What’s Up with this Virus, Doc?

Todd is a long term patient of mine who recently saw me on a telemedicine follow-up appointment. His usual greeting is “What’s up Doc?” This time, he added, “with this virus?” Todd and Dean are brothers, Southern gentlemen, and so-called working class. They both ask the most pertinent questions from their “gut.” I chatted with Todd in simple words, but here is what I want people to read and understand amongst all of the new information, uncertainties, confusion, media scare, and more. 

This new “novel” corona group virus began infecting humans from animal transmissions in Wuhan, China. Population density, mobility, international travel, and easy transmission via air droplet and contact turned it into a pandemic. 

This pandemic has been handled in different ways across the globe. Sweden tried keeping everything open to create a “herd” immunity. Natual infection created immunity in a large portion of the population but they paid the price with a higher mortality rate compared to other countries. Countries like South Korea and Japan, where there are cultural and geopolitical differences, measured far better than other places at the price of privacy with contact tracing. They did massive testing, isolations, and strict personal hygiene and protection by using masks and other PPE. Their results are worth noticing compared to the handling of the pandemic by places like the USA, which had poorly handled public health measures and oversight, including limited testing. 

The world has seen viral diseases under control with effective public health strategies, mass vaccination, and other measures. For example, the eradication of smallpox, controlling measles, mumps, and other diseases that once plagued our world. 

COVID-19, caused by SARS-COVI- 2, is a disease unlike others we have managed. Humanity, with its scientific advances and global attention to this pandemic, has promises of a full blast effort to develop effective vaccines and effective treatments for COVID-19. The science to understand the epidemiology of this virus is constantly evolving.

The world is awaiting how this pandemic will phase out, and so far the news has not been good, with new “hot spots”, second waves, and what poorly managed reopening efforts have shown. 

Improved personal hygiene and social distancing have shown benefits with other infections in hospital settings. As an example, our local hospital has shown a one hundred percent hand hygiene score has dramatically lowered the infection rate of another infectious disease, C. Difficile Colitis.
People are currently practicing safety measures within their judgment and are awaiting effective treatments and hope for natural immunity or vaccines protecting them in the near future. The world economy has taken a dive with lockdowns and long term effects on the economy, and the health of people is speculated to be taking a big hit. My patients are scared to go to the hospital emergency room as they feel threatened that they will get infected with COVID-19. Essential care and preventive care are suffering from being given limited access to health care for multiple reasons.
As we understand this virus better with science, ongoing clinical trials, treatments, and vaccines available, we will be near normal or at a better “new normal” hopefully soon. Meanwhile, we have to protect our most vulnerable citizens like healthcare workers, the elderly, and folks with multiple medical conditions and low immunity.

Let us not forget that with any infection, including COVID-19, the host response is very variable and some patients are doing well with minimal symptoms. The science is unknown why some healthy patients are doing poorly. Public health authorities and the CDC will have to continuously manage trustworthy and sound guidance for managing and preventing this disease.

I told Todd and Dean that a healthy lifestyle, not smoking, and having a good nutrition and exercise regimen will go long way in immune response and the ability of our body to fight this or any infection. I advised them that it is time to be smart and not be scared! 

Dean said, “I knew some of these but wanted you to tell me straight like it is, and that’s why I come to you” in his Southern drawl. Until the next time they show up to me on a video call or visit, I will be prepared for my next response to their “What’s up — Doc?”