March 29, 2020

Entering new territory

Today was more restful than expected. I was expecting more phone calls to patients about having COVID-19. Interesting that things are slower. The curve has flattened here, at least. Our peak is expected in about 2-3 weeks and officials are anxious and preparing. it is not over, just delayed.

In talking with the patients today, a few questions came up. One is that the test for SARS-COV-2 is not 100% sensitive. There are false negatives. The data is evolving and we don’t know the exact statistics. This patient had clear signs and symptoms on March 18 and a negative test. She never improved, got a little worse, blaming her asthma, but went in again and on 3/27 had a positive test. Fortunately she is doing better now. That negative test can give a false sense of security, which can be dangerous. Please keep this in mind.

The second question is will it make a difference when we can get results in 10 minutes, like with a rapid flu test or rapid strep test? Yes, for a host of reasons. Those tests are coming soon- we may have them in a week. We can increase capacity for testing quickly, without having to send them off to an outside lab and wait. This will give us a clearer idea of where we really stand. It will also help with follow up of patients.

The third question that came up with one patient is wondering if her children had been infected with it, too? They had similar symptoms about the same time, but no symptoms for the past week. Testing them for viral RNA would not be useful, but if we could test to see if they have antibodies, that would be helpful. And that test is coming soon! Fantastic news. The difference between the two tests is that the tests we use now tests for actual virus genetic material, the new test will be a blood test that shows antibodies, that are the proteins used for defense in our immune system. You only get those antibodies, if you have been exposed- either by infection or by vaccination. It can help people figure out if that “cold” last month was COVID-19, which will help people feel safe to go out again, it can reassure healthcare workers who can then care for the patients with less fear, sons, daughters, and grandkids can go visit the elders again. And those that are negative, know to stay sensible. This is a huge breakthrough. There are caveats and concerns about how long our immunity will last, but it is a start. The more we know, the better off we all are.

And today, also bad news, more deaths, severely ill beloveds, more infections, tough economic times for so many, and blame and anger. But along with those negatives are the beauty that is there, the kindness, the new growths, the sharing, so many working so hard to help even the least of us, and so many recognizing that we are all connected as human beings. That is what I am left with at the end of the day. Love wins.