Week 2 coronavirus update

I thought I would start sending out weekly updates to provide a perspective from those of us in the trenches of medicine.

First off, please remember that if you have been directly exposed to someone who has symptoms consistent with COVID-19, you must quarantine yourself until you know if they are positive or not. Until you know, you and those who live with you must adhere to the 14-day isolation recommendation.

As most of us isolate, and we are only seeing a few urgent cases in the office, there’s lots of time to keep up with the literature, both scientific and popular press. I am sorry, but I am not much of a TV person, as I consider information from that source severely biased, and will not include that in my reviews. If you hear something on TV and have a question, please contact me.

There are 4 sources of information to please keep in mind when reading or listening to anything about COVID-19.

1. Primary information from published studies that have passed scientific and literary standards. I read a scientific paper and that constitutes me obtaining primary information. Unfortunately, only in the past 1-2 weeks have there been reputable primary source information about the course of the disease in different age groups and descriptions of the different presentations.
2. Secondary information is information I would then tell others about the primary information. This newsletter is secondary information.
3. Tertiary information is when you tell others what I said. Most of the time our conversations are sharing tertiary information or hearsay.
4. After that comes hearsay. It is the typical, “I heard someone say that someone they heard say etc., etc., etc. Most of the internet is hearsay or one person’s opinion or marketing information. One must be very critical of easy-to-come-by information from the internet.

There were a growing number of misinformation pieces this week on the internet that were based on purely theoretical considerations. I suspect these will continue as we learn more about how the virus works.

1. Some pieces have been reported to say to not take your ACE or ARB for your blood pressure or other heart conditions. This is FALSE. It is ok to continue to take your ACE or ARB if you get infected. If anything, it may help prevent heart and kidney complications. The American College of Cardiology supports continuing to take these medications as do I. Taking these medications also does not increase your risk of getting the infection.
2. Some pieces have been reported to say to not take ibuprofen or naproxen for fever or muscles or headaches as they could adversely affect your immune system or increase your risk of liver and kidney problems. This is FALSE. It is ok to continue to take ibuprofen or naproxen for muscle aches, headaches, and fevers. Theses medications do not increase your risk of getting the infections or increase your risk of getting the severe complications if you do get it.
3. There is no treatment for this condition at present. The use of malaria medications and azithromycin and other antiviral medications is based on purely theoretical considerations and has no proven basis of benefit. Although this is not misinformation, these treatments fall in the theoretical and unproven treatment categories. At best they may give one hope, at worst they may cause complications.
4. There is not a way to safely boost your immune system except by healthy eating and regular exercise. A growing number of supplement manufacturers are pushing supplements to boost your immune system and even prevent infection. These are completely unfounded statements and products.
5. A supplement manufacturer came out this week with a treatment for SARS-Co2. They are currently under FDA crackdown.

We have a limited number of tests kits in the office. Please be aware that the current iteration of tests take 3-6 days to get back and even longer if you are positive as it must be confirmed by the CDC. Currently we are testing:

1. Those with symptoms consistent with COVID-19. We now know that diarrhea is quite common, fevers and shortness of breath may not come on for several days, and the severe complications may be as late as 7-10 days after the onset of symptoms. Severe sore throats and runny and stuffy noses are still uncommon but not without having been reported by a few.
2. Those who have been directly exposed to anyone known to have tested positive.

Other general recommendations are:

1. If you are directly exposed to someone with symptoms AND they are not tested, then you MUST assume they have it and you have it and quarantine yourself for 2 weeks.
2. If #1 applies to you and you have a family, EVERYONE gets to share your 2 week quarantine.
3. Call if you need to be tested, and we will give you special instructions so to minimize exposure.

We will be starting tele-medicine visits early this coming week when we get our systems set up. Guidelines and standards have been relaxed to use programs like Facetime and other commonly used video chat programs that are not HIPPA compliant.

There are some new testing procedures available that are reported to return results in as little as 4 hours. Yet the validity and reliability of these tests is still to be seen.

The FDA has relaxed standards for bringing testing kits, vaccines, and treatments to market. This a bit of good news and bad news, where procedures and treatments are used that may provide misleading results or even harmful consequences. We will just have to see what passes through the FDA to the labs and when treatment and vaccine trials conclude and what their results show.

Remember that the best treatment is prevention and practicing diligent hand washing for 20-30 seconds after touching anything in public, thorough sterilization of all surfaces at home and work, keeping the recommended 6 feet of distance from others, frequent hand sterilization and washing, and try your best not to touch your face until after thorough hand washing or sanitization.

Yes, there are more cases and more ill with the virus. Thankfully the evolving information still shows the vast majority of people only get mild to moderate illnesses that does not lead to the need for hospitalization. Unfortunately, those over age 85 will be severely affected if they get ill, so remaining quarantined is vitally important for them.

Lastly, the safest place in the world at present is Mother Nature. Go take a walk, get some sun and fresh air.

Please email through the MDVIP or Athena portal with any questions. I am also available for text messages and phone calls.

As time goes on, I will be more succinct, but I thought sharing the sources of information was important at this time as a way to share a way of thinking about the information presented to us in print and on screen.

Dr. Gipson