Week 10 – coronavirus update – remdesivir, caution about hand sanitizers, should we screen everyone NOW?, thoughts in retrospect

A perspective on coronavirus testing among those without symptoms of COVID-19

As mentioned in my previous post about testing, screening the general population with nasal swabs makes no sense, particularly if you have no symptoms. If you have symptoms, then testing within the first 5 days makes good sense.

Again the antibody testing looks backwards and can tell us if you were infected with the virus.

Thinking back about my early awareness of COVID-19

I remember seeing reports around the holidays in late 2019 about a new virus in China. I did not make much of it at the time, because the SARS-Cov1 virus (the original SARS) had been limited to southeast Asia and not spread worldwide.

One of the other known coronaviruses, MERS-CoV, was a viral illness limited to the middle East and had not spread rapidly to humans beyond that region.

There was little expectation at that time of the current coronavirus mutation becoming a pandemic.

In January 2020 more leaked reports suggested that the virus was spreading in China and greatly impacting Wuhan China and had spread into Iran. First hand reports from Wuhan were published via social media platforms and not through official channels.

Then in February reports came from other countries and even Italy of spread.

It was clear then that this was going to be a big issue for the US and the rest of the world. The past events I will have to leave to the historians, but there is no question that the US was slow to respond to the evidence at hand.

In late February into March most of us were in limbo about what to do. We did not know much about the presenting symptoms. We did not have the ability to test and know what we were dealing with. We did not know how to advise our patients except to stay away from each other. We did not know how severe this epidemic was in its early phases and did not know what recommendations were necessary. The uncertainty was professionally unsettling.

We all knew that a pandemic meant that most of the world would have to become ill or vaccinated to become immune. How that would happen was unclear, because getting the illness posed a risk of dying from it. How many of us would get ill and potentially die, we did not know. Mathematical predictions at the time suggested epic proportions. Most of us waited to see the reality of what was before us.

It was a time of great confusion and uncertainty for us in the medical community, as we did not know how severe this could become. Most of the popular literature and press came from New York City. Many assumed it would be that way for the rest of us.

Only as of this writing is enough known to allow some reasonable dialogue about this disease. But there is still an immense amount to learn.

Dr. Gipson