Transcription:
Coronavirus

Introduction: Memorial Health System provides compassionate patient centered care with some of the most advanced technology and treatment options available in healthcare today. We proudly present Memorial Health Radio. Here's Melanie Cole.

Melanie Cole: Welcome to Memorial Health Radio. I'm Melanie Cole and today we're discussing COVID-19. Joining me is Dr. Francis Wadskier. She's an Infectious Disease Specialist with Marietta Memorial Hospital, Department of Infectious Disease. Dr. Wadskier, thank you so much for joining us with this barrage of information we're all getting in this unprecedented time that we're living in. Tell us what's the latest information on COVID-19.

Dr. Wadskier: The first thing I would like to say is that right now there's a lot that has been talked about, these models about when are we going to get a peak in number of cases and people is hearing a lot about this. And it is really important to say that every state behaves different. But what we have been able to see is that probably we're getting to the point where we're going to be in a plateau, and in these curves meaning that probably we're seeing the number of cases where we're going to seen the peak of that curve and that's something important for people to know. This is all because of what they have been doing. This is something that we're going to be like hearing every day on the news and it's important for them to know that what the community is doing, it's what's the most important part. By keeping social decency and forcing hand hygiene. Now there was a new recommendation about the mask using public and again, we cannot stress this enough, but it's important for them to know that just by wearing a mask, it doesn't mean that you need to stop social distancing because we know that where we're at right now, it's because of what people have been doing and how strict on the recommendations we have been given about social distancing that is going on right now. And it's really important for people to know that.

Host: Well thank you. It certainly is. How are you and your team evolving care for your patients right now? Some people are asymptomatic carriers. When someone comes to you and you're not sure if they're COVID-19 positive, is there testing? Tell us how you're evolving your care because we've never seen anything like this.

Dr. Wadskier: First of all, this is something that we have been working on since early in December when we knew about the out break in the city of Wuhan China and this is pretty much what we were planning for. Of course there's some things that are unexpected because this is all a new your situation and pretty challenging. But we have been evolving like in different phases. Initially we were getting ready to see a high number of cases, which we are. And then now the part comes to testing possibilities and also the management of the patients. So, of course we've had more cases not only being diagnosed with more people being to the hospital we have now like a great team that we have been working on just to have designated units where we are keeping patients either on their investigation or people who have been diagnosed already and they are getting the treatment. Those have specific units.

So the other thing that we have been evolving, it's in terms of the testing. So initially we started tests that were being sent out to the referral labs, local labs, and now we have the capability of doing the PCR testing in our facility which is the best test that we can do right now just to detect if someone is infected. And now we got to the point that we initially had an assessment clinic where we were sending only people that had symptoms with an exposure, meaning for example, traveling to a high risk area or to being in contact with someone who was positive detected already. And any family member or even a friend, if they knew about a positive contact, they would be tested. But now we're to the point where we moved to a pan of like phase two, where like two to three weeks ago it was important for us to know that exposure. But at this point we're now at the community spread level and that exposure to it's not so relevant anymore. And we are able now to test in our Physician's Care Express for whoever is presenting with either fevered or any respiratory symptoms. So that's something that we have been also hearing about. We need more testing and that's what we're getting now. Of course we don't have enough tests like we would like to just to know what's kind of like the prevalence of the disease in our community. But I think moving to these phase where we can test more people, we're going to be able to know how this disease is behaving in our community.

Host: Well, thank you for telling us about that. So as far as symptoms, because right now there's seasonal allergies and there is flu and colds and all of these other things. And now we're hearing about smell loss and taste loss. So how do we know? And if someone didn't get tested, how would they know that as well? And really what do you want them to do if they start to lose their sense of smell or taste or they develop a fever or a cough, what is the first thing they should do?

Dr. Wadskier: So the first thing I would say is that if you're having symptoms and by saying these would be either having a subjective fevered or having chills and for sending with any other respiratory symptoms, for example, a runny nose and nasal congestion or a cough. And it's again, a challenging situation, not only because of seasonal allergies, but we also we're on the phase of getting a lot of cases from flu. And that's something that we cannot really kind of like make a difference in terms of the symptoms. So that's why we have in place like 24/7 nurse triage line. So we're, we have trained nurses that they can guide people in their care pretty much if you're having these symptoms, you would be directed to either talk to your primary care physician or going to the physician's care express so you can get tested. So that's the first part. And then the other challenging situation it is that, yeah, we know that we don't know everything about these condition and there's a lot of things that have been said about having other symptoms or even having no symptoms. So we know that one of those, as you said, it's like the loss of smell and the taste.

And if you're concerned about this for sure, like we're open to that. You can call us and we can guide you. Probably it would be a situation in which we're going to consider testing because that would be part of the symptoms even though it's not something that we're used to with a respiratory virus. But probably you would meet the criteria for us to test you. And then for the people that we don't know because they are not having any symptoms, that's kind of like one of the most difficult parts because we are not to the point yet where we have enough testing to test the whole community, which we love to get to that point. But at these times, the best thing I could tell everyone, even though you're asymptomatic, remember you can be a carrier and then you can be transmitting the disease. And that's why we're encouraging, like even though they're talking about opening cities and everything, which we're going to get to that point, but just to let them know that the best thing that we can do now is just continue to be as strict as we can on social distancing. So we can continue to like having permanent curve of, and maybe even if we plateau if we continue to have the same hygiene condition, doing your hand washing, doing the social licensing, we are going to get to the point that we're going to see a decreasing number of cases.

