A Modern History Lesson

A Modern History Lesson

(Editor’s Note: While Dr. Grossman is not specifically talking about chronic pain issues, she is discussing the current COVID-19 crisis. Those of us who are wary of the Covid-19 issue, will find this valuable. She promises more writing about our specific issue going forward. In the meantime, enjoy and comment)

A century ago, New York was ravaged by the Spanish Flu pandemic. In a little over a month it went through the city like wildfire – the number of sick people surged and the death count was nearly 500 per day. Dr. Royal S. Copeland, the city health commissioner, attacked the virus by treating the infected and protecting the well. This involved isolation and containment.

Those with moderate symptoms were self-quarantined at home and the seriously ill were sent to hospitals. This protected the general population from the sick. Unfortunately, the sheer numbers of Spanish Flu patients on the wards did not allow protection of non-infected hospital patients. Fortunately, Dr. Copeland and his team recognized this and began using gymnasiums and similar facilities as makeshift wards. And to contain the virus, they shut the city down, allowing for essential services only.

Dr. Traci Grossman

Most of our leaders have done an admirable job working to contain the Coronavirus by closing schools, restaurants, and other places we congregate. But we need a stronger approach to isolate those who are ill or those who have been exposed but not sick yet, from healthy residents.

Protecting the uninfected is not just about testing. There were no tests available a century ago and there still are not enough test kits available today to adequately determine how far the virus has spread. I am arguing, that doesn’t matter.

We can’t make decisions in the medical community based on what we don’t have. We can, however, decide to mobilize and utilize the resources we do have. With a limited number of test kits and a limited amount of protective gear, we must be smarter.

A Fever Center is a designated facility where symptomatic people and those exposed to the virus can go to be tested, treated and monitored for 72 hours. More protective gear and the potentially ill and contagious patients should be sent to these Fever Centers.

Right now, people are encouraged to go to ANY health facility in search of testing and help. This is taxing our present medical care systems. Any patient in any ER/ Urgent Care must now be considered sick or contagious with Covid-19, because of this. It doesn’t matter if they presented for a broken leg or laceration, they will probably be exposed and most will eventually fall ill. Thus, protective gear for health care providers are dwindling and the risk of virus spread is equal in every facility.

But if patients, concerned they have Covid-19, are seen and evaluated at designated Fever Centers, the overall risk to our population will reduce. These patients should all be managed away from the general population of hospitals, clinics and urgent care centers.

With Fever Centers, the overall patient load will be reduced at most of the major hospitals. Since the symptomatic patients will be directed to these specified Fever Centers, the majority of the limited supplies of test kits and protective gear can be focused there.

Consider using any designated regional medical facilities for testing and housing of these patients for 72 hours. Patients could receive necessary CT scans of the lungs, blood work and supportive care during that time. The acutely ill could be sent to a designated hospital, ensuring no single facility is overwhelmed. Then, after 72 hours, the mildly ill and otherwise exposed patients could be sent home from the Fever Center where they could isolate for 2 weeks.

In Nevada, where I live and practice, we are fortunate to be in the lowest tier in the nation of both prevalence and mortality. To maintain this standing, and “flatten the curve,” our state, and many others, need to be smarter.

China, and the other first countries who had the capability, learned quickly and segregated their resources and the sick. We need to follow suit and also take our lessons from history. The dedicated physicians and incredible nurses with little protective gear and minimal access to ventilators, halted the spread of the “Spanish Flu” in New York, and inarguably, got the health of our nation back on its feet.

The time is right now, today, to take action.

Featured image: ID 156544400 © Sachkos | Dreamstime.com

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Traci Grossman, MD

Las Vegas, NV

Traci Grossman, MD, is a physician practicing in Las Vegas. Her training in Surgery and Internal Medicine has afforded her a unique perspective on patient care. Her 25 years of experience, personally and professionally, has afforded her valuable insight on the people behind the word “patient.”

