At last, we have clear directions and unvarnished information.
- President Trump agreed to continue social distancing through the end of April and maybe beyond, guided by more data and the input of Drs. Fauci and Birx.
- Dr. Fauci predicts millions of infections and as many as 100,000 to 200,000 deaths before the pandemic winds down. Sobering news but we need to face reality.
We can only hope that as our understanding of the behavior of this virus increases, we will be able to make better decisions about what we must do as a society and as individuals.
I think the next breakthrough will be the development of an antibody test (serology), to measure antibodies in the blood. There are two uses for this:
- Serum from individuals with high antibody titers can be given to sick patients as what is called passive immunization.
- Identifying people with immunity will allow those people to forgo social distancing restrictions. We may be surprised by the number of infections that have come and gone.
THE BAD
Cases in NYC have yet to peak with the expectation that we will see many more deaths. Epidemiologists predict that there will be additional waves of critical epidemics in other cities that are lagging behind New York which is now the epicenter. New Orleans and Detroit will be flaring in the near future.
Images from Brookdale Hospital Emergency Department televised on CNN this morning graphically shows the “war zone” conditions that front-line providers are facing. As the demands on medical care increase, doctors are facing life and death decisions about discontinuing care for patients who are least likely to survive.
THE GOOD
The USN Hospital Ship “Comfort” has docked in NYC adding 1,000 beds and 1,200 personnel to our hospital capacity. It will be used to treat non-COVID-19 patients. It was quite moving to watch the ship transported by classic NYC tugboats to its berth on the Hudson, on the west side of Manhattan.
I have heard from many patients who have been diagnosed with the infection and recovered uneventfully. Included in this group are patients who have been hospitalized for pneumonia and recovered.
Mortality rates are stable at about 1.7%. Eighty percent of patients with pneumonia survive with supportive ICU care.
COPING
Deepak Chopra and Oprah have developed a free 21-day guided meditation course that can be accessed here.
Learn as much as you can about avoiding infection from reliable websites such as the CDC and the NYC Department of Health. Because information changes frequently get daily updates.
NYC Health: Coronavirus Disease 2019
The President’s Coronavirus Guidelines for America (PDF file)
MedPage Today: COVID-19 Update
Ibuprofen Update
We are still uncertain about the use of ibuprofen and NSAIDs like aspirin. Both the FDA and WHO does not recommend against the use of NSAIDs. That being said, it is important to remember that NSAIDs can cause ulcers and kidney injury and that acetaminophen within the dosing limits of 3,000 mg a day is the safest choice.
At this time, when things seem so bleak, I am optimistic that technological advances and ingenuity coupled with the awareness of the danger of a pandemic will result in an acceleration of the knowledge we need to manage microbial illness in the future.