Hello, and Good Day,

I hope all are well and adjusting to a new normal.  I want to try and paint a picture about what I know to be happening locally. 

First, here at the clinic I have made the difficult decision to limit my hours and cut staff.  These are economic measure that we are all taking in some form.  I have to recognize our limitations in facilities and equipment and do my best to support the hospitals without putting our community at risk.  We have closed Saturdays and limited hours to 9-5 Monday through Friday.  We are not accepting any respiratory cases that could represent Covid infection.  

Many of our specialty governing bodies have released guidelines regarding the delivery of routine care and elective procedures. The American Academy of Family Practice recommends against routine visits and well exams like Physicals.  I have adopted that standard and we are accepting all other patients.  The gastroenterology society recommends against all endoscopic procedures due to the inherent risk of transmitting infection. Guidance is similar across the other societies depending upon resource utilization and infection risk.  The local hospitals like Piedmont and Emory have cancelled all elective procedures and dedicated staff to Covid cases.  

Regarding the issue to test or not test let me give you my insights. 

So far nationally only about 10% of febrile illnesses tested for Covid have returned positive.  So remember the majority of fever and upper respiratory illnesses remain viral and non-Covid.  Generally healthy adults and children younger than sixty do not need testing for Covid because of fever, myalgias, congestion, dry cough, etc…Older adults with lower respiratory symptoms; cough dry or productive, fever, shortness of breath, and chest pain should seek testing and treatment in a hospital setting.  

Testing is coming to a parking lot or retail outlet near you.  The counties will assume this burden but have been a little slow to act with Cobb probably ahead of most here in the metro area.  Again i do not think testing is warranted for the majority of the population.  Keep an eye on County Health Department sites for availability.

The numbers in Georgia as of 7p.m. last night were a total of 2386 tested 485 positive (roughly 20%).  Fulton (88 cases) Bartow (54) are leading the state.  There is a roughly 20% increase in positive cases daily and should increase considerably by the first of the week as lab companies have adjusted to the increased burden of Covid testing.  Emory has officially published that they are caring for 35 Covid inpatients at this time.

I know you all have heard of potential drugs like Chloroquine, Hydroxychrloroquine, or other immunosuppresives to treat infected patients.  I was aware of this roughly two weeks ago and these meds were sold out and unavailable by then.  Remember we do not need these meds.  This will be only for the sickest patients and can only be safely used in a hospital setting so please do not try to gather them. It is just not logical to do so.

I am in agreement with local government officials to close bars, restaurants, and other gathering places and in general I think most are taking quarantine and social distancing quite seriously.  I know France has had an uptick in juvenile cases as the teens social practices have created a ready reservoir of virus with schools being out and the general invincibility and intellectual arrogance of the average adolescent.  I think fondly of the days when I new everything before I became educated and unsure of myself.

Lastly I wanted to leave you with some of the successes we have had around the world as we come together to battle this pandemic.  Don’t forget to hit the attached link for up to date number reporting. 

Positive News: COVID-19

There have been A LOT of facts going around regarding COVID-19, and a flurry of “positive news” items to lift our spirits.
Here are a number of major victories from the Pandemic line. I’ve had my team fact-check these wins with links.

  • (1) Vaccine development: An experimental vaccine developed by Moderna Inc. began the first stage of a clinical trial on Monday, with testing on 45 healthy adults in Seattle.
  • (2) China’s new cases plummet: China has now closed down its last temporary hospital built to handle COVID-19. Not enough new cases to warrant them.
  • (3) Drugs that work: Doctors in India have successfully treated two Italian patients with COVID-19, administering a combination of drugs — principally Lopinavir and Ritonavir, alongside Oseltamivir and Chloroquine. Several are now suggesting the same medical treatment, on a case-by-case basis, globally.
  • (4) Antibodies to the rescue: Researchers at the Erasmus Medical Center claim to have found an antibody that can fend off infection by COVID-19.
  • (5) 103-year-old recovery: A 103-year-old Chinese woman has made a full recovery from COVID-19 after being treated for 6 days in Wuhan, China, becoming the oldest patient to beat the disease.
  • (6) Stores re-opening: Apple has reopened all 42 of its Apple retail stores in China.
  • (7) Test results in 2 hours: Cleveland’s MetroHealth Medical Center has developed a COVID-19 test that can now deliver results in just two hours, rather than in a matter of days.
  • (8) South Korea’s dramatic drop in new cases: After its peak of 909 newly reported COVID-19 cases on February 29th, South Korea has now seen a dramatic drop in the number of new cases reported daily
  • (9) Mortality rates inflated? Experts predict that Italy has seen a higher mortality rate of COVID-19 given its significant aging population, as well as its higher percentage of COVID-19 patients with pre-existing health conditions. This might suggest that COVID-19’s fatality rate may have been slightly more inflated than previously thought for the general population.
  • (10) Israeli vaccine development: More than 50 scientists in Israel are now working to develop a vaccine and antibody for COVID-19, having reported significant breakthroughs in understanding the biological mechanism and characteristics of the novel coronavirus.
  • (11) Full recoveries: Three patients in Maryland who tested positive for COVID-19 have now been reported to have “fully recovered.”
  • (12) Isolated virus: A network of Canadian scientists isolated the COVID-19 virus, which can now be replicated to test diagnostics, treatments, and vaccines.
  • (13) Yet another vaccine in the works: San Diego biotech company Arcturus Therapeutics is developing a COVID-19 vaccine in collaboration with Duke University and National University of Singapore.
  • (14) Treatment protocols: Seven patients who were treated for COVID-19 at Jaipur’s Sawai Man Singh (SFS) Hospital and Delhi’s Safdarjung Hospital in India have recovered. The treatment protocol will be widely scaled to other hospitals.
  • (15) Another treatment: Plasma from newly recovered COVID-19 patients (involving the harvesting of virus-fighting antibodies) holds promise for treating others infected by the virus.
  • Some of COVID-19’s hardest hit nation victims are already emerging strong after peak infection, and biomedical innovators are tackling the virus at unprecedented speeds.
  • IMPORTANT TO REMEMBER… While everyone is concerned about the super-high mortality rate of this virus — which is calculated by the “number dead” divided by “the number who have tested positive” (currently ~8,000/200,000)— the denominator, i.e. the number infected is actually VERY hard to know because so few people have been tested.
  • It may well be that 10x more are infected but subclinical. So, is the mortality rate 4% or 0.4%?
  • We will find out as large scale-testing comes reliably online.

Wishing you the best. Remember that our most important tool during times of panic and crisis is our mindset.

*Information by Peter Diamandis.com