The rapid spread of SARS-CoV-2, a novel coronavirus that emerged in late
2019, and the resulting Covid-19 disease has been declared a pandemic by the
World Health Organization.
In a short span of time, about 8-12 weeks, the disease has spread from China
across many continents to the United States. Here we have recorded the
highest number of cases and unfortunately the highest number of deaths
which continues to rise daily. Though it seems like a lifetime, these few weeks
and months have affected us in so many ways and changed our lives forever. In
addition to the death and suffering it has caused around us, it has a
tremendous impact on our social and economic well-being. It has placed an
enormous burden to our health care system. It has brought us all together in
many ways. At this momentous time, we recognize all those working
diligently to provide essential services and keep us going to sustain our daily
lives. There are many heroes working fearlessly on
the frontlines including our first responders, and all the different health care
providers- nurses, doctors and ancillary staff, who have been infected and lost
their lives fighting to save us.
As the pandemic has progressed, there are certain areas where we as health
care professionals have learned more, both from our experiences and from
medical data from our colleagues in other countries. As new information
comes in, we realize that there is so much more to the virus that we do not
know about. What physicians need to know about transmission, diagnosis, and
treatment is the subject of ongoing updates amongst doctors all over the world
including infectious disease experts.
This is truly a novel virus, that behaves so differently from previously known
viral epidemics including its incubation time, its mode of transmission and
rapid spread and its wide spectrum of clinical illness. It ranges from
asymptomatic and mild disease, to moderately illness that needs careful
management at home and in some people leads to a quick progression to severe disease with
CFID – Insight into Covid 19
increased need for oxygen therapy, hospitalizations, ICU care and ventilator
support that are associated with complications and fatality.
For those hospitalized and with more severe disease it causes significant
morbidity and the road to recovery is often prolonged and tedious. It is fraught
with the uncertainty of having developed immunity, the potential exposure
and infection of family members, caregivers and medical personnel, the
reports of testing positive after recovery about the period of infectivity and
when is it safe to return to work or to public activities.
It is an ever-changing scenario. For example, latest reports indicate that viral
shedding is most during the asymptomatic phase which may account for its
unexplained rapid community spread.
Factors that we can control in this timeline which have significantly reduced
the number of cases and flattened the curve are maintaining social distancing,
wearing masks when in public and frequent and careful hand hygiene and
cleansing measures. As we are preparing to reopen the country from stay at
home orders, we expect a resurgence of cases and it is during these times we
have to be vigilant and continue these measures that have been shown to be
effective.
Scientists and researchers across the world are racing to find a cure.
Uncertainty reamains as to the many antiviral agents and other drugs that may
play a role in the successful treatment of this disease, but we have limited data
on the actual efficacy and safety of these from published case reports from
across the globe so far .A randomized controlled study eliminates bias and
offers the best evidence of the safety and efficacy of any drug or treatment
modality to help guide us in making the right decisions. As of today, there are
numerous such trials being conducted across the United States that are in the
final phases and we do not have results from these yet but are hopeful that
the results will be available to us soon within the next few weeks.
CFID – Insight into Covid 19
As we move to the next phase in the pandemic, there are still many challenges
we face, about recognizing its varying clinical presentations and atypical
symptoms in certain patients, the avilability, types, validity and interpretation
of different modes of testing, the timing, safety and clearance to return to
work after illness and about the latest evidence on treatment options and
about convalescent plasma donation and treatment. We are understanding
more what a negative test mean, what a positive test means, how often do we
have to test and when to retest patients.
Our team of providers at CFID have the expert knowledge and clinical
experience of caring for COVID patients at home and those hospitalized with
relatively mild illness to those who are critically ill on ventilator support in the
ICU. We help manage discharged patients on their journey to recovery at home
or at rehabilitation facilities.
Currently there is a special need for the safety of our patients and there exists
a need for consultation with an infection disease specialist. With this in mind,
we have started Telemedicine visits. We are open for referral from any
provider and health care treatment facility. We are also accepting
appointments from our existing patients and are open to new patients as well
who need our help. Our goal is to provide expertise in both inpatient and
outpatient care based on the latest available information and help provide
education to all our patients during the COVID crisis.
We are confident that we will be able to navigate through this difficult time.
We all have a shared responsibility in educating ourselves to prevent the
spread of infection and in uplifting and helping others at this time of need.
Together we can make a difference!