Tonight will be a brief update, mainly because there is only a little good news, and it’s a bit depressing to keep reiterating the bad. Also I may have been wearing you out with the length of the last few posts.
A little modestly good news
Some news reports are indicating that hydroxychloroquine (also known as Plaquenil) may have utility to reduce the second-hand spread of Covid-19 from an infected person. There is no real information that it is of help for the infected person directly. Hydroxychloroquine is originally an antimalarial drug that was found useful in various arthritic diseases such as psoriatic arthritis. However, I cynically suspect there will immediately be a run on this somewhat uncommon drug and it will soon be hard to obtain. I am not sure in what country it is manufactured.
Briefly updating the most depressing important items
- While more testing is now becoming available, it is still difficult to obtain and slow to get results regardless of what national leadership says. We remain far behind the virus growth curve in testing. Without testing we are still flying relatively blind as to the actual number of cases and the rate of increase. We are beginning to get some drive-by testing in Boston area, but it seems like it will be several weeks more before hospitals and public health are really set up to test en masse. I hope I am unduly pessimistic.
- The number of Covid-19 cases is increasing rapidly, much more so than we can clearly document because of (1) our inadequate testing. It is almost certainly not true that the increase in reported cases results only from increased test reports. We just aren’t doing that many tests on a daily basis. We are doing perhaps several hundred a day now in Massachusetts (that may be generous) when we need thousands.
- Personal protective equipment (PPE), which is essential to protect health care personnel from infection, is in short and almost critically short supply. Health care organizations are telling their front-line clinicians to reuse their N95 masks on successive patients over many hours. That should be unthinkable. Normal hygienic practice is to discard any mask after single use! My niece is a pediatric anesthesiologist in Los Angeles. She does not have sufficient N95 respirators to protect her during her day’s surgical procedures when she is intubating children and directly exposed to their respired air. How did we arrive at this sorry state!
Taking care of yourselves matters in blocking virus
- Continue to wash your hands regularly and after any possible contamination. Soap and water. Happy birthday two times through.
- Social distancing. No unnecessary trips to stores or public places. No large group gatherings. Get things delivered or get curbside pickup whenever possible.
- Keep to your circle of relative safety for any in-person contact. That means immediate family and friends who mutually acknowledge this relationship and do not themselves mingle with others.
- Older people and especially those with significant chronic illnesses or on immunosuppressive drugs should be especially careful to avoid public mingling. If you want me to identify you, just email me if it isn’t obvious to you. If you are at such higher risk, and need food, take advantage of the new early morning food shopping at most major supermarkets (Stop & Shop is doing this, and so is Market Basket, typically before 7 a.m.).
Plan for the long haul
Yes, Spring is here, but the Covid-19 epidemic is really just starting in earnest in our country. There is most likely to be further spread (more new cases and total cases) during April and May, not resolution despite the social distancing and staying at home that we have really just begun. We clearly hope that social distancing and keeping to circles of safety, together with more testing and, we hope, some therapies becoming available, will eventually bend the curve and reduce virus spread and new cases. But to date there is almost no data point that suggests the tide is turning or is likely to turn soon. Prepare for many months of Covid-19 concern and tension.
So keep up your self care. Try to maintain your composure. Keep busy. Read some good books. Work on your picture files and get them organized the way you always promised. Go outside for a walk or a run or just to stand around. That’s perfectly safe. Gardening is safe. So is caring for fruit trees. (I actually hope to be bringing peaches to the office in August.) Life can still be enjoyed.
Let’s all keep together. We will get through this. Send me or Dr. Sobel and our staff any questions or concerns or post them in the comments here as many of you have done. We will answer within a day. Finally, I promise to stop misspelling coronavirus.