidelines for who is eligible for the shot.

The FDA’s acting commissioner, Dr. Janet Woodcock, said in a tweet that “others who are fully vaccinated are adequately protected and do not need an additional dose of COVID-19 vaccine at this time.”

Even before Friday’s change, booster shots were being given in Indian River County on a case-by-case basis by Dr. Gerald Pierone, an infectious disease specialist and founder of the Whole Family Health Center.

Pierone has also been seeking to increase awareness of another drug treatment, the monoclonal antibody cocktail REGEN-COV, made by Regeneron.

A week ago, the FDA authorized the use of REGEN-COV in people exposed to COVID-19 who are at high risk of severe disease, but have not yet tested positive. The drug can prevent or lessen severe disease if administered early on by IV.

REGEN-COV is available at several infusion centers and infectious disease practices in the county, including Whole Family Health. Pierone has treated more than 100 patients with the Regeneron cocktail since early June. Last Saturday, the clinic treated five patients, with 10 more scheduled Monday. And demand is growing.

“We are trying to figure out how to build capacity to meet the need,” Pierone said.

To read full article visit: http://www.vb32963online.com/STORIES%202021/AUGUST%202021/VB32963_Vaccine_Booster_Shots_Available_Locally_Now_For_Those_Eligible_Issue33_081921.html

The post Vaccine Booster Shots Available Locally Now For Those Eligible appeared first on Whole Family Health Center.

Nearly 367,000 Treasure Coast residents — about 56% of the population — had been at least partially inoculated against COVID-19 through Aug. 12, according to the Florida Department of Health’s latest data.

As unvaccinated patients fill local hospitals in record numbers, health officials urge the remainder of the community to get the vaccine as soon as possible — not only to protect themselves, but also others.

TCPalm will update this list as vaccine clinics open and close, for Treasure Coast residents’ one-stop shot information.

Who can get vaccinated?

All Floridians 18 and older became eligible for a shot April 5, per a March 26 executive order issued by Gov. Ron DeSantis. Those 12-17 are eligible only for the Pfizer vaccine.

Whole Family Health Center

Online registration: https://book.appointment-plus.com/ct8zrrye

Phone registration: 888-976-9342

Manufacturer: Pfizer

Second dose: Patients will be prompted to book a second dose during the scheduling of the first appointment.

FAQs: https://www.wfhcfl.org/covid

Whole Family Health Center participating locations:

• 981 37th Place, Vero Beach
• 725 N. U.S. 1, Fort Pierce

To see the complete list: https://www.tcpalm.com/story/news/health/2021/02/15/coronavirus-covid-19-vaccine-florida-indian-river-st-lucie-martin-publix-sams-walmart-winn-dixie/6712249002/

The post TC Palm – Unvaccinated? Here’s Where You Can Get A Free COVID-19 Vaccine To Protect Yourself, Others appeared first on Whole Family Health Center.

What if everyone had just listened to two Treasure Coast infectious disease specialists?

As Florida hospitals reel from record numbers of COVID-19 admissions — 90% unvaccinated, according to Cleveland Clinic Indian River Hospital CEO Greg Rosencrance — I couldn’t help but think back to a cautiously optimistic column I wrote in February.

“More than 1.5 million Floridians are fully vaccinated, a new one-shot vaccine is on its way and COVID-19 cases are easing up from a holiday season peak,” I wrote.

“Ready to get back to normal?”

Not so fast, infectious disease physicians Gerald Pierone and Moti Ramgopal told me at the time.

Getting back to normal would be an evolution, said Pierone, chief medical officer and founding physician of Whole Family Health Center, which has clinics in Indian River and St. Lucie counties.

“We will start seeing protected pods or bubbles of fully immunized individuals who will interact with other family members and friends who have also been fully immunized,” he wrote to me in February, citing the safety of small groups whose members were careful elsewhere, too. “Members of these bubbles will be able to have social events without the need for social distancing and masking as long as they exclude others who are nonimmune.”

Pierone’s prescient nine words

Looking back, Pierone’s last nine words were prescient. He cited the possible spread of COVID-19 by asymptomatic vaccinated people to the unvaccinated.

No vaccine is foolproof; the Pfizer and Moderna two-shot doses, if given correctly, have shown to be about 90% effective in preventing illness, with an infinitesimal number of vaccinated being hospitalized or dying.

To Continue Reading: https://www.tcpalm.com/story/opinion/columnists/laurence-reisman/2021/08/06/covid-surge-came-after-failing-listen-these-experts-opinion/5494414001/

The post TC Palm – COVID Surge: What If We Had Just Listened To Local Doctors Pierone, Ramgopal? | Opinion appeared first on Whole Family Health Center.