April 24, 2020

Smart People

One of the reasons I love medicine is that there is always something new to learn. I am attracted in particular to new knowledge and research done on infectious diseases, especially HIV, but also Hepatitis C, Hantavirus, and others. And now we have SARS-CoV-2 the virus that causes COVID-19 and I am in my element. It excites me and engages me to keep up with all the understanding and knowledge that is being discerned on a daily basis. This is one of the things that keeps me going. I enjoy thinking about it and trying to put it all together to make sense to me and to my patients.

I am also loving the people I work with and the approach my organization is taking to the pandemic. We have been having Town Halls frequently, where we review data and developments, and discuss approaches. These are some really smart people I work with. This evening we had presentations from the infectious disease docs about the new antibody testing from Abbot that we will start using next week. It looks pretty good for confirming someone had been infected: few false positives or negatives. Patients are already clamoring to get the test done, but we still don’t know about long term immunity. A hematologist/oncologist talked about the coagulation disorders that people are getting and how possibly to treat it. Interesting but alarming, and reassuring that these are the people taking care of the sickest people. And then a dermatologist present info about “COVID Toes”. This condition called Pernio is when the toes and/or fingers turn a dusky color when they get cold. Similar but different to Raynaud’s phenomena. We are going to start keeping track of patients we see with this- usually in children or young adults, for the study mentioned in the article. Who knew? Sort of like the anosmia symptom when people with COVID lose their sense of smell, Pernio can be a clue to COVID infection.

And I am also so happy to be in Seattle and have access to the amazing research and faculty at UW. Dr. Trevor Bedford has been running the Seattle Flu Study and sent out the first models on number of infections and how fast infections were doubling. He reviewed and retested specimens done in October through January to see if COVID was here earlier than thought. He did not find it, which supports that COVID did not get here until January. And UW has put together this great resource that shows treatments, clinical trials, and education. It will keep getting better as our knowledge grows.

The more we know the better we will all do. We are in this together.

Wash your hands.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://covid.idea.medicine.uw.edu

https://www.washingtonpost.com/health/2020/04/22/coronavirus-blood-clots/

https://www.silive.com/coronavirus/2020/04/coronavirus-symptom-in-children-dubbed-covid-toes-seen-more-frequently-in-us.html

https://www.healio.com/dermatology/dermatitis/news/online/%7B1f54025b-e860-4862-979d-46daebae6818%7D/dermatology-expert-weighs-in-on-covid-toes-tracking-dermatologic-symptoms-of-covid-19

https://threadreaderapp.com/thread/1249414291297464321.html

https://time.com/5826136/mild-coronavirus-infection-advice/