To my Patients and Friends,
Here are some of the latest COVID-19 news items.
No hyperbole here
As you most certainly have heard or read in the news, COVID-19 cases in the United States are skyrocketing. All journalistic sensationalism aside, we are in trouble. To blame: a continued disregard for scientific evidence and the experts who try their best to convey it daily at the tops of their lungs, inconsistent physical distancing and use of face masks in many populations, and the conspicuous absence of clear and consistent guidance and support at the federal level. Additionally, innumerable lives would have been saved and we may not be where we have now found ourselves but for the lack of an early, proactive national response. I acknowledge that there are political undertones here, but there’s no escaping these truths. And despite what you’ve heard from certain figures, increases in illness, hospitalizations and deaths (127,485 U.S. deaths were reported as of 11:30 PM on July 1st) are not the results of increased testing, but rather of increased transmission and actual disease.
We are facing a monumental national crisis. Here in the U.S., the daily incidence has more than doubled since June 9th. Our current daily incidence is 30% higher than our first peak on April 10th and there is no indication that it is slowing. A recent New York Times analysis indicated that 35 states have reported increased disease incidence over the last couple of weeks and at least half of these have set records for daily incidence. And we should not rest on our local laurels: although our region did very well earlier in the course of the pandemic due to our diligent physical distancing efforts, cases are popping up once again in Fairfield County as a result of graduation parties, other large social gatherings, an increased rate of travel, etc. And younger people are representing an increasing percentage of those affected, so age alone is not as reliable a determinant of risk as was once believed. This is no time to relax physical distancing measures.
This great tool provides up-to-date regional data on COVID-19 activity, and you can sign up for alerts… check it out.
Where have I been?
Over half of adults diagnosed with COVID-19 reported no known close contact with an infected individual in the preceding two weeks, according to a survey recently published in the CDC’s Morbidity and Mortality Weekly Report (MMWR). The researchers indicate that this lack of known contacts underscores a “need for increased screening, case investigation, contact tracing and isolation of infected persons during periods of community transmission,” and that “ensuring social distancing and more widespread use of cloth face coverings are warranted,” along with “enhanced measures to ensure workplace safety.”
Big brother is watching- and helping
An interesting study from the journal Lancet Infectious Diseases has provided further evidence that physical distancing can slow the spread of COVID-19. The researchers used mobile cell phone data to determine movement patterns across the country over the course of approximately four months. It was found that, where decreases in mobility (i.e., staying put) occurred for a period of 9 to 12 days, a reduced rate of COVID-19 case growth was noted.
Get the right test
A study recently published in The British Medical Journal has confirmed that existing point-of-care COVID-19 antibody tests are highly inaccurate and should not be used. These tests- often run in urgent-care or other ambulatory settings- are generally the ones that offer immediate results, versus those in which blood specimens are sent to a reference lab for processing.
On the face of it
Many have speculated that face shields can be used as alternatives to face masks. Although they can provide some protection, it is generally recommended that face masks be prioritized as the best means of protection; face shields may represent a reasonable alternative for those who cannot wear masks.
More from the experts
The Infectious Diseases Society of America (ISDA) has issued updated guidelines with respect to diagnosing COVID-19. Among their suggestions:
- Those with symptoms of COVID-19, even when mild, should be tested.
- Nasal or nasopharyngeal swabs are recommended over oral swabs or saliva tests.
- Certain patients- particularly those with cold or flulike symptoms- may be eligible to perform home-based specimen collections for testing. Preliminary data suggest that self-collection results in detection rates that are similar to those associated with clinic-based collection. Much of this will depend on the availability of home collection kits.
- Since no test is perfect, repeat testing in 1-2 days is recommended in symptomatic people when the initial test is negative.
- Testing is recommended for those who have been in contact with someone with known or suspected COVID-19. The ideal time to test is 5-7 days after the exposure.
And if you have the time, I strongly recommend watching this comprehensive review of all things COVID-19.
More on racial disparities in the age of COVID-19
As I’ve discussed in previous installments, COVID-19 disproportionately affects minority populations. Check out this insightful interview to learn more.
Here’s another brief interview featuring Dr. David Ansell from Rush University that addresses racial disparities that result from unequal distribution of resources.
According to a study recently reported in the journal Hypertension, degree of lifetime discrimination is correlated with an increased risk for high blood pressure in black adults (an established risk factor for more severe COVID-19 disease).
Finally, please take a moment to read this moving poem written by a black surgeon at Walter Reed National Military Medical Center in Bethesda, MD:
If I die tonight
For Ahmaud, for George, for Breonna
For Freddie, for Botham, for Eric, for Trayvon
For that young black girl, Dajerria, who was thrown to the ground
Kneeled on by a cop and arrested at that pool party in a bathing suit in Texas
For my grandparents whom I never knew who gave my father up for adoption
But I know dreamed of a kinder world
For my parents who taught me equality when they got none
For my wife who loved me and tried her best to understand the complexity of waking up black in America
For my three daughters to whom I taught equality but may never see it
I tried to live my life treating everyone with love, so please
Because all these degrees I have didn’t protect me from
The tidal wave of hate that crushes and erases
After I’m gone.
Marvin E. Dingle, M.D.
That’s all for this week. Be safe, be patient, be kind, and be part of the solution. And while I hope you all enjoy the upcoming holiday weekend, please remember to be safe and follow all recommended safety measures… there was a significant spike after Memorial Day due to relaxed distancing, large gatherings, etc., and we can’t afford to repeat these mistakes. I’ll see you soon!
PS- As a reminder, please don’t forget to download and use the How We Feel app.
For more information about Dr. Leibowitz’s concierge practice, please click here.