COVID-19 update with Dr. Benjamin Marcum

Advertisement

Myth 3: If I get COVID-19, I have to go to the hospital.

The VAST majority of patients who have COVID-19 after being infected with SARS CoV-2 will be able to recover at home.  Remember, only 19% of infected patients in New York City are getting admitted (based on one study – this number is a bit higher or lower but around 20% no matter where you look) and only 4% are going to ICU.  That means 4 out of 5 people recover successfully at home.

People who most often are hospitalized are people older than age 65, or people who have heart disease, COPD or asthma, cancer, diabetes, hypertension or other immunocompromising conditions.  For example, if a patient has rheumatoid arthritis and is taking a medication that affects the immune system like methotrexate or Humira, they are at increased risk from the infection because their immune system can’t adequately fight off the disease.  These are precisely the people we are striving to protect by following our city, county and state guidelines and only leaving our homes if we absolutely must.  

While this virus is serious enough to cause severe disease in otherwise healthy young people (people of all ages and health status have died due to COVID-19), the majority of healthy people will weather the virus at home without long term issues.  If you are diagnosed with a SARS CoV-2 infection and even if you have fever, cough, sore throat and just feel terrible, you can stay home and get better.  There are no prescription medications to help you get better.  Some news outlets have discussed Plaquinel as a possible treatment but actual statistically significant evidence that it works is lacking.  Azithromycin has also been implicated in improved outcomes but this is for people who have pneumonia at the same time as the virus.  Remember, azithromycin is an antibiotic and SARS CoV-2 is a virus.  Antibiotics kill bacteria and so are only useful in secondary bacterial pneumonia – which happens often in COVID-19 but not every time.  So you don’t necessarily need a Zpack if you are healthy enough to recover at home. 

So when should you go to the hospital?  It’s simple – when you can’t breathe.  By far the most vulnerable organs in your body when it comes to SARS CoV-2 are your lungs.  The virus uses a specific cell surface receptor that is in the lungs to enter the body.  If you can breathe normally, YOU DO NOT NEED TO GO TO THE ER.  If you can’t, then please go right away.  You also don’t have to go be tested if you develop symptoms as knowing whether you have SARS-CoV 2 or not will not change your management.  You should just behave as if you do have it and quarantine and work to prevent spread to your family members.  Speaking of which…

Myth 3.5 – If I recover at home, all my family members are doomed to become infected. 

If the person infected with SARS CoV-2 isolates themselves from their family members by quarantining in a separate room with their own bed and their own bathroom and significantly limits their exposure to their family members, it is unlikely they will spread the disease.  Remember, the vast majority of transmission happens when people touch virus laden respiratory droplets on a surface with their hands and then they touch their face.  And the vast majority of community spread happens at home.  So this is a skill me MUST ALL LEARN.  Wash your hands after touching any potentially contaminated surface – in your home or in the public.  Be constantly aware of where your hands are.  Practice not brushing your hair out of your face or scratching your nose, etc.  Using a cloth or medical mask will help you remember not to touch your face.  

The CDC has specific guidance about when you can emerge from quarantine but essentially, you can do that when you have been 3 days without a fever and your symptoms have been improving during those three days.  Certainly your primary care physician can help guide you when it comes to ending the quarantine.  

Update on Molecular testing: You may have read that a company named Abbott has created a method to do a rapid SARS CoV-2 test that will be available this week.  That is true.  What is disheartening is that the demand for the machines to do the testing and the actual test supplies are in high demand and relatively short supply.  Stephenville Medical Surgical Clinic was working on obtaining the machines for use in the fall for flu and RSV testing (multiple types of viral tests can be run through the same machine) so we are hoping that our previous desire to have the tech will put us higher on the list of locations that get machines and tests but more than likely they will be sent to higher population areas first and so we may be several weeks from a rapid SARS CoV-2 test here.  The good news is that results from Quest, the lab company we have been using, are starting to trickle in sooner, 3-4 days as opposed to upwards of 10-12 days.  

In the meantime if you have been tested and don’t have results back or if you just think you might have COVID-19, you should behave as if you do, in fact, have it and do everything in your power to not spread the disease. 
Undoubtedly we are on the precipice of one of the largest challenges we have ever faced in the Cross Timbers.  It will get worse.  The positive tests we have identified in Erath County are only the tip of the iceberg.  There are unidentified people in our community who are shedding virus as I type (through no fault of their own – this virus is highly contagious and very sneaky).  But that does not make your neighbor your enemy.  It makes them your brother or sister in arms.  We all have a responsibility, every single one of us, to do what is in our power not to spread this disease.  You don’t have to fear your neighbor.  You should encourage them.  Say hi from a distance.  Check on them.  Ask them how they are doing.  Tell them what you are doing to help slow the spread of this disease.  It’s easy to feel fear or anger or inadequacy in the face of this challenge.  We might have a tendency to want to blame someone though it is no one else’s fault.  We all have the ability to prevent the spread.  Follow the guidelines in this article and put forth by public health and government agencies and you will have made a dent in the power of this virus.  I can’t beat this virus by myself and neither can you.  But together, by separating – we can. 

1 Comment

  1. My daughter woke up this morning with a bad sore throat and she just text me and said her chest was hurting and it’s hard for her to catch her breath. She has asthma

Leave a Reply