April 5 2020
Q: Hi, I hope you are well. So.... I believe (and so does my husband John) that he had COVID-19 in early February. Here are the symptoms he was experiencing:
Fever
Cough
Hallucinations
Chills
Trouble breathing
Can he be tested for COVID-19 (antibodies)? John, please add any other symptoms and any comments.
A: Hi, this is a very likely scenario, but we must remember that there are no specific symptoms, which can distinguish coronavirus infection versus infection with influenza, versus adenovirus, versus rhinovirus, versus bacterial pneumonia, versus “strep throat”! Regardless, it is irrelevant, because we know that John does have a chronic lung disease and therefore he has to be on alert at all times and taking his medication as a prayer.
I personally have to be careful as a “senior” (just kidding!), but you have nothing to worry because your youth protects you (no sarcasm)!
This is immaterial and does not warrant any discussion unless you are symptomatic!
Also, considering that both John and Joe attended ABC’s meeting in Florida in late January, and, as far as I know, John stuck around for two out of the three days and Joe stuck around for three out of the three days, they must have infected everybody else in the group. How many people got sick? I know of one with a confirmed COVID-19 infection. I will not disclose his name, but this is a somebody who definitely was there. He spent 6 days in the hospital with a moderately severe disease. His wife is on a “tail-end” of mild case of the disease. She did not seek care and did not get tested.
Joe went on to infect his wife and two kids upon his return home. All had a mild form of the disease. They did not get tested either.
Can I tell for sure that John or/and Joe had the disease?
No!
Again, I would like to repeat, it does not matter and it makes no sense to investigate, because we are not going to do anything different other than “we are not going to attend meetings, or meet anyone for coffee, or send our child to school when we are sneezing, coughing, having fever, etc”
Q: I can tell you that John passed infection to our older son, then the older son passed it to a house keeper, but neither I, no our younger son got sick. Why?
A: Any, I mean ANY, infection is associated with asymptomatic, minimally symptomatic, moderately symptomatic and a severe disease course. Nine (9) out of ten (10) COVID-19 infections are in the first three categories. I am quite confident that I was exposed to it and approximately a dozen of my patients had it.
Q: So, can we do a laboratory test to find out if we had COVID-19 infection?
A: Yes, soon. FDA granted Emergency Authorization for first rapid antibody test for COVID-19 yesterday (April 4th).
Q: Is Russia hiding true prevalence of the disease? Why Russia and some others report such low numbers?
A: No. Russia closed its land boarder with China before the USA did. Of note, it is a 2,500+ miles long land boarder, while the USA does not have any land/sea boarder. What the US did is not close “ports of entry” - airports - to Chinese.
Interestingly, Russia’s airline Aeroflot kept flying between Beijing and Moscow all this time. Russia and some other countries in the former “Soviet” sphere of influence, including China, preserved centralized system dedicated to responding to emergencies and disasters.
The key to the success is not isolation, physical distancing, masks or other PPE (personal protective equipment), but TRACING OF THE CONTACTS. The goal is to trace ALL contacts within 24-hours. This capability does not exist in most “democracies”, or to be accurate is not acknowledged by governments.
Other factors is enforcement of self-quarantine, discipline of citizens (which significantly depends on local culture), and, when it comes to responding - the competence and preparedness of everyone from top down.
It just came to me: appointments to ANY of the positions within emergency preparedness and health care systems MUST NOT be political, but only on experience and merit. These must be filled by “career” experts, not the ones who published the most or have “PC” party affiliation, etc. but the ones who have practical experience.
Would you like your money be managed by an amateur - a political appointee?