Coronavirus questions: Sierra Vista ER doctor talks about situation in SLO County
Health officials throughout San Luis Obispo County are facing a variety of challenges in preparing for a potential wave of coronavirus patients in coming weeks.
At the forefront of the pandemic are emergency room doctors and nurses already treating people who have tested positive for COVID-19 and bracing for a potential influx of new patients. Epidemiologists are warning about the increased spread of the disease, after a steady rise of cases countywide.
Dr. Brad Knox is the vice chief of staff and the chair of the emergency department at Sierra Vista Regional Medical Center in San Luis Obispo. He is also an emergency doctor at Twin Cities Community Hospital. Both hospitals are part of the Tenet Health Central Coast system.
Via video conferencing site Zoom, Knox talked to The Tribune about COVID-19.
Q: What’s the overall situation at the hospitals now?
A: The biggest thing medical staff is going through is preparation. Right now, numbers (of patients overall) are really low. Hospitals have canceled elective surgeries. Our census in the emergency room is down by about 65% to 70%. We’re seeing far fewer patients, which has allowed us time to prepare and re-allocate resources (for a potential influx of coronavirus patients). We’ve built two separate respiratory emergency rooms in anticipation of patients. I think the general attitude is one of anticipation... We have a wonderful team. It’s all hands on deck. I think there is a little bit of apprehension. You’re in the situation right now where there’s been an offshore earthquake and you see the water fading away on the beach. You know that wave is coming. You just don’t know when it’s going to hit.
Q: Are you doing a lot of coronavirus tests? When do you give them?
A: Testing is limited. We don’t have the ability to perform this test in house. For patients who are going to be hospitalized, they are being tested, and those tests are being (sent) over to the (San Luis Obispo County) Department of Public Health. They have on average about a 48-hour turnaround time. Health care workers would also fall under that realm of tests being sent to the Department of Public Health (for administering results). From an outpatient standpoint, say my mother was having a cough and runny nose and some mild body aches, she’d call her doctor and the doctor would decide whether to order the test. If they did order it, they’d get a swab, a tube that gets stuck down the nose, which is very uncomfortable, and they’d sent it to an outpatient lab and that turnaround time is about five days. In the meantime, they’d recommend self-isolation.
Q: How can COVID-19 patients be treated?
A: Estimates are that about 80% of people who get this disease will have no symptoms or they’re going to have very mild symptoms — a sore throat, a runny nose, a cough, against maybe some body aches, some fevers. Symptoms are well managed with rest, fluids, ibuprofen, acetaminophen (such as Tylenol), as well as Dayquil, NyQuil, the usual over-the-counter cold medications. Patients that are more ill or have shortness of breath or feel they can’t catch their breath will need to go to the hospital. They may need oxygen therapies, lung therapies, or if they’re really ill and going into respiratory failure, to be on a ventilator in the (intensive care unit). The goal is to buy them time and help their bodies beat this virus with its own immune system.
Q: How careful should the public be about touching surfaces?
A: Let’s say you touched the same milk carton as someone who went to that grocery store and had coronavirus and coughed on their hand and touched the same carton. On surfaces, estimates are the virus can live anywhere up to 72 hours. Plastic and stainless steel tend to be on that side of things. On cardboard and other materials (the lifespan of the virus is) not anywhere near that long. But regardless, if you touch that same milk carton, and then you scratch your nose, or pick your teeth or whatever, and eat without washing your hands, there’s a chance you could get it. There’s also a very good chance you couldn’t. The way to mitigate that is you touch that milk carton, you get your groceries, and then when you go home — before you touch your face or blow your nose or eat your food — wash your hands. Then you won’t have the virus on your hands anymore. ... This isn’t a virus that hovers in the air for hours and hours. If you sneeze, those droplets could have the virus. But they won’t remain suspended in the air, so someone would inhale them three hours later.
Q: Are you concerned about reports of dogs and other pets getting coronavirus and potentially passing it on?
A: The best way I can put it is, my wife and I have three dogs and two cats and we’re not concerned about it all, and we’re both ER doctors. Don’t worry about that.
Q: What about folks with underlying health conditions, such as Type 1 diabetes? How cautious should they be about going outside?
A: It’s not a bad idea (to be more cautious). If they’re doing the standard things as far as keeping their distance, washing their hands, using hand sanitizers, this isn’t something that can get on your skin and into your body. Skin is one of the most important immunologic barriers we have. Our nose, our mouth, our eyes, those are the areas that have the big problems. That being said, yes, if you have comorbidities (two chronic diseases at the same time) and you have a neighbor or friend to get your groceries for you, all the better.
Q: Are non-ER and respiratory doctors being reassigned to coronavirus treatment at this point?
A: Not yet. Assuming this will hit us as we’re all preparing for it to, (the peak) hasn’t hit us yet. We’ve had people reach out, we’ve had general surgeons, general medicine and anesthesiologists, and they’re saying. “I may not have had the particular training, but I went to medical school and you can give me a crash course in what I need to know, and I can work along somebody and can divide up the workload.” We’ve seen that in other countries. We haven’t seen it here. But we have a lot of people ready to help out.
Q: When can we go back to our regular lives?
A: It’s too hard to say because we haven’t seen our instance plateau. We’ve only seen our (COVID-19 cases) increase...Once we start to see that plateau, where we’re not seeing a huge spike, we’ll have a much better idea given the traditional 10-to-14 days course of the illness and its infectious rate, then we’ll be able to say we’ll be out of the woods at x, y or z (date). But we’re not there yet.
This story was originally published March 31, 2020 at 10:01 AM.
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