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COVID-19 UPDATE, March 27, 2020

COVID-19 Update March 27, 2020

NEW INFORMATION

Yesterday evening the CDC published its first report on COVID-19 infections in the United States. The data is reported from a total of 4226 positive cases, 2449 of which included the age. Thus, the number of patients who have been studied is still extremely small even though as of this update the United States now leads the world in cases with 82,400. The next CDC report will likely provide significantly better data.

Here is what we know from the 2249 infected patients on whom we have age data:

  1. 6% of patients were 85 years old or greater
  2. 25% were aged 65 to 84 years
  3. 18% were aged 55 to 64 years
  4. 18% were aged 45 to 54 years
  5. 29% were aged 20 to 44 years
  6. Less than 5% of cases occurred in people 0 to 19 years of age.

Among 508 patients known to have been hospitalized:

  1. 9% of patients were 85 years old or greater
  2. 36% were aged 65 to 84 years
  3. 17% were aged 55 to 64 years
  4. 18% were aged 45 to 54 years
  5. 20% were aged 20 to 44 years
  6. Less than 1% of hospitalizations were among persons 0 to 19 years of age.

Infected patients who were less than or equal to 19 years of age were only hospitalized 2% to 3% of time, whereas those equal to or greater than 85 years of age required hospitalization 31% of the time.

The case fatality rate (the number of deaths per 100 cases) increases significantly with age. Particularly at risk are those 85 years of age and older. There were no deaths in people less than or equal to 19 years. However younger healthy people are at risk of severe disease and death as well. Persons aged 20-54 have a case fatality rate of 0.1% - 0.8% (1/1000 - 8/1000).

Based on this very limited and early data those at highest risk must avoid potential exposure to COVID-19. Measures to do so include social distancing, minimize gatherings when at all possible, practicing excellent hygiene such as washing your hands with 60 to 95% alcohol or soap and water, coughing into your elbow, the back of your forearm or a cloth, avoiding touching your face particularly after contact with another person, and disinfecting frequently touched surfaces such as sinks, counter tops, and toilets.

Caregivers of those in the high-risk categories must ensure that they have at least a 30 day supply of all necessary medications and that they continue to take those medications as prescribed. To the extent possible, they should shelter in place. Asthmatics and persons with known lung disease must make sure that they take their medications as prescribed, particularly if they are on daily medication.

The imperatives in the report are to protect the healthcare system and to protect vulnerable older adults. Avoid travel. Avoid crowds and stay home as much as possible to reduce the risk of being exposed. The entire community must work together to slow the spread of COVID-19.

LOCAL IMPACT

The second COVID-19 case in the area has been confirmed. We fully anticipate many more cases as the weeks go by. Local health authorities in partnership with hospital administrations and medical personnel are managing contacts of all cases.

At this moment in the pandemic we are learning who our enemy is. Our knowledge is growing daily. We will get on top of this infection in time. Until then we all must be smart, aware, engaged and caring. The best information is typically not on the inflammatory 24-hour news cycle of the television. The CDC, NIH and WHO are the organizations collecting and interpreting the data with greatest accuracy. Our team of practitioners will continue to post updates as information becomes available.

Our clinics remain open for well checks, participation evaluations, behavioral health care, and all sick patients with non-COVID symptoms. Please share any comments or thoughts on The Children’s Clinic of Lufkin Facebook page.

HOPE IN THE FIGHT

The first doses of the COVID-19 vaccine were administered March 16 to small group of individuals. The study is designed to test three dosage strengths. A second dose will be administered one month after the first. Two weeks afterward blood will be drawn from the subjects and analyzed for results. The manufactures of the vaccine are hopeful to have a commercial product available for healthcare professionals in the fall of this year. A vaccine for the general public may be available mid next year.

The World Health Organization announced the launch of SOLIDARITY, an unprecedented coordinated push to study thousands of patience in dozens of countries with at least four different regimens of medications. The study design is open label which means everybody knows which drug combination they’re getting. The study is extremely simple in design and should yield answers quickly.

Chloroquine and Zithromax remain a medication combination under evaluation. While some results are preliminary encouraging, particularly one study in France, there are no formal controlled studies to date. Thus, all data is anecdotal.

Testing availability is increasing daily as manufacturers produce thousands of tests.

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George Fidone, M.D., FAAP

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George Fidone, M.D., FAAP

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205 Gene Samford
Lufkin, Texas 75904
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