COVID-19 update with Dr. Benjamin Marcum

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Myth 6: “I need to know who tested positive and where they’ve been so I can keep myself safe.”

No, you don’t. 

First, those who have tested positive have been reminded by their primary care physicians, local health authorities and the Department of State Health Services to quarantine to prevent the spread of disease.  Their contact history has been investigated.  They have been encouraged to contact anyone they have spent a reasonable amount of time with and ask them to quarantine and watch for symptoms.  Contacts have stopped working and quarantined and, in fact, contacts of contacts have quarantined.  Many of them have come in for testing and are awaiting results before they venture outside their homes.  

Second, we have only tested perhaps 200 people in Erath County.  It is impossible to test everyone – we don’t have the supplies nor the manpower.  The medical community is dependent on those people who have symptoms or exposure to identify themselves and seek out testing.  If there are 8 known positive cases in Erath County, that is 8 out of the 150-200 people who have been tested but there are likely many more who have not identified themselves as being at risk and coming to be tested.  The implication is that there are likely many more cases of SARS CoV-2 infection in the community than we know about.  So, even if it were not an egregious violation of civil rights, knowing who has tested positive, where they work, etc. is irrelevant when there is evidence of community spread – and there is community spread in Erath County. 

Third, you already have all the knowledge you need to keep yourself safe.  I know because it has been repeated by me and almost every other health and government authority ad nauseum for weeks.  We even got a call from Stephenville ISD tonight reiterating what we must do.  It is very simple.  If you touch a surface that has potentially been contaminated, (consider every surface available to the public a potentially contaminated source) don’t touch your face before you wash your hands.  Use a 60% or more alcohol gel or wash for 20 seconds.  If you need to touch a door knob, an elevator button, a PIN keypad, wash with 60% alcohol or soap and water before you touch your face.  Better yet, try not to touch your face at all.  Wearing a surgical mask or even a bandana while in public will help you remember not to touch your face.  Also, it’s best if we avoid touching those potentially contaminated surfaces unless it’s absolutely essential – meaning only touch a PIN keypad if you have to buy groceries or gasoline but not if you want to shop for unnecessary items.  

You do not need to know who is infected.  You must assume everyone is infected.  If you behave that way, it’s the best chance you have of limiting the spread.  If you are a close contact of someone who has tested positive, you have likely already been contacted by them or the public health authority.  People who have positive tests are less of a threat to your health than those who have not been tested because you may be tempted to let your guard down.  THIS DOES NOT MEAN YOUR NEIGHBOR IS YOUR ENEMY.  It means you love them by staying 6 feet away, smiling, not shaking hands but treating them like they are experiencing the same terrible reality that you are. 

People who have tested positive for SARS CoV-2 did not become infected because of some hygienic misbehavior or inherent character flaw.  It just spreads – easily.  It’s what viruses do.  I must admit I have been surprised at the number of positive cases that resulted from some of our very first tests.  It is obvious that SARS CoV-2 was active in our community a few days before I thought possible.  Patients who I thought were very unlikely to test positive have done so.  

Yesterday I wrote about medications we might use to treat cases of COVID-19.  It’s true that we rely heavily on medicines to help us with some of our most challenging health problems.  But though I am a physician, medication is not my most important tool in fighting disease.  Doctors are many things but I believe that first, we are educators.  I swore an oath to use whatever tool I have at my disposal to promote life, health and wellbeing.  Right now my most important and most effective weapons against SARS CoV-2 are these words I have shared with you.  That is why you see me wielding them every single day.  If I can prevent one infection in the chain by teaching my fellow citizens how to avoid contamination, then I have prevented countless other infections down the line and saved a life or two (or more) in the process.  

Tomorrow I will write about the actual disease process… what happens in your body when you become infected with COVID-19.  The short explanation is that it increases entropy – chaos.  Entropy, for the non-physicists in the crowd, is a principle of thermodynamics – the universe’s natural tendency to increase disorganization.  One kinetic process triggers another and on and on until an organized system becomes chaotic and unorganized.  Our bodies are miraculously tuned, extremely complex and exquisitely organized systems.  They function as beautiful well choreographed ballets; biochemical processes weaving in and out of one another to the unique melodies written in our strands of DNA.  It must be that way for the perpetuation of digestion, respiration, thought, movement.  Viruses threaten the balance of that system through increasing inflammation while hijacking cellular machinery and biochemical pathways.  With some viruses, many people are not able to overcome the attack and ultimately die despite our efforts with interventions such as mechanical respiration, oxygen supplementation and medication.  That is why our best treatment for COVID-19 is to avoid infection in the first place.  And that is why I will continue to wield my most effective weapon against SARS CoV-2 – education. 

Be wise, be kind, be helpful.
BAM

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