18 March 2020 Blog Post: COVID-19 Update

It has been a bit of time since my last update. At this writing there are now 217,031 worldwide #COVID-19 cases, 8,911 deaths and 84,383 recoveries. In the United States the total number of cases is now at 8,055 with 127 deaths and 106 recoveries. As I outlined in a previous post, the US case number, while rising rapidly, is undoubtedly a significant under representation of true cases. More likely there are 40,000-80,000 true cases.

At Santa Monica Primary Care we are now in our third full day of exclusive use of telephone and video conferencing with patients. I have found the video conferencing via Facetime to be most useful in the evaluation of specific concerns.

Unfortunately, we have not had a much success in obtaining COVID-19 testing results through our commercial partner LabCorp. We began sending samples last Wednesday (one week ago) and thus far have only had two results (both negative) return. The initial 3-4 day turnaround time is now listed as 6-7 days. The lack of availability of testing and the slow turn around time will continue to be major barriers to any hope for effective containment of coronavirus in the United States.

In terms of what to expect moving forward, a recent study from the Imperial College UK evaluated the effectiveness of the following five interventions – alone and in combination:

1. Home isolation of cases – whereby those with symptoms of the disease (cough and/or fever) remain at home for 7 days following the onset of symptoms
2. Home quarantine – whereby all household members of those with symptoms of the disease remain at home for 14 days following the onset of symptoms
3. Social distancing – a broad policy that aims to reduce overall contacts that people make outside the household, school or workplace by three-quarters.
4. Social distancing of those over 70 years – as for social distancing but just for those over 70 years of age who are at highest risk of severe disease
5. Closure of schools and universities
 
By fitting the projected effects of these scenarios on available COVID-19 data, one of two scenarios occur:
 
Scenario #1: Three specific interventions (home isolation of cases, home quarantine of household members of cases and social distancing of those over 70 years) slow down but do not completely interrupt the spread of COVID-19. This would reduce the demand on the healthcare system by 66% while protecting those most at risk by reducing mortality by 50%. This pandemic would then peak over a three to four-month period during the spring/summer.
 
Scenario #2: Employing all 5 of the above intensive interventions could interrupt transmission and reduce case numbers to low levels. However, once these interventions are relaxed, case numbers are predicted to rise. While there are initially lower case numbers, there remains risk of a later epidemic in the winter months unless the interventions can be sustained.

At Santa Monica Primary Care we intend to continue our current virtual clinic stance until at least March 27th and will reassess at that time. I will be making some house calls next week (forgive the full protective gear) to perform evaluations or procedures (such as suture removal or medication delivery by injection) to those that remain in necessitated self isolation.

Also today we have begun to proactively call our patients who have been asked to self-isolate due to age or a compromised immune systems. The goal of these calls is to ensure that each patient has adequate medication supplies as well as access to medical equipment, food and any other necessities that they may be lacking. We remain available 24/7 for any concerns and Dr. Bretsky will remain on call again through this upcoming weekend at (310) 828-4411.

𝗦𝗶𝗴𝗻 𝗨𝗽 𝗳𝗼𝗿 𝗢𝘂𝗿 𝗡𝗲𝘄𝘀𝗹𝗲𝘁𝘁𝗲𝗿

Dig deeper into the health topics you care about most by signing up for our newsletter.

by submitting this form you indicate you have
read and agree to our Privacy Policy and Terms
of Use. Please contact us to for us for more
information.

Recommended Posts

No comment yet, add your voice below!


Add a Comment

Your email address will not be published.