First, let me say how proud I am that the patients in our practice are doing a spectacular job of following the pandemic precautions recommended by the CDC. I have spoken to many of you over the last three weeks and clearly, everyone is compliant to the degree that is possible. I remind seniors and those with pre-existing conditions that allowing family and friends to deliver food and supplies is prudent and NOT a violation of your independence (I know who you are and I’m asking again that you stay home).
Yes, my optimism took a hit when the task force announced a potential mortality number of up to 200,000 but, the projections have since been adjusted based on daily numbers of deaths. We have seen the projections drop every few days and today it is around 60,000. That is a huge change and as Dr. Fauci has said, we don’t have to be satisfied with that number. We can lower it even further with the mitigation procedures we have in place. Everyone needs to pitch in to help reduce the burden and risk of our hospital staff around the country. Many of them have fallen ill while heroically saving lives so we need to work together, all of us, to help them. Let me repeat, everyone should reduce potential exposures, stay at home, decline visits from family and friends, and sacrifice now to help their communities. If you are sick, DO NOT EXPOSE OTHERS to your illness.
In my previous email, I talked about the measures beyond social distancing that will help us past the pandemic. Many of these are in progress. We should be hearing soon about the clinical trials with medications and convalescent serum treatment. There are testimonials from doctors around the country that some treatments are showing positive results but, we cannot be sure yet if this is true. What we do know is that the treatment of the sickest patients in hospital ICU’s is being modified for the peculiarities of this disease. Doctors around the country are exchanging their experiences and adopting the best strategies to help patients on ventilators. Hopefully, we can save more lives now that we have more experience.
We may hear that certain treatments may work best when given prior to the need for a ventilator and not very effective once a patient requires artificial ventilation. It is also possible that certain treatments should be reserved for the sickest patients. In fact, we may learn that certain treatments should be started very early in the course of disease to be most effective, even prior to hospitalization. We don’t know yet but, we should know soon.
Unfortunately, the 15-minute test for coronavirus is not going to be available to most primary care doctors in the near term. The Abbott test requires a base unit which most of us do not have and will not receive. Those tests are appropriately going to hospitals to test patients and medical personnel. At Family Healthcare, we have started sending our tests to a different commercial lab which has a faster turn around time. So far, two patients have tested positive and I am happy to report they both recovered at home, with close monitoring.
I previously described the antibody test which can tell us if a patient has had and has recovered from the disease. FDA approval and widespread availability should happen in the next few weeks. The process of approval takes some time because we must make sure the test is accurate and reliable. This may well be the tool that helps us make decisions regarding opening the economy after the shutdown.
Regarding what to expect in Virginia- we have not reached the peak yet. That is projected to happen sometime later this month. We will not have a high peak like in New York but, questions remain about Washington, DC. The rate of infection in DC has many calling the city the next hot spot. We shall see. Of note, the death rate in Virginia remains below the projections of even the newest model. Good news!
Day to day life at this office is dramatically different from one month ago. We do video visits primarily, with rare visits for patients needing in-person care or testing. Of course, we do those visits with the appropriate precautions. We have adequate PPE and test kits and our staff is working hard and remains focused on keeping all of you healthy. Keep scheduling your follow up visits, call when you need assistance, and above all remain optimistic. You are not bothering us with your calls and we prefer to stay busy.
This pandemic will end. Many things about daily life in America may and should change but we will be OK soon. I am considering a video conference for patients interested in the latest news with an opportunity for asking questions. Let us know if you are interested.