Host: I think one of the most confusing parts for the listeners is the incubation period. How long after exposure would, you know if you had it and when you talk about those asymptomatic carriers, you know, we hear about young people being asymptomatic carriers, how long can you carry this virus without showing any symptoms?

Dr. Wadskier: Yeah. And I wish I had an answer for that, but actually there's no answer yet for that. So the disease, there's a lot of research going on right now. But unfortunately we don't have all the answers. And that's part of the things that we don't know yet. We don't know for how long a person could have been transmitted the disease before developing symptoms. We don't know for how long someone can continue to transmit the virus if they already have resolution of symptoms. And again, there's no data that we on that yet. So unfortunately, the only thing that we can continue to stress is that until we get more information about how these viruses are transmitted, the best thing that we can do is just continue to practice social distancing and make sure that if you're getting symptoms you're not sure about what's going on, just call and then probably we can guide you in. If you need to be tested, we will do it at that point.

Host: What about people with chronic conditions, Dr. Wadskier, people that might be going through cancer treatments or have diabetes or have any kind of GI issues, Crohn's disease, any of these things. What do you want them to know about not only keeping enough medication on hand for quarantine, but about needing to visit with their Doctors? Are you using telehealth? Tell us how you're using it for people that still need to see Doctors for other things.

Dr. Wadskier: Yes. So that's one of the most important parts. And kind of like one of the earliest phases that we started doing here in Marietta Memorial because we still need to deliver care to our patients. That's something that we have been emphasizing to the community. We're not delaying your care. If you need to get medical attention, we're here and if it's to the point that you need to come to the emergency room, we will take care of you. So I just want for that specific population to know that yes they are at increased risk, they get these condition and as much as they can avoid to go out and limit exposure to other people, that's the best thing they can do. You said also about the medication having enough medication, also have a plan that if they get sick they should have a plan. If there's someone who can take care of them, is there someone that they're taking care of and if they come into the hospital and need to be seen, like they need to have a clear plan in case it happens. But the other important part is that, because we don't want to delay care. I think we're now of the point where it all our clinics are offering a telehealth and we do an assessment before even scheduling people to make sure they're aware about how the system works and in case we feel like they need to be seen in person that's not something that we're going to again, delay care for our patients. We're going to make sure that we do the right assessment if we can do the management and send prescriptions for our patients, we'll do that. And I think right now this is not new telemedicine, it's not new, but it has been a great tool that we have right now just to make sure that we get cared of all our patients.

Host: So important. And as we wrap up, please give us your best advice because not only do we want to know about things like symptoms and testing and what you are doing to protect yourself and your healthcare workers and patients, if doctors do have to see them put the stress that we're all feeling seems to be a worldwide stress. Give us your best advice on how we can put this into perspective and manage our expectations. And while you're doing that, tell us what you guys are doing to protect yourselves.

Dr. Wadskier: Well, first just to let you know, what are we doing, project ourselves. The same thing. We have been going through different phases initially, like following the guidelines from the CDC and local departments of health. We have been doing that, but also as everyone knows, there's been like shortage on PPE and we're doing the best we can just to provide all the protective equipment to our staff, including doctors and nurses. And we are keeping all the protocols here just to have like the best cleaning technique and whoever needs to get care. We don't want our patients to be afraid about that. They can come and get care because we are keeping this a safe environment for them. So that's something that we really need to make sure that the community is aware about that. And the other thing is that even though there's a lot of information out there I want for people to understand that not everything you hear is true and there's still again a lot of information we need to know, but we have been trying to get updates on a weekly basis to our community and all the information we get out there.

It's because we have the data to know what we are talking about and what we have been doing. Again, most of the things we don't know yet and the best thing that we can do is just to try to keep up with the recommendations based on the information that comes available. So my message to everyone would be just keep yourself informed and just follow our updates on a weekly basis. And as soon as we know that we have more testing available, we're going to continue to develop protocols depending on the number of cases we see and depending on the supplies we have for testing. And we're just going to make sure our community safe and we're not going to stop doing that. And this is a team effort. The community needs to be doing their part and we need to be doing our part. And I think we have been doing a great job on that and we have to thank the community for all their support and just by following all the recommendations we have been making.

Host: Thank you so much, Dr. Wadskier, thank you for coming on with us today and thank you for all that you're doing to keep the community safe. It's really just absolutely amazing to me what healthcare providers are doing right now. So thank you again. For information about COVID-19 including symptoms and prevention, please visit MHsystem.org. And that wraps up this episode of Memorial Health Radio with Memorial Health System. Please remember to subscribe, rate, and review this podcast and all the other Memorial Health System podcasts. I'm Melanie Cole.