Selected Podcast
COVID-19 Update
Dr. Keith Moss gives an update on COVID-19.
Featured Speaker:
Keith Moss, MD, MA, FACP
Dr. Keith Moss was appointed to his current position in 2015. In 2013, he was appointed Vice President and Chief Medical Information Officer. After spending time in academia Dr. Moss received his medical degree from the University of Illinois College of Medicine in 1999. He completed his residency at Rush University Medical Center in 2002. Prior to his current positions, he served Riverside as Chief Medical Advisor for Information Technology. He was recognized in 2016 and 2017 as one of the nation's “Hospital and Health System CMIOs to Know” by Becker’s Hospital Review. Dr. Moss continues to practice as a general internist in Bourbonnais, Illinois and is a Fellow of the American College of Physicians. Transcription:
COVID-19 Update
Carl Maronich (Host): We are joined today by Dr. Keith Moss. Dr. Moss along with being a physician, an Internist, he also is Chief Medical Officer at Riverside Healthcare as well as Chief Medical Information Officer. Dr. Moss, thanks for being with us again.
Keith Moss, MD, MA, FACP (Guest): Thank you for having me.
Host: You were in that chair about a week ago, maybe a little more than a week ago and we talked about COVID-19 and the world has changed in a week’s time. A lot of different things have gone on. So, we wanted to bring you back and get a bit of an update as to what the more significant developments in the past week since we last talked.
Dr. Moss: Yes, I think the most important developments that have gone on are the increase in numbers of cases in America which unfortunately is significant now and in certain areas it is quite widespread. I think that the important other aspect of this is that because of those increased numbers and the fact that it is now so widespread; that new rules have been put in place for everyone. And those rules are there to make sure that people minimize their risk because again, this is a virus that we’ve really never seen before. We really have no immunity to it to speak of and we want to protect or most vulnerable patients and community members.
Host: Yeah, which are generally the elderly as we are seeing.
Dr. Moss: As a rule it is. And unfortunately, the elderly are the most at risk from this virus.
Host: Yeah, we opened a command center which we do in high intensity incidents I’ll say, and a lot of planning has gone on since that command center has been opened.
Dr. Moss: It’s our job to make sure that we prepare ourselves as best we can to make sure that we are able to handle any crisis that comes along. And this is a crisis. I won’t lie to you. It’s something where we really have to make sure that we are prepared as a hospital system to care for as many patients as we possibly can. And in doing that, what we’re doing is making sure that all of our departments are involved, that all of those departments are activating their plans and that everything goes through one central command. And that’s the reason we have a command center.
Host: Yeah so, an unprecedented time as you say, that everyone sitting in their daily life is the unprecedented steps that are being taken with reduction in crowds and doing all those kinds of things that really are going to help ultimately keep this from getting worse.
Dr. Moss: Well, here’s what I will say about that. Unfortunately, it will get worse in terms of the number of cases. What we want to do is to spread the number of cases out over a longer period of time so that you don’t have a big surge of patients who get sick all at the same time which would overwhelm the hospitals no matter how much reserve capacity they have. And so, that’s the reason for all of this that’s happening. We want to keep people from starting to get sick so that we can slow the progress of this virus and doing that means that people have to stay away from each other. They have to practice all of these things we talked about before like hand washing, like not touching your face and washing your hands after you do so. Keeping an appropriate distance from other people. All of this has been shown to help. And what we want to do is to keep things slowed down. Again, that’s the point. Because then the resources of the hospitals can stay intact and we can make sure that everybody can be cared for that needs to be cared for.
Host: Kept at a manageable level. So, Dr. Moss, let’s talk a little bit about the illness itself. Is it always going to be a severe illness?
Dr. Moss: No, actually in over 80% of the cases, it’s going to be mild in nature and will be more like a cold or maybe a mild influenza. So, most of the time, in fact a majority of the time, you won’t have a lot of symptoms and probably won’t need to see your provider for it because like when you have cold or mild symptoms, you tend to just ride that out yourself.
Host: There had been talk early on that the warm weather that is coming hopefully someday, right, is going to be helpful. Is that still the case?
Dr. Moss: Unfortunately, what’s been shown to be the case is that, that was true for influenza, this is a different kind of virus. And so, what we found out subsequently is that this is a virus more like the MERS virus from several years ago which really has no temperature dependence so people in Iran unfortunately are getting this virus and we do not expect any change with an increase in temperature.
Host: Let’s talk a little bit about testing. There’s been a lot of conversation about testing, the availability of testing, whose appropriate to be tested. Talk a little bit about what’s going on in that regard.
Dr. Moss: Right now testing is available to the sickest patients. Unfortunately, testing is not available for patients who have mild or even moderate symptoms at this moment. We’re hoping that changes quickly over time and we are doing everything we can to make sure that we can get that testing for you. The problem with that is that we only have so much available in the country itself. And so, as things get online, we will be able to get that testing material and be able to run those tests. Right now, we have to preserve our resources and do the testing only for the sickest patients who are coming into the hospital.