@tracigrossman

#FeverCenters

Authored by: Traci Grossman, MD

Traci Grossman, MD, is a physician practicing in Las Vegas. Her training in Surgery and Internal Medicine has afforded her a unique perspective on patient care. Her 25 years of experience, personally and professionally, has afforded her valuable insight on the people behind the word “patient.” @tracigrossman #FeverCenters

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Hello anyone reading/sharing comments here now.
Myself and many other CPP’s are grateful for Dr. Grossman’s valuable time, lending way to this informative message provided within this article.
My husband John, several years back became involved; after measurable caution was placed on,”DoomsDay” revelations. We began stocking up on essentials required for living,” Off the grid”, storing separately safely well protected with longer expiration dates than usual. Companies such as those with/ for camping , extensive traveling etc were of greater meaning and now valuable commodities.
Given this as a backdrop to today’s virus and circumstances of social distancing, its highly relevant and beneficial now for our circumstances! Being unable to run out because we need toilet paper and reaching on a counter at any store and purchasing has become an unexpected, dare I say it; LUXURY..?
In order for this virus spreading to cease, as TheDr. Points out along with bringing to the forefront how Dr. Copland had a century ago dealing with The Spanish Flu in NY; we have a more focus today on just how NOT to extend the containment time!
So let’s do these things NOW
++Everyone should be wearing facial masks- protecting even ourselves from touching our mouths, noses and lower faces ALL together regardless right now
•••We can ALL DIG Out/Up a pair of Gloves as well! – Especially while we’re carrying around & using : A N Y // A L L OF OUR
FILTHY DIRTY CASH MONEY, Plus CREDIT CARDS TOO! These items along with shelved in/on Public stores floors ITEMS.
Thought this was sent back when I opened and commented on date written!
Oh well
Everyone stay safe out there.
Physicians in need of supplies, please contact me on my cellphone (203) 330-5879. There’s some that became available through a health company ordering from both Germany, and Taiwan.

Mary Clark

A friend of my boyfriend has a daughter that has been battling multiple myeloma for over 4 years. She’s back in the hospital because she tested positive for the virus. Her husband was with her prior to being admitted, they are NOT testing him. He’s stuck in a hotel and not allowed to be with her because of this virus. I can’t imagine being so young and fighting Multiple Myeloma for so many years, their lives torn apart. Physically, emotionally and financially, my heart breaks for them and their entire family, She’s alone and has to be terrified, she has a child that she can’t see. The sadness is unbearable, that poor child wondering about “when will I see my mom” !! Totally heartbreaking 💔!!

Margaret Drumheiser

I actually agree and have said the same thing. The problem though with this virus is many sre walking around asymptomatic but dont even know they have it till exposing others . Our govenor has also tried to contain it by setting a stay at home order, closed all non essentials like restaurants, bars ,schools , work places , encouraged limited staff at places that are open , those that can work from home stay at home , and social distancing 6ft apart when having to go to store for supplies encouraging others to have 1 person per family pick up what needed . Problem many dont listen or have not taken this seriously believe it’s nothing more then the common flu. They are the ones I most worried about spreading the virus. I am immuno compromisedand a chronic pain pt so staying at home and isolating is pretty much my everyday anyhow. Also I must go to dr for my pain management wont do tela doc. Even though DEA has lax the rules some for us too do that my dr has the right too refuse and he has. But I agree having a place for those people to go that have a fever but who are not critical and test them their and monitor . My daughters boyfriend was sick with sob , and chest tight , coughing and runny nose problem couldn’t get tested he dorsnt have primary doctor all the CDC kept saying was to call your primary care dr for instructions . Well he had none so now what paid a 50 dollars for some app that did absolutely nothing for him . So finally when to smaller and older hospital they left him sit in waiting area with others they could have atleast tested him for influenza A or strep and sent home to isolate till he got results atleast if rule oyr them may then be a le yo call department of health or CDC where to get tested. They did nothing sent him home signed him off work instead of too isolate they signed him off work for only 2 days. His job threated to fire him if he didnt come him had had to go back to work never tested he does maintenance at small groc

Sonia Bodie

Absolutely spot on Dr. Grossman! It feels as though our nation needs to listen carefully and heed what the health care system, who had so few resources, put in place a century ago to halt the deadly Spanish Flu! Thank you for your very precise and timely lesson!

