"I like this stuff. I really get it. People are surprised that I understand it. Every one of these doctors said, 'How do you know so much about this?' Maybe I have a natural ability. Maybe I should have done that instead of running for President."
"But as of right now and yesterday, anybody that needs a test -- that's the important thing -- and the tests are all perfect, like the letter was perfect. The transcription was perfect, right? This was not as perfect as that, but pretty good."
"They have the tests. And the tests are beautiful. Anybody that needs a test gets a test."
- President Donald Trump
dy·nam·ic
/dīˈnamik/
adjective
adjective: dynamic
1.
(of a process or system) characterized by constant change, activity, or progress.
"a dynamic economy"
The world appears to be coming to an end. At least watching the news makes you feel that way. We arrived home from traveling abroad 3 days ago to find the tip of the wave of cases appears to be cresting. The news makes you feel like the King novel ‘The Stand” is about to happen right in front of you.
As we traveled home we noticed a few more face masks than usual. Most were of the kind that would not prevent you from getting the virus. We would wait to board the plane and someone would cough and all eyes would turn that way briefly then slowly turn back and stare at your boarding pass. We were never really afraid, but you just noticed the behavior.
So I was curious when I returned what work would be like. I should explain. Even though I retired from full time practice 3 years ago, I still do a couple of Emergency Room shifts a month to stay current and have a little cash flow. I am a Board certified OB/GYN and many hospitals now employ OB’s in ‘Obstetrical Emergency Rooms’ to evaluate pregnant patients that come in for treatment. I work in one such ER.
My patients are all young and, of course, female so therefore of a lower risk group for the Covid virus. Still, one of the most common complaints pregnant patients will come to the hospital for is cold and flu symptoms. Many are anxious about taking medications they feel might harm their baby so they seek treatment and reassurance.
So the most significant symptoms for Covid are dry cough, fever, and shortness of breath. These are extraordinarily common complaints in the ER so trying to sort out who needs further evaluation is a real challenge.
When I arrived today, I checked in with the staff about any new procedures that were in place. When I left 6 weeks ago, this was not a concern, but what is the situation today? I was surprised to find out we do not have any tests available to look for Covid here. This is not just my hospital, but the same is true for the state at the moment. This may not be true for large Level 3 centers like Methodist Hospital, but I do not have that information.
All we can do is try to figure out if the patient needs isolation and even then, since most cases are reportedly mild, it is hard to justify hospital resources for such a situation. In the USA, coming to the ER is extraordinarily and criminally expensive. Just a simple evaluation can be well over $1000. It is not known at this time how expensive the Covid test is and will the patient have to pay for it?
The situation is very dynamic and changes hourly. The risk of infection, at this time, in the US remains very low. If you are concerned, the first step is to call your primary care MD so they can properly prepare to analyze you. This is the most cost effective and safest path. You should try to avoid the ER unless you are really sick or have no other options.
What if you do not have insurance? What if you have no Primary Care MD?. Then the ER is your best bet. Medicare for all is starting to sound pretty good right?
As to future traveling, we are not sure right now. We were scheduled to start Episode X in late May. As I have pointed out in an earlier post we are trying to balance being prudent vs overly cautious. I have spoken with a friend of mine who also travels extensively. He reports unless the CDC says otherwise he is going to continue to travel, take a bottle of Purell, and practice common sense. I admire his bravado and in the end we may choose the same path
Unless of course the world ends.
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