Host: And then as a note about that, the testing isn’t done onsite necessarily. The swabs can be taken and that part of it, but the testing needs to be sent out to a lab – labs that are doing this kind of testing.
Dr. Moss: That’s correct. They are sent our to a reference – what’s called a reference site and those sites are things like places like Mayo Clinic, Northshore, other places and the turn around time can be anywhere from two to seven days because of course of the demand for this testing now.
Host: So, to be clear on this point, not everyone who wants a test is going to get one. If a healthy person walks up and says I want to be tested, that is not going to happen.
Dr. Moss: At this point, we can’t do that.
Host: Healthcare workers, they are on the frontline of all of this. How are they keeping themselves healthy and safe and prepared for all that’s going on?
Dr. Moss: Well for those providers, we have equipment to protect them. We have gowns, masks, eye protection, and it does vary depending upon the type of patient that is and what you are doing with the patient. There are certain things where you generate a lot of really small droplets; then those providers need much more protection than those who may not be doing all of those procedures. So, we have that equipment. We are using that equipment as judiciously as possible but again, we are dealing with shortages nationwide so we are going to have to be extremely careful in terms of what we have and how we can dole it out. We want to make sure that we keep our providers as protected as possible.
Host: Sure. Resources, if someone is listening to this. I know the Riverside website certainly is keeping up to date with particularly policies around Riverside. What other resources would you recommend for folks who are trying to get the latest information?
Dr. Moss: To me, the CDC website has been excellent in terms of keeping up with different recommendations and making sure that they are keeping everybody as updated as possible on all of the things that they know about with regard to this virus and its transmission. That’s my favorite website right now. The IDPH does have significantly good resources locally as to what’s going on now in our area as well as in the state of Illinois. And again, these things are all local in nature in terms of how they spread and there has been more spread sometimes that was before people knew the precautions they needed to take. We have some idea and that’s why the governor and other state officials has decided to put in these measures which are again, we know that they are Draconian. We know that they are disruptive to our lives, but they are absolutely critical in order for us to save the people that need to be saved and that is all of us.
Host: Wow. The one thing you’d like folks to keep in mind as they are hearing this. What’s the really the one thing that suits everyone to bear in mind?
Dr. Moss: To me, I think people need to understand that this is for real. And so, these measures that we’re asking you to take, the social distancing, the hand washing, staying at home if you are sick, working from home, all of those things are absolutely critical to minimize the spread of this virus at this moment and to keep our resources so that they don’t run out.
Host: Again, all those things as you mentioned are going to help us to keep this from getting worse and it’s going to get worse as you said. Dr. Moss, thank you for joining us. All this great information. And again, I would direct folks to the Riverside website, www.riversidehealthcare.org for up to date information regarding Riverside and as Dr. Moss said the CDC website which is www.cdc.gov for other general information. Dr. Moss, thank you.
Dr. Moss: Thank you for having me.
COVID-19 Update
Carl Maronich (Host): We are joined today by Dr. Keith Moss. Dr. Moss along with being a physician, an Internist, he also is Chief Medical Officer at Riverside Healthcare as well as Chief Medical Information Officer. Dr. Moss, thanks for being with us again.
Keith Moss, MD, MA, FACP (Guest): Thank you for having me.
Host: You were in that chair about a week ago, maybe a little more than a week ago and we talked about COVID-19 and the world has changed in a week’s time. A lot of different things have gone on. So, we wanted to bring you back and get a bit of an update as to what the more significant developments in the past week since we last talked.
Dr. Moss: Yes, I think the most important developments that have gone on are the increase in numbers of cases in America which unfortunately is significant now and in certain areas it is quite widespread. I think that the important other aspect of this is that because of those increased numbers and the fact that it is now so widespread; that new rules have been put in place for everyone. And those rules are there to make sure that people minimize their risk because again, this is a virus that we’ve really never seen before. We really have no immunity to it to speak of and we want to protect or most vulnerable patients and community members.
Host: Yeah, which are generally the elderly as we are seeing.
Dr. Moss: As a rule it is. And unfortunately, the elderly are the most at risk from this virus.
Host: Yeah, we opened a command center which we do in high intensity incidents I’ll say, and a lot of planning has gone on since that command center has been opened.
Dr. Moss: It’s our job to make sure that we prepare ourselves as best we can to make sure that we are able to handle any crisis that comes along. And this is a crisis. I won’t lie to you. It’s something where we really have to make sure that we are prepared as a hospital system to care for as many patients as we possibly can. And in doing that, what we’re doing is making sure that all of our departments are involved, that all of those departments are activating their plans and that everything goes through one central command. And that’s the reason we have a command center.
Host: Yeah so, an unprecedented time as you say, that everyone sitting in their daily life is the unprecedented steps that are being taken with reduction in crowds and doing all those kinds of things that really are going to help ultimately keep this from getting worse.