Alan Edwards

Why has teledoc and the 2 trillion skipped me

Very good article.Many Harvard experts say this FLU would pass more quickly if left alone allowing the body to develop antigens and other defenses without help. A carefully watched fever can kill the virus. Anecdotal reports say children get over covid19 very well
The elderly and those elderly with the virus and serious comorbidities are definitely in need of care or dearh may result. Naturally, the best masks and protective equipment are available for police, vips, and doctors. I use a welding or HEPA mask. The FDA and CDC continue taking credit for the great job and are planning more illegal torture aimed at chronics and intractables until our painful deaths. Accept Christ’s salvation before arthritis and back pain kills us.

Margie

P.s my dog is my emotioal support I went only for meds because dog cant just stop meds. Vet staff said no refill next time without visit. They said themselves nonething else can be done for my dog other than putting down. Which with meds dog will eat. So vet is forcing me to bring dog and I cant see or ask ? about what they did because their not letting people in. If theres nothing else to do for my dog why now but for money. They also went up two dollars on meds since 2 weeks ago. Vet office also were in last stage of building another building. I feel vet is being creeding by knowing I won’t let my dog go w/o meds for a fake office visit. But he will lose a customer. And I will also put it on web. I am sure alot of pet owners in my dog situation are seeing how they don’t really care about animals or me but $$. Did they ever stop & think people who have pets usually get another pet and if they treat pet/owner right during life/death pet owners always be loyal to vet. In long run he make more money.
Off subject when i had two pain doctors say they don’t have to give pain meds even if they feel its needed. Its totally what ever they chose to treat or not treat a person with any medication or even see a person. So that proves there isnt a medical oath. My family doctor office is totally closed , no teladoc them.

Margie

Here’s what I’ve seen so far grocery store clerks with gloves only no mask but young & shoulder to shoulder talking. Yes I am grateful the store open but should only have self check out , 1person to clean check outside. Only stock selves at night w/ limited staff. Vet staff have come to car get pet. But no gloves/mask. My dog has cancer needed meds. I myself had a box of gloves from past projects and 1 mask. I hardly ever throw things away but who knew theses things could save my life or others by if I am infected hopefully I won’t pass it on. I was lucky I grocery shop before the hit but stuff runs out. What about those on food stamps or very limited income who didn’t get to shop? Or the prisoners being set free or homeless. My spouse is one of millions need to file for unemployment. I grew up very poor. I was taught to hunt & fish. At least I live where that’s possible. Fish could be radioactive. I can barely get around during this time, my foot has gone numb on one side spontaneously. Don’t know if I can teladoc about that. Good luck everyone.

Thomas Wayne Kidd

Thank you for your wise and timely advice.

Cindy too

Note to Carolyn –

A few minutes ago — at about 2pm Wed — on yesterday’s column, I posted a reply to your question to me on yesterday’s column about the emergency DEA Order which allows for telehealth and phone rx’s for opioid patients..

Cindy too

This column makes so much sense.
Too much for this country.
But, I am sending the link to my governor, state surgeon general, and federal senator, and maybe more.
I may send it to others, but for now I think these 3 are the only ones who may take it seriously and act on it, or try to.

Samantha

Well Doc, I’m in the foothills of CA, less than an HOUR from Reno. Problem is… California. My entire household was really sick at the end of January. We were sent home from the local clinic’s urgent care with a dirty look and told, “why are you even here? You know it’s just the flu, just tough it out” (2 of us are immuno-compromized.) Apparently, there are tests available but… California is not testing!! There’s an increase of people getting hospitalized, no testing. Raleys Corp has only started ALLOWING their grocery store staffs to start wearing gloves ONLY, so as to “Not alarm the customers”. No testing.
NOT…GOOD…ENOUGH…