A Glimpse of Coronavirus from the Hospital: Lessons Learned

By Benjamin Gilmer, MD, MAHEC Family Health Center at Cane Creek.

I write to you from Mission Hospital where I have been for the last 14 days on our inpatient service. You have probably been asking yourselves, on the outside, the same questions that we have been asking on the inside. By the time this article is published, we will hopefully have found ourselves on the downward slope of the peak. But we will be battling this for many months ahead.

I had an interesting conversation this week with a friend of mine, Dr. Billy Fischer, who is a critical care lung doctor at UNC and also works for the World Health Organization (WHO). He recently travelled to China, Iran and South Korea—the initial hot zones—to help them prepare to deal with Coronavirus. He reminded me that the key to stopping this pandemic is what happens on the front line, in primary care, and also at home.

As many of you know, as many as 50% of infected patients may have no symptoms at all and can spread the virus silently. This is what is so insidious about Covid’s contagious nature. The measures we are taking now to self-isolate are the most important in slowing its spread. In North Carolina, we have been doing a good job with this. Dr. Fischer reminded me that the symptoms associated with the coronavirus are wide. They can be very subtle or deadly. You can have GI symptoms, headache, mild fever, or no fever, cough, fatigue, and shortness of breath. These are all the same symptoms that anyone can have with the flu or a simple cold. Typically, Coronavirus symptoms worsen on days 5-7.

I tell you this because over the next several months, if you have any symptoms that are cold-related, you should consider that you may have contracted the virus. It is best to self-isolate for at least 7 days, or 3 days after your symptoms have resolved. You do not need to visit your doctor if you have cold-like symptoms unless you get much worse. Please call your healthcare provider if you are concerned.

Lessons learned from China and South Korea are that the greatest amount of infectious transmission happens at home and with those people who are close to you. Self-isolation is absolutely key if we are going to contain this virus.

Many people continue to ask, “when should we wear a mask?” This has been a moving target, but I would advise that if you are out at a store or around people, you should be wearing a mask. The greatest benefit of wearing one is that it decreases the spread from you to others. Remember, you can spread the virus even if you have never had any symptoms. Similarly, the most effective practice in the hospital is for all patients, as well as healthcare providers, to wear masks.

These are trying times for all of us—both inside and out of the hospital. Stress is high. Depression is real. Money is tight. Being isolated from our family and friends is saddening. We will return to what we considered normal before the pandemic, but it may take many months. This virus is not going to disappear overnight. It may rear its ugly head many more times.

I hope that everyone finds some peace in the midst of this chaos. Perhaps you will have more time with your family, your children, or even with yourself. In every tragedy, there is always an opportunity to learn something. Maybe we will be able to reimagine how we would like to structure our lives or what is truly important to us. Being so close to it in the hospital has certainly challenged me to consider how I want to live my life.

Like many other offices, we are offering telemedicine visits at MAHEC so that we can see you via a video screen or talk to you on the phone while you remain safe at home. Telemedicine allows your provider to take care of many of your complaints and symptoms as well as your medications. This is not as fun as it is in person, but it is the best we can do right now. Please be safe, and, for the short-term, please take social distancing very seriously. It is the difference between hundreds of deaths versus the thousands of deaths that have happened in New York City. We will make it to the other side.