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

  1. 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.
  2. 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.
  3. 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

  1. Continue to wash your hands regularly and after any possible contamination. Soap and water. Happy birthday two times through.
  2. Social distancing. No unnecessary trips to stores or public places. No large group gatherings. Get things delivered or get curbside pickup whenever possible.
  3. 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.
  4. 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.

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9 Responses to Covid-19 Brief Update for OHC Members 3.19.20

  1. Laurie ONeill says:

    My niece is a medical resident in Hartford and she and her colleagues must reusing masks while seeing patients and they are not able to test everyone who shows symptoms. My cousin in West Hartford has two sick adult children and a sick elderly mother. They were all refused testing.
    This is inexcusable.
    As is the fact that my young nephew teaches at an alternative high school with a residential component in CT and the school refuses to close.
    Again, thank you for these email updates.

    • DrKanner says:

      I agree. The testing deficit is inexcusable. I am both embarrassed for our country and really angry at the alleged leadership. We are much better than this.

  2. Tom Myers says:

    The home pregnancy test is 99% accurate (and more accurate if the person taking it has missed her period). If the COVID-19 test is as good (and we can take it as often as we like), we’d quickly have 3.3 million false positives consuming scarce clinical resources and thousands of false negatives going around spreading the disease despite having been tested.

    Tests are not a panacea.

    It’s hard to plan for a disease where the cases increase 10-fold in a week—-for a couple weeks. Yeah, you can maybe plan for one, but which one? One that requires ventilators, 21st century med-surg beds or some other scarily expensive piece of equipment. What if polio were to come back and we’d need millions of iron lungs, should we have those in reserve, too?

    We’re in the process of spending $2 trillion to save the lives of perhaps 0.1% of the US population—-$6 million per person. The average age of the people whose lives we’ll save is 80.

    And $2 trillion is just a downpayment. We’ll create a precedent and new programs that will endure forever. It’s like the TSA which has yet to catch a terrorist in nearly 20 years. It’s all brought to us by the folks who told people in the South Tower not to evacuate because they were safe.

  3. Holly Rose says:

    Dr. Kanner
    I am a former patient of Dr. Sobel. I have been impressed and highly educated by your updates. They are clear, concise and very informative. Your deep dedication to your patient’s and profession are obvious. I look forward to each update. Thanks for taking the time and thought to keep us updated with facts. I am sorry I was not able to continue with your practice. Dr. Sobel was an amazing PCP to me for almost 20 years. Thank you both for your expertise, dedication and sincere commitment to not only your patients’ but to the human race.
    With gratitude
    Holly Rose

  4. Karen Belinky says:

    my son in San Francisco has been taking his two-year-old to the park – – not the playground – – to run around in the grass. He is careful about social distancing but there are a lot of people who go there. Does the virus live for any length of time in the grass?

  5. HMB says:

    My wife and I have a wedding to attend on June 6 in Kennebunk, Maine. There likely will be at least 150 people there. We are in our 60’s. Should we attend? Should the parents of the bride postpone the wedding? When would be a safe month to postpone to?

    • DrKanner says:

      Current data and trends suggest strongly that the wedding is unlikely to take place at that time. We will be, if lucky, beginning to come out of the rapid proliferation phase of this epidemic in early June. I would expect the family to postpone the wedding ceremony, likely to the fall for safety. Certainly not before August sometime. The couple can certainly get married legally before then, since a small number of people seeing a justice of the peace can be done safely (with some forethought). Then the celebrations can follow much later. This is the time we are living in right now. Our complete federal lack of preparedness to protect us has to be remembered. This is a major fail. No one alive can recall such an awful situation. Perhaps the closest would be the polio epidemic in 1954 or so.

  6. Jennifer Collins says:

    Thank you for the updates.
    We have a dog and we have been keeping her home from dog daycare, and trying to keep her from physically greeting other dogs when we go out on walks. We have a friend who does allow her dog to play with other dogs in a park. I am wondering if it is safe to allow her to go to the dog daycare. Could she get virus on her fur by being touched by human staff or other dogs? We love this dog daycare place and want the business to survive. Is it safe to allow her to play with other dogs or be petted by humans we see on walks?

    • DrKanner says:

      I did a quick review of recent international experience, and also advice from American Veterinary Medical Association. The consensus is that dogs neither contract nor pass on Covid-19. So attendance at dog daycare should be fine. Of course do more careful hand washing after petting or caring for your own animal. However, just to complicate things, I also saw recent apparent confirmation of a case of human-to-dog transmission of Covid-19. So I’d think you should not allow passers-by who admire your gorgeous and friendly pet to actually pat them. Rather, some equivalent of air elbow bump, or perhaps a short Japanese bow, will have to suffice to acknowledge your dog.

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