Keeping up with COVID
If you’re anything like me, you probably spent a huge portion of the initial days of the lockdown watching the news like a hawk, attending multiple public health and medicine webinars, and in my case reading every medical journal articles on the matter. Needless to say, that became pretty tiresome, not only did it incite bouts of anxiety about my future, my productivity level dropped to zero. Of course, it didn't help the situation when I discovered I couldn't get the supplies I needed from my local stores.
Hospitals have struggled to keep up. Some hospitals have had to convert their ORs to makeshift ICUs. They all seem to be operating at capacity, Of course, there still aren’t enough ventilators and PPEs. Despite all of this, there is a growing debate on whether to end lockdown and resume business as normal.
I recently read an executive physician’s experience about trying to obtain PPEs for his hospital. His account seemed to resemble something you would read in a fictional spy story or in a drug scene in a movie. PPE’s being transported in vehicles being disguised as food trucks, Homeland security showing up to stop the transaction, because they were suspected of being black market traders, etc . (link to full article)
While it has been established that risk factors like obesity, diabetes, heart disease, chronic lung disease, and hypertension put patients at an increased likelihood of complications of Covid-19, it was unclear about how patients with chronic Kidney diseases would fare. Montefiore hospital released a report confirming that kidney transplant patients are very high risk due to their immunosuppression drugs and in many cases, this condition is simultaneously coupled with other co-morbidities.
Unfortunately, it has been found, although rare, that some patients have developed Guillain Barre syndrome. It is essentially a neurological syndrome caused by the patient’s antibodies attacking the myelin sheath in the peripheral nervous system. It usually presents as changes in sensation, muscle weakness,+/- tingling and tends to start from the feet and move upwards. What makes GB terrifying is its ability for the symptoms to travel upwards and to the patient's diaphragm, where they become unable to breathe for themselves. In the report, most of the patients developed the GB syndrome 1- 2 weeks after testing positive for SARS-CoV-2. Therapy for GB syndrome usually involves intravenous immune globulin (using ab to attack the patient's ab) and plasmapheresis (running the patient’s plasma through an exchange to get rid of the antibodies). More details about the report can be obtained here.
Treatment options currently being explored include Remdesivir, which works by inhibiting the SARS-CoV-2 RNA polymerases (aka machinery used for duplication). A study funded by Gilead Sciences has shown some form of clinical improvement in 68% of the 53 patients studied.
But this outcome contradicts the report from the WHO, pertaining to the first Remdesivir trial carried out by China, which apparently reported no change in clinical activity or reduction of viral load. If you are just as confused as I am at this point you are not alone. I will continue to follow up and write more on the progress we are making with treatments and vaccines.
Some courses, classes, and webinars you may find useful.
