March 10, 2020

Getting real

Today was a day of routine visits, a full schedule, no cancellations, but plenty of My Chart messages full of concern. The nurses are busy on the phones, reassuring and deciding who should stay home, who should go to the Acute Respiratory Clinic, and who needed to go to the hospital. Then came news of positive tests in patients at the acute clinic who did no have the most commonly described symptom of fever. Fever has been the one screening question, besides coughing, that we have depended on as a symptom of COVID-19. Suddenly our protocols have shifted again. We are learning every day.

But still most of the tests were negative and the results are coming back after 24 hours, speedy compared to last week when it took 2-3 days. And testing is ramping up in numbers, which is good because demand is about to sky rocket. Today we also got the dreaded news that at least 10 nursing homes in King County have a case of confirmed COVID-19. This has the potential to be devastating. As expected there was a big increase in positive results in our community which will continue to escalate. The curve is climbing. We could spend time analyzing what went wrong, but that is not what I want to focus on. Flattening the curve and decreasing transmission is vital, and we all must help with that. And we hear about cases in more states, and each state’s response, which varies. Some faster to isolate and cancel events than others. We are learning more about transmission and “incubation” time which is the time after exposure it takes to show symptoms. And I have seen many different posts on Facebook and others, some with good info and others not so good, and others inflammatory and panic driven. Please be careful about your sources, even me!

The theme today is that this is real and the situation is escalating and we all need to be part of the solution by paying attention, washing our hands, social distancing (but not social isolation).

But there is some good information out there that can help us understand and help us stay safe. Knowledge is powerful and I encourage you to read some of the links that I have listed below. I am in awe of how fast science has analyzed the genome, made viable and reliable tests, identified a potential vaccine, and already some medication possibilities that are in clinical trials already. It is just about two months ago the virus was even identified as a problem. This is astonishing and hopeful. But we need to slow the rate of transmissions down. We don’t want to overwhelm the health care system, we want to flatten the curve. That is the job of all of us, COVID-19 is here to stay for the time being and will disrupt our lives and our livelihoods. Hopefully, all of our loved ones will survive. Just keep 3 feet away from each other and please 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.

Links:

Make your own hand sanitizer:

https://www.ncbi.nlm.nih.gov/books/NBK144054/

World Healthcare Organization:

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

Info cartoon from Singapore, which was able to flatten their curve:

https://designyoutrust.com/2020/03/singaporean-artist-creates-useful-infocomics-about-covid-19-and-how-to-exercise-precaution/

Johns Hopkins database of infections that updates regularly:

https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

King County Health Department information and advice:

https://www.kingcounty.gov/depts/health/communicable-diseases/disease-control/novel-coronavirus/protection.aspx

The Internet Book of Critical Care has compiled some info on COVID-19 https://emcrit.org/ibcc/COVID19/