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Coronavirus (COVD-19)

To our patient's and fellow citizens of the region, beginning on 16 March 2020 Lafayette Foundation Clinic will have the ability to screen for those experiencing suspected symptoms of the ubiquitously reported novel Coronavirus (COVID-19).

Do contact the office via telephone, email, or your patient portal for instruction PRIOR TO arrival at the clinic. We will discuss the implemented protocol at that time to prepare ourselves, as well as you, for the visit.

At the time of this writing they are 91 reported cases with 2 associated deaths. 247 tests were completed. 10 of 64 Parishes have reported cases. However, most cases are clustered in the extreme Southeastern portion of the State of Louisiana as well as the extreme Northeastern portion of the State.

Their website is updated twice daily at 9:30 a.m. and 5:30 p.m.

We must consider the wisdom of reporting to healthcare centers for every minor respiratory symptom. Given the degree of concern, and in some cases out right hysteria (where is my toilet paper for god sake?!!!), which has been raised or spawned by various entities, I believe that it is our duty to act and behave with an evenness of mind to ensure the continued safety for our fellow man.

First, at present there are no local cases and the nearest two are situated in Terrebonne Parish. Do note that Iberia Parish was removed as that person is a resident of LaFourche Parish and is being treated there.

Second, once this specific strain of respiratory virus (yes, Coronavirus belongs to the larger grouping of common Cold viruses) migrates its way across the nation we must consider the utility of sick people with minor symptoms leaving their home in search of testing. For the sake of discussion, a person with symptoms which raises concern for the diagnosis of Coronavirus will leave the isolation of their home only to intermingle with other persons who are likely UNEFFECTED. They will expose people in their travel to and from the testing site, including healthcare workers, only to be told to return home to await testing results [this scenario does not include those exhibiting severe symptoms (you can’t breathe)] who need hospitalization. Within a few days someone will tell you that you either have a “presumed positive” or you do not.

If you indeed test positive, currently there is NO universally accepted and available treatment, and you will be advised to bunker down at home for a determined duration of time.

The moral of the story is that all persons without the need for hospitalization should remain at home to begin with and utilize common sense. Wash your hands. Cover your mouth if you cough or sneeze. Behave like you were reared.

Admittedly, as alluded to above, persons with severe symptoms should report to an Emergency Department setting for evaluation and initiation of supportive care.

These measures of prevention have parallels that are also applied to the influenza virus.

CDC estimates that influenza was associated with more than 35.5 million illnesses, more than 16.5 million medical visits, 490,600 hospitalizations, and 34,200 deaths during the 2018–2019 influenza season. This burden was similar to estimated burden during the 2012–2013 influenza season.

The overall cumulative hospitalization rate was 61.6 per 100,000 population which is higher than all recent seasons at this time of year except for the 2017-18 season. Rates in children 0-4 years old and adults 18-49 years old are now the highest CDC has on record for these age groups, surpassing the rate reported during the 2009 H1N1 pandemic

I mention this because it should stop and make us ask why do we not shut down our societies with every flu season? Why are we so dismissive of influenza yet hyperacute in our preoccupation with corona? Why have I received more emails in the last 3 weeks from OPH than I have about HIV and Hepatitis C (which are of epidemic proportions in the South with “clusters of outbreak”) in the last 10 years combined?

This is absolutely not written to be dismissive but to ask for all involved to think and compare. Reflect without hysteria.

Given our current inability to gather accurate statistics in this country due to our sampling bias (only testing those who require hospitalization but for whom no cause could be identified) we look to other countries who have far and wide superseded our efforts.

Enter South Korea.

South Korea is a nation of approximately 99,720 km² and the population of an estimated 50 1. 2 million people. United States for comparison purposes is 99 times larger in land mass (9,833,517 km²) with 275. 4 million people. Despite the small size of this nation they have illustrated an aggressive screening campaign which allows us to see, perhaps, a truer mortality rate. This small nation has quickly mobilized and mustered great strength to test up to 15,000 people per day. More accurate identification of all persons affected by this virus reveals a mortality rate of a whopping…are you ready for it…. 0.6-0.7%.

In contrast, the United States at the time of this writing and has tested a total of

19, 744 specimens [CDC labs (N=3,995) and U.S. public health laboratories* (N=15,749)].

I know this was lengthy and that I likely lost most two paragraphs in but I thought it necessary. Again, keep living life and call us if you need anything!

Jason D Landry, MD, AAHIVS

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Interesting Read.

Good read....

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