All,
I do not want to make this political but wanted to share (briefly) my experiences treating patients with Covid-19. As you may or may not know, I’m a physician working mainly at 3 hospitals in the Bay Area as an ICU doc.
1) We aren’t as inundated as NYC but are seeing an uptick of Covid related hospitalizations.
2) I have taken care of several patients with Covid (20 or so).
3) I have taken care of hundreds/thousands of people with the Flu.
4) I could usually tell who would die from flu related complications or develop severe illness. Usually this would be dialysis/severe obstructive lung disease (COPD), immunocompromised etc/CHF.
5) At the main hospital I’ve been working at, we currently have 6-7 covid ICU patients, 5 of whom are intubated (life support). A few of these are younger (40’s) without KNOWN underlying medical problems.
6) We have several patients on the regular medical floors that are younger with viral pneumonia/pleural effusions. This is something I would rarely, if ever, see with influenza.
7) I have 2 colleagues (MDs) that required hospitalization for Covid, younger guys (40’s).
8) we are giving azithromycin+hydroxychloroquine to patients on 02/viral PNA. I haven’t seen an amazing response to these. Any benefit at this point is anecdotal, hard to tell if the ones that are stable/improving would’ve improved by themselves or if it’s the meds. We seek remdisivir from Gilead for compassionate cases for the intubated patients in the ICU. As well as perform prone ventilation and ecmo.
9) we need randomized controlled trials before we know for sure about these meds.
10) the RN’s, MDs, all staff are having to use the same mask all shift (they weren’t designed for that). Puts us at extremely high risk for contacting the virus.
11) If we get more volume of Covid (as we expect), we will not be able to effectively treat patients that would otherwise do well with supplemental 02 etc.
12) Keep social isolation, shelter in place, whatever you want to call it as long as possible to give us a fighting chance.
13) It’s very difficult coming home to a wife and 4 young kids not knowing if I am the reason why they may become sick. I wipe down my badge, throw my clothes in a bag, and wash my hands as nauseam but am pretty sure I will catch this virus soon as all it can literally take is me touching an infected keyboard and then my face. It is very disconcerting.
I’m not a politician, I understand the huge economic ramifications, but we are not out of the woods and will not be for several more weeks. I’m going on more than 24 hours of no sleep so please excuse any errors above.