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COVID Crisis Post 4: A Realistically Fearful Disease.


I do not consider myself an idealist. I am a realist, first and foremost.


And realistically, there is rightfully a lot to fear at this moment in our history.


Novel viruses like COVID-19 that get transmitted from animal to human are pathogens our immune systems have never encountered before, and therefore have never had the chance to develop any prior immunity.


And the level of contagiousness of this virus is even greater than the flu as we are experiencing. A study published in the New England Journal of Medicine found that viable COVID-19 particles lasted on steel and plastic for 48-72 hrs and cardboard for 24 hrs, but the numbers decrease rapidly over time. More concerning is their determination virus could remain airborne for up to 3 hours: https://www.nejm.org/doi/full/10.1056/NEJMc2004973


There ARE instances where a young person develops severe disease, and this terrifies many. But besides age, we as the general public know VERY little about what other risk factors these individuals may have had that predisposed them to such severe disease, as I listed in my previous post.


In addition, genetic factors could play a factor in both the young and old. Studies emerging from China suggest that for many patients who die of Covid-19, it may be their own immune system, rather than the virus itself, that deals the fatal blow.


This is called a cytokine storm.


During a cytokine storm, an excessive immune response ravages healthy lung tissue, leading to acute respiratory distress syndrome (ARDS) and multi-organ dysfunction syndrome (MODS). Untreated, cytokine storm syndrome is usually fatal. Patients in other studies who developed cytokine storm syndrome after viral triggers often possessed subtle genetic immune defects resulting in the uncontrolled immune response.


There is a LOT of information being disseminated about medicines with the potential to dramatically reduce viral load of COVID-19 or treat the most severe patients. Hydroxychloroquine (Plaquenil) +/- azithromycin. Various HIV antivirals. Possible interleukin-targeted drugs that have proven to dramatically reduce mortality from cytokine storm in other disease states and could potentially help do the same with COVID-19.


But... PLEASE be patient until we have more conclusive data. I am NOT opposed to utilizing these potential treatments in the most severe cases, but I think we need to be more careful before we start saying the entire general population should be on these meds.


Instances like people packing the beaches in Florida are pathetic. We have physicians who are treating large numbers of sick patients and then subsequently get sick as a result. In both instances, getting innoculated by a large amount of virus at once could be the reason disease spreads. But we don't know. Our focus should be on prevention and spread of disease, and we ALL need to be a part of the solution.


And... STOP LISTENING TO IDIOTIC "INFLUENCERS" ON SOCIAL MEDIA.


STOP licking toilet seats for a challenge (seriously?? 🤦🏽‍♂️🤮).


STOP trying to superheat your sinuses with blowdryers to kill the virus. Though if you think this is a cure, feel free to melt the one or two brain cells you have left 👍🏽.


STOP drinking tequila or other spirits as a cure. Only drink for "normal" reasons 👍🏽.


I hope this pandemic leads each and every one of us to start taking care of ourselves a little bit more. Quit smoking. Exercise. Eat right. Take your meds as scheduled. We can all do better, myself included.


The city's hospitals are preparing for the onslaught. Healthcare workers are scared all over the nation. Personal protective equipment is scarce, leading many people to purchase their own from outside sources or even make their own. The CDC even posted today that in a worst-case scenario, we can use scarves or bandanas when taking care of COVID-19+ patients. For serious.


Things aren't f-ed yet, but they may be getting there soon.


I've volunteered to assist wherever I can, including helping to man additional ICUs and intubating and placing lines in COVID+ or suspected patients.


Maybe I'm stupid for volunteering. Maybe deep down a part of me still doesn't believe things are as serious as they seem. Maybe I'm just overly confident in my ability to ward off this infection if I catch it, too stupid to realize that self-preservation may be the best course of action.


Or maybe, just maybe, I've found my lost idealism when it comes to medicine.


I have had many friends, family, acquaintances, and even complete strangers message me in a number of ways to thank me for doing what I do. Thanking me for risking myself for others. Asking me how I am doing. Offering to run errands for me or do anything else that could be of assistance to make things easier.


This is fucking humanity personified.


And it brings tears of appreciation to my eyes and fills my heart with hope.


Thank you, everyone. We will persevere. Together.


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