The Rant

I haven’t written in a few days for three reasons. Firstly I’ve been very tired, the daily work is mentally and physically draining to the point where I sort of just sit and watch life at home flow around me when I’m not at work. Secondly, I’ve had a series of impressive anxiety episodes that I’ve only come to understand now that I’ve come out the other side. I have a Fitbit (I’m not an Apple Watch person yet) and it measures heart rate, exercise, and all that. For the last week, I have had over 45 minutes of “exercise” (heart rate over 100 bpm) and I can assure you I have NOT done any cardio (I wanted to but I fell asleep). I searched the app and found that my heart rate jumped over 100 bpm when I started rounds in the morning and proceeded in fits and starts during the day. That was a bit of an insight that made it easier to realize and control. This results in enough energy to write this post. Thirdly, I have been supremely pissed off.

Idiots

I am not generally critical of fake TV “Doctors” who push diets and therapy and such (everybody needs to make a living) but over the last several days I am astonished at the behavior of two particularly influential peddlers of their own egos.

Dr. Phil (not going to write his whole name because I don’t care) went on TV and in order to gin up his “base”, stated outright that social distancing was not necessary – Jeez what a moron! I read on a popular meme that opening up social distancing because we’ve flattened the curve is like taking off the parachute because we’re slowing down. Dr. Phil, you overinflated egotist, you are a psychologist who used to be a jury profiler and have now peddle stories of nympho 13 year olds… stay in your area of expertise and don’t pretend to be physician.

Dr. Oz (OMG I hate this guy). He went on Fox News and said (he REALLY SAID THIS) that “2% mortality of the total population could die if you open schools, and that is an acceptable outcome to open the economy.” Two percent of the US population is 7 Million people. Think about it… 7 million people!

Both these charlatans went on TV to walk back their BS, likely to try and save what little credibility they have. But, mark my words, they will have shows showing “the horrors of Covid” up close. It’s red meat to these guys.

Finally the President.

OMG

“liberate your state” (?) Seriously?

I fear for my colleagues who will have to dive into the ICU’s in the Mid-West and South when these “patriots” begin filing in and needing intubation. I’m sorry, I’m too old for another round of this (AIDS, SARS, MERS, H1N1, and now Covid), I’m going to sit the next one out thank you very much.

Observations From the Inside

Let me disabuse any of my readers from the mistaken idea that life on the inside has gotten any easier.

We have many more discharges than we used to have (the hospital plays “Here comes the sun” when someone gets discharged who had Covid) but there are still many many admissions. Some of whom we can gingerly nurse along keeping them on high flow oxygen and keeping them prone (face-down) and so far what we’ve been doing seems to help them.

Most still fall into catagories of a rapid crash and intubation and mechanical ventilation or long indolent courses that may or may not improve – we don’t really know yet (it’s still developing).

The plateau is like scraping along a bumpy road in a car with no shock absorbers, it’s bumpy, uncomfortable, and potentially dangerous. Every day more and more nursing home patients just die, and our fellow health care workers are taken off the board as they get Covid.

PPE is adequate but NOT what we all learned about in school… and we make all kinds of compromises.

Everyone is tired, and the first line of expert health care workers are being burnt to a crisp. I fear what our souls and hearts will look like when this is all over. I also fear for those who have been “rushed” to graduate into this environment. They will forever know medical care as Covid, and likely suffer intellectual myopia like I did when AIDS swept through the world and Polio was still a major player.

There is too much food being donated to the hospitals (in my opinion) maybe some can go to a food bank or outreach programs to feed those who have lost work.

I truly appreciate the applause and fire trucks, but please… just take care of yourselves and stop calling us heroes and yet make more work for us.

Information

So here is what we know about drugs for Covid so far:

Hydroxychloroquine

Useless and dangerous. Just don’t.

Azithromicin

Might help to address any co-infections with bacteria. May have some immunosuppressive effect. Has the same problem of lengthening the QT interval and causing sudden cardiac death. Don’t.

Remdisivir

Works by inhibiting the enzyme that allows a virus to do its thing and attach to cellular DNA. Developed originally for Ebola. Shows really good promise in very early studies. Trials happening now. Once safe dosing worked out, will need to scale up production. Promising.

Ritonivir and Lopinavir

Ant-virals devloped for AIDS. Doesn’t work at all.

Immune System Inhibitors

Mainly IL-6 or Interleukin 6.

Trials ongoing and shows some promise. Hard to get but very promising.

Convalescent Plasma

Being given now, has to be obtained from blood of those who had disease.

Shows Promise.

Bottom Line

Until a vaccine comes along, a combination of medications may be effective, but as of now There are NO CURES and precious little in the way of treatment.

Reference:

Here’s What We Know about the Most Touted Drugs Tested for COVID-19: Scientific American Medicine 2020 by Tanya Lewis