A Physician’s Point of View: COVID-19 Abounds: Every patient I have seen has the virus
It is my third day back at work after recovering from COVID-19. (Thank you for all who have inquired about my health.) It helps so much to be able to tell patients that I have been through COVID-19 myself. There is an instant identification with that person, and I am more engaged with the questions raised.
Recently I have read that half of all COVID-19 infections are spread by those who do not know they have the virus. For each person we see who tests positive, there are most likely 8 people out there who are positive but did not get tested.
I did not get COVID-19 at work, but rather caught it from an outside, close contact. This instills the importance of all the precautions we take at work.
Monoclonal Antibody Treatments
I have sent many patients with COVID-19 for mononclonal antibody treatments to help reduce complexities and severe illness. The data for Bamlanivimab states a reduction from 9-10% to 3% for hospitalization or emergency room visits for at-risk patients who receive the treatment within 10 days from onset of symptoms. I also have heard that it works best if patients receive the treatment the first several days of contracting the virus. I don’t know how realistic this is for most of our patients. I imagine this is similar to giving rabies and hepatitis B immunoglobulins, the sooner the better. The official statement published after the FDA emergency approval also says that Bamlanivimab should not be denied to pregnant patients.
Pregnancy and COVID-19
I summarized what is known about pregnancy and COVID-19 to a patient last week; she was COVID positive and 3 months pregnant. Her symptoms were not severe. I recommended she speak to her OB to see if they recommended Bamlanivimab.
In general, most women who are infected with COVID during pregnancy do just fine from results of research. However, those who become sick can have a harder time in some cases, especially later in pregnancy. This is typical of most respiratory diseases during pregnancy, including the flu. The immune system has to be “turned down” to safely carry a baby. Pregnant women should take extra precautions to avoid getting COVID-19.
Mild cases of COVID-19 have higher rate of loss of taste and smell
Interesting that in mild-to-moderate cases of COVID-19, the chance of losing taste and smell is around 80%. In more severe cases, there is less of a chance. The theory is that there is more IgA in the mucosa to stop the progress of COVID, which then takes out the cells that allow for taste and smell.
The aftermath of this “battle” knocks out the support cells that help us smell and taste. If experiencing loss of taste or smell, it could mean patient is having a milder case, not a more serious one. This could be reassuring for patients who have this symptom. Just a thought, not a definite.
You have certainly heard about the more infectious strains of COVID-19 that have been popping up. It is normal for viruses to mutate to more infectious forms because those are the ones that survive better, much like a mountain climber who learns where the safe foot and handholds are with repeated climbs. Apparently, the virus’s spike proteins have an “on and off” position. The mutations that are being seen allow the spike to be “open” longer.
These strains are not causing greater severity in symptoms but could cause more problems due to the fast growth in numbers of infections over a shorter period of time. Even if only a small percentage of people are going to the hospital, the faster growth in overall infections could fill spaces quickly.
The good news is that the COVID-19 mutations will be covered by the COVID-19 vaccines.
And, ending with just a small thing. I started asking “how are you today?” as my opening line when calling patients who are receiving a curbside COVID-19 rapid antigen test. The extra 5 seconds and the pause to listen is huge. It adds a really important human element that makes a big difference in the height of a pandemic.