In the last several weeks, COVID-19 numbers have skyrocketed throughout the country, and throughout Iowa. This dramatic increase has seen our hospitals fill across the region. The issue is not just with COVID-19 patients, but our hospitals were already filling back up from the many medical problems that were put off or delayed due to COVID-19 over the spring and summer. What this means to us as a hospital system is that it becomes more challenging to transfer the critically ill patients to larger hospitals. Our neighboring critical-access hospitals are keeping an increasing number of COVID-19 patients as well. This is a very alarming trend.
I am quite proud at how BVRMC has cared for COVID-19 patients throughout this pandemic. This week we admitted our 100th COVID-19 patient to our medical floor since the pandemic began, which is significant in its own right. This doesn’t factor in the thousands of patients we have seen through the Emergency Department and clinics. The treatment and care we have been able to provide in this pandemic has truly been remarkable.
As these cases mount, we need your help to get COVID-19 under control. Please take this disease seriously. We need people to act like it could be their loved one that is critically ill and we have no ICU beds to transfer them to. We have had several super spreader events in the area stemming from funerals, weddings, birthday parties, etc. I know these events are special and it is heartbreaking to have to miss or postpone them, but it is more heartbreaking to lose someone you love because they contracted COVID-19 at one of these events.
We need people to start wearing masks anytime they are in public. I do not care about politics or government mandates; masks help stop the spread of COVID-19. No they are not absolute, nothing works 100%, but it is all about risk reduction (just like seatbelts!). Masks do not stop all the airborne virus but they do knock down the droplets that most of the virus is carried on. The fewer virus particles the less chance you have of catching the virus. Same with social distancing. The more space between you and someone with the virus, the less chance of you catching it. We pride ourselves on being polite, on being “Iowa Nice”. Masks and distancing are part of that same courteousness, and can help go a long way towards reducing the spread of COVID-19.
There seems to be about four “types” of people with COVID-19. The first is people who can spread COVID-19 and never really have any symptoms, typically young people and children. The second type are people who have very mild symptoms: mild cough, sore throat, sinus congestion, a fever or body aches for a day or two, and then feel better. These first two types really drive the spread of COVID-19 because people either do not know, or think it cannot possibly be infected. The third group is the classic COVID-19: high fevers, body aches, cough, chest pain, back pain, abdominal pain, headaches, and shortness of breath. The fourth type we see is the one that surprises many people, as they might never have a cough or congestion, but have a lot of abdominal pain, nausea, vomiting, and diarrhea. Any of these groups can have loss of taste and smell, which is the only symptom I can definitively tell people if they have they probably have COVID-19.
If you have or think you have COVID-19, the quickest testing is often through Test Iowa’s website at www.testiowa.com. We also test patients who have symptoms through the hospital as well. If you have been exposed to someone with COVID-19, it is best to wait about 5 days before being tested, as it takes some time to build enough virus load to test positive. I know that everyone wants a rapid test, we get calls about it daily. However, some of the rapid tests being offered are less reliable, and often a rapid test doesn’t change what you should be doing. If you have symptoms you need to stay home, regardless of what a test says. We frequently see patients that we are fairly certain have COVID-19 but we cannot get them to test positive. It happens. If you think you have it, make sure you are isolating away from other people as best as you can. Once you have symptoms, the biggest thing is to get lots of rest and drink lots of water and fluids with electrolytes (like Gatorade, Powerade, Propel, etc.). Tylenol and Ibuprofen help with the fevers and headaches. At this time there are no other medications that have really been shown to help people get better (though there are hopefully some in development). Eating is tough for a lot of people, as appetite seems to go away and everything tends to taste terrible. Push to eat what you can, especially protein. Ensure, Boost, or other protein supplements can help when people cannot stand to eat anything.
The biggest thing to watch for is shortness of breath. If you have COVID-19 and get mild shortness of breath, the first thing is to try laying on your stomach; it surprisingly seems to help quite a lot. Worsening shortness of breath is the biggest reason to come get evaluated. People also need to watch for dehydration, confusion, and frankly if someone is getting a lot worse they need to get evaluated. Once people are hospitalized we do have other treatments available, such as convalescent plasma (donor plasma from people that have recovered from COVID-19), Remdesivir, steroids. None of these medications are a cure, most seem to help with symptoms. There has been a lot of talk of various other medications use, and quite frankly a lot of it has entered the political arena and forgotten about the medical one. Our goal in treatment of our patients has always been the use of evidence based medicine, meaning that there are studies and trials that demonstrate the medicines and treatments we use will help our patients and not cause more harm. I assure you, we will pursue any medications or treatments that show progress in treating COVID-19.
We have made great strides to treat COVID-19, and we need everyone to do their part to stop the spread. Please AVOID LARGE GATHERINGS and DO THE FIVE:
- HANDS – Wash them often
- ELBOW – Cough into it
- FACE – Don’t touch it
- FEET – Stay more than 6 feet apart
- FEEL SICK? – STAY HOME!
Garrett Feddersen, DO
BVRMC ER/EMS Medical Director
2020 BVRMC Chief of Medical Staff