Dr. Moss: Well, here’s what I will say about that. Unfortunately, it will get worse in terms of the number of cases. What we want to do is to spread the number of cases out over a longer period of time so that you don’t have a big surge of patients who get sick all at the same time which would overwhelm the hospitals no matter how much reserve capacity they have. And so, that’s the reason for all of this that’s happening. We want to keep people from starting to get sick so that we can slow the progress of this virus and doing that means that people have to stay away from each other. They have to practice all of these things we talked about before like hand washing, like not touching your face and washing your hands after you do so. Keeping an appropriate distance from other people. All of this has been shown to help. And what we want to do is to keep things slowed down. Again, that’s the point. Because then the resources of the hospitals can stay intact and we can make sure that everybody can be cared for that needs to be cared for.
Host: Kept at a manageable level. So, Dr. Moss, let’s talk a little bit about the illness itself. Is it always going to be a severe illness?
Dr. Moss: No, actually in over 80% of the cases, it’s going to be mild in nature and will be more like a cold or maybe a mild influenza. So, most of the time, in fact a majority of the time, you won’t have a lot of symptoms and probably won’t need to see your provider for it because like when you have cold or mild symptoms, you tend to just ride that out yourself.
Host: There had been talk early on that the warm weather that is coming hopefully someday, right, is going to be helpful. Is that still the case?
Dr. Moss: Unfortunately, what’s been shown to be the case is that, that was true for influenza, this is a different kind of virus. And so, what we found out subsequently is that this is a virus more like the MERS virus from several years ago which really has no temperature dependence so people in Iran unfortunately are getting this virus and we do not expect any change with an increase in temperature.
Host: Let’s talk a little bit about testing. There’s been a lot of conversation about testing, the availability of testing, whose appropriate to be tested. Talk a little bit about what’s going on in that regard.
Dr. Moss: Right now testing is available to the sickest patients. Unfortunately, testing is not available for patients who have mild or even moderate symptoms at this moment. We’re hoping that changes quickly over time and we are doing everything we can to make sure that we can get that testing for you. The problem with that is that we only have so much available in the country itself. And so, as things get online, we will be able to get that testing material and be able to run those tests. Right now, we have to preserve our resources and do the testing only for the sickest patients who are coming into the hospital.
Host: And then as a note about that, the testing isn’t done onsite necessarily. The swabs can be taken and that part of it, but the testing needs to be sent out to a lab – labs that are doing this kind of testing.
Dr. Moss: That’s correct. They are sent our to a reference – what’s called a reference site and those sites are things like places like Mayo Clinic, Northshore, other places and the turn around time can be anywhere from two to seven days because of course of the demand for this testing now.
Host: So, to be clear on this point, not everyone who wants a test is going to get one. If a healthy person walks up and says I want to be tested, that is not going to happen.
Dr. Moss: At this point, we can’t do that.
Host: Healthcare workers, they are on the frontline of all of this. How are they keeping themselves healthy and safe and prepared for all that’s going on?
Dr. Moss: Well for those providers, we have equipment to protect them. We have gowns, masks, eye protection, and it does vary depending upon the type of patient that is and what you are doing with the patient. There are certain things where you generate a lot of really small droplets; then those providers need much more protection than those who may not be doing all of those procedures. So, we have that equipment. We are using that equipment as judiciously as possible but again, we are dealing with shortages nationwide so we are going to have to be extremely careful in terms of what we have and how we can dole it out. We want to make sure that we keep our providers as protected as possible.
Host: Sure. Resources, if someone is listening to this. I know the Riverside website certainly is keeping up to date with particularly policies around Riverside. What other resources would you recommend for folks who are trying to get the latest information?
Dr. Moss: To me, the CDC website has been excellent in terms of keeping up with different recommendations and making sure that they are keeping everybody as updated as possible on all of the things that they know about with regard to this virus and its transmission. That’s my favorite website right now. The IDPH does have significantly good resources locally as to what’s going on now in our area as well as in the state of Illinois. And again, these things are all local in nature in terms of how they spread and there has been more spread sometimes that was before people knew the precautions they needed to take. We have some idea and that’s why the governor and other state officials has decided to put in these measures which are again, we know that they are Draconian. We know that they are disruptive to our lives, but they are absolutely critical in order for us to save the people that need to be saved and that is all of us.
Host: Wow. The one thing you’d like folks to keep in mind as they are hearing this. What’s the really the one thing that suits everyone to bear in mind?
Dr. Moss: To me, I think people need to understand that this is for real. And so, these measures that we’re asking you to take, the social distancing, the hand washing, staying at home if you are sick, working from home, all of those things are absolutely critical to minimize the spread of this virus at this moment and to keep our resources so that they don’t run out.
Host: Again, all those things as you mentioned are going to help us to keep this from getting worse and it’s going to get worse as you said. Dr. Moss, thank you for joining us. All this great information. And again, I would direct folks to the Riverside website, www.riversidehealthcare.org for up to date information regarding Riverside and as Dr. Moss said the CDC website which is www.cdc.gov for other general information. Dr. Moss, thank you.
Dr. Moss: Thank you for having me.