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(Another) ER Doctor's Ramblings on Coronavirus

These are polarizing times indeed! Here is one ER doctor's attempt to shed some light and a touch of reason on a confusing and hotly debated topic.

By Rocky Jedick MD, MBA · · 7 min read

INITIAL RAMBLINGS

  • My position on the pandemic continues to evolve…daily
  • Know Thyself: I was slow to take this seriously. I have high-risk tolerance. I'm an intrinsic optimist. I am not an alarmist. As consequence, I rarely over-react. But, I do occasionally 'under-react'.
  • If still on the 'liberal media conspiracy' bandwagon, you're wrong. The Magic Kingdom didn't close while trying to sort out where the aliens were at Roswell.
  • The pandemic continues to be used on both sides to score political points. This is shameful. Now is not the time to assign blame.
  • Interestingly, this invisible microscopic threat provides ALL of humankind one common adversary. A virus has no respect for national borders, race, gender, or sexual orientation. All it wants to do is replicate.

ALL THINGS VIRUS

CoV-19: Frighteningly beautiful

The World Health Organization (WHO) has owned the process of creating terminology. This virus was initially labeled novel coronavirus 2019 (nCov-19), but is now referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The actual disease this virus causes is known as COVID-19.

Mortality Risk vs infectivity

This virus is novel and uniquely dangerous due to its MODERATE mortality risk and MODERATE level of transmission. This is not the common cold. True, other coronavirus strains cause 15-30% of common colds, but they don't typically kill. This virus has real potential to kill people.

The Basics

COVID-19 is often called a respiratory disease. The virus seems to wreak havoc on humans by attaching to a tiny receptor called ACE2 found on cells in certain tissues - most abundantly in the lungs, heart and the gastrointestinal tract.

12 Feb - 16 Mar: COVID Hospitalizations, ICU admits, & Deaths in USA

SOME EPIDEMIOLOGY FOR KICKS

US Daily Deaths by COVID19

The mortality rate continues to be a moving target. The WHO initially declared a mortality rate of 3.4%. A more recent paper suggests a range of 0.25 to 3% are all plausible.

Flattening the Curve

This concept of 'flattening the curve' makes a lot of sense. Social distancing & home-quarantine can delay the impact so that the stressed healthcare infrastructure has room to breathe. It worked in China, where they are seeing almost no new cases.

Daily CoV-19 Cases in China 22 Jan - 24 Mar

MEDICAL INNOVATION & NEEDS

Wonder drug?

The other benefit of delaying disease (flattening the curve) is that later cases may enjoy novel treatments and a vaccine that are aggressively being developed in a number of labs across the planet. A number of older known treatments are being studied for COVID-19.