July 16, 2020 Covid update

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There are many different therapies being looked at for Covid19. As I have discussed in past messages, three being utilized here in Tucson are Remdesivir an antiviral medication, Dexamethasone a steroid, and convalescent serum, which is essentially antibodies collected from the blood of people who have recovered from Covid 19.

However, several agents are being investigated nationally and internationally, and I have posted on this website an extensive summary of them along with the available scientific evidence. This list is from the American Society of Health Care Systems Pharmacists, who also have a website http://www.safemedication.com/ which is a good resource for general drug information as well as updates on Covid 19 therapies.

Some common medications in use have been speculated to either help lessen or prevent Covid19. Specifically, Pepcid/Famotidine was suggested as reducing the severity of Covid19 infections when used in high doses in ill patients. To date though, there is no firm evidence supporting this observation, and no proof that it can help prevent an infection. Unfortunately, this has not stopped people from buying this medication to prevent Covid19, and shortages have now developed. Due to the unavailability of alternative agents in this class (specifically Zantac/Ranitidine), patients are sometimes being switched to a less desirable class of medications for their acid reflux. Likewise, hydroxychloroquine went into short supply when that drug was touted as a preventative measure, and my arthritis patients on that medication had increased expense and difficulty getting it.

Supplies continue to remain a major issue with shortages of testing supplies now again becoming a limiting factor. While more readily available than a few months ago testing is still difficult to get, and worse, the time to get results is now 5-7 business days, making screening for asymptomatic and pre-symptomatic disease almost useless since those individuals will most likely still be out and about. This is especially noteworthy for younger individuals who are the most likely to spread the disease since their symptoms tend to be mild.

The discussion about when to reopen the schools is directly related to the inability to screen. As a parent of a school age child, I know my child is best educated in a classroom. However, until we can screen adequately, and more importantly, until we see our case numbers go down dramatically, the risk of infection to teachers, older students and the public is too high. As hard as it may be for some to imagine, our situation can get much worse.
On a positive note, one of the vaccines in development has shown tremendous promise and is now advancing to the final stage of testing. This final stage will take several months, so if everything goes as hoped it will still be early 2021 before it would be widely available.

The number of cases and deaths remain essentially unchanged from last week. We appear to have reached a plateau, with a little over 3,000 new cases each day. Things may be slowing down a little, yet the numbers will not reflect that for a few more weeks. Mask wearing and social distancing remain the mechanisms for reducing cases. While uncomfortable, there is no danger to wearing a mask for extended periods of time. Ask any surgeon or operating room nurse.

In the office we welcome a new assistant Cynthia and continue to see patients on a reduced schedule due to social distancing requirements. My next message will be in 10 days since my contact at MBS who sends out these messages will be on vacation next week. Take care.