May 13, 2020

Pandemics are biologic

This young virus is reminding us humans of our hubris. For a while after the rise of antibiotics and vaccines, it felt like infectious diseases were mostly conquered. Small Pox eradicated, Syphilis and Strep throat treated with shots of penicillin, the silent threat of polio solved with a vaccine. Antibiotics could cure most anything and most people took them readily, even when they really didn’t need them. But then came diseases like AIDS and Ebola. Bacteria developed resistance to the overused antibiotics. Novel viruses caused outbreaks of SARS or Zika, and Lyme Disease continued spreading. Infectious Disease doctors were needed again. I am glad for that, I think they are some of the smartest and funniest people I know. I have treated and cared for many patients with infectious disease over the years and counsel people regarding travel medicine, as well. I have continued to pay attention to these issues, getting a newsletter from a Pandemic Task Force for years. We knew some sort of “emerging” infectious disease would eventually happen. This is really not shocking to many of us.

And now we have our own pandemic, still young, still unknowable. Every day new data and new stories help us know more about SARS-CoV-2 and its surprising effects on the human body. Initially it seemed that children were spared with mild symptoms, if any. But now reports are coming of a rare but disturbing syndrome in children called Pediatric Multisystem Inflammatory Syndrome. Symptoms are red eyes, enlarged lymph nodes, fever, rash, and abdominal pain, similar to a disease called Kawasaki Disease, that can cause issues with the heart and systemic inflammation. But it is not the same as Kawasaki. It can cause inflammation of blood vessels and can be dangerous if it involves the heart. It can be fatal. This new syndrome seems associated with COVID-19, even if tests for it are negative. Italy and New York have higher numbers of cases, probably because they have had higher total number of COVID-19 patients. It is treatable if diagnosed and treated with IV immunoglobulin. Important and scary developments. Now we must include the health of children when we consider opening up.

I am starting to have more of my patients in my video visits dealing with more stress, anxiety, and depression, I share with them the COVID Coach App and other resources to help. Help is available out there. This is good article about resources in Seattle.

The days are getting longer and warmer, people long to get outdoors and spend time with friends. I think we can do it reasonably safely with masks and staying 6 feet apart. Being indoors and closer are problematic. So practice safe six! (I have been waiting to say that)

Wash your hands and cover your nose.

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://www.nytimes.com/article/kawasaki-disease-coronavirus-children.html

https://www.nytimes.com/2020/05/13/health/coronavirus-children-kawasaki-pmis.html

https://www.nytimes.com/2020/05/12/nyregion/coronavirus-new-york-update.html

https://www.ptsd.va.gov/appvid/mobile/COVID_coach_app.asp

https://www.seattletimes.com/life/wellness/in-this-stressful-pandemic-era-keep-these-seattle-area-mental-health-resources-in-mind/