(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.
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
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.”