June 12, 2020 COVID19 Update

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Unfortunately, Covid 19 cases in Arizona have essentially gone off the scale. Today’s numbers show over 1,600 new cases, and we have been averaging over 1,000 new cases a day. In addition, the death rate is slowly increasing, now averaging about 30-35 new deaths a day, up from 20-30 deaths a day two weeks ago.

The hospitals are getting full and ICU beds are in short supply, especially in the Phoenix area. While no one predicts that the hospitals will get overwhelmed in the short term, the hospitals have been instructed to activate their emergency plans, indicating the seriousness of the current conditions.

These numbers were not predicted by the models being used, indicating how imprecise such tools can be at times. In addition, modelling is now not very helpful in predicting where the number of cases will go.

Currently, there is no indication Arizona will go back to the general stay at home order. However, it is recommended those at high risk for a complicated case of Covid 19 remain at home for the time being. That group includes people with underlying lung disease such as asthma and COPD, diabetics, immunocompromised individuals (such as from chemotherapy or other medications or HIV), and older individuals.

I am disheartened by the reluctance of some to wear a mask when in public. We do not have great ways to reduce the spread of Covid19, yet wearing a mask is one which works. A few weeks ago, two hair stylists in Missouri exposed 140 customers to Covid19. The stylists were wearing masks, and according to news reports, amazingly none of the customers has tested positive or come down with Covid19 two weeks after the exposure.

We now recognize that the combination of loss of smell, taste, fever, decreased appetite and diarrhea are 99% specific for COVID19. We already knew that a loss of smell was an early sign of infection.

Studies done with convalescent plasma so far remain disappointing. Convalescent plasma is when antibodies to Covid 19 are taken from people who have recovered from an infection and infused into someone with active illness. Some limitations of the studies are that most of them involved seriously ill patients, rather than those with less advanced infections. Once again time and additional study will determine if this treatment has any value.

There are several vaccines moving into phase 3 clinical trials. Phase 3 trials are the final step before a drug or vaccine can be approved for widespread use. They are the phase where the effectiveness of a treatment is determined along with evaluating additional safety issues and side effects. Many treatments never make it out of phase 3 trials. Hopefully, one of the studied vaccines will succeed.

Finally, the ongoing fires around the Tucson area have created unhealthy air quality and I do recommend avoiding outdoor exercise until the smoke has diminished. Take care.

Jeff Mayer, MD