CFID – Insight into Covid 19
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 and 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 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 remains 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.
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 availability, 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!