What We Have Learned From COVID-19

When the COVID-19 pandemic arrived in McDonough County this spring, McDonough District Hospital turned to its two most experienced tenured physicians to provide the necessary clinical leadership in leading our efforts to combat the new devastating coronavirus.

Dr. Ed Card, Chief Medical Officer (CMO), who began his surgical practice in Macomb on July 17, 1984, and Dr. Jack McPherson, Director of the Hospitalist Program, who began his family practice on August 16, 1976, have teamed up with the MDH medical staff and hospital management to assure that the clinical and administrative preparedness of the hospital is structured to assure optimal performance in combating COVID-19. 

With five months behind us and quite a distance yet to go, both physicians wanted to share with all McDonough County residents what they’ve learned so far from their COVID-19 pandemic experience.

- Brian E. Dietz, FACHE
MDH President/CEO

Dr. Edwin Card, MDH Chief Medical Officer:

1. COVID is a virus native to bats, which was able to move into human populations. This is called a zoonosis. Other zoonoses include: Ebola, HIV, swine flu, bird flu, SARS, and MERS.
2. COVID-19 is more infectious than influenza but less infectious than measles. Most COVID-19 spread probably occurs through droplets suspended in the air. Spread could also occur during close contact with infected people.
3. As many as 30% of infected people will remain either minimally symptomatic or asymptomatic. People are most infectious in the 2 to 5 days prior to their developing symptoms. Because of this, the virus can be spread by people who do not even know that they are infected.
4. COVID-19 is not just like the flu. While most people recover spontaneously, about 20% require hospitalizations and a significant number of these people will die. 
5. We do not yet know if there are long-term consequences of COVID-19 infections. There are numerous reports of chronic fatigue, persistent cough, lung injury with shortness of breath, severe muscle weakness, and neurologic symptoms which persist after infection.
6. Since spread occurs by droplets in the air, social distancing is effective by allowing those droplets to settle out of the air prior to their coming in contact with another person. 
7. Face coverings and masks are effective because they limit the dispersal of droplets when we talk, cough, or simply breathe. They may provide some protection for the person wearing the facemask, but they are much more effective in protecting other people who are in the area.
8. Viruses consist of a strand of genetic material, either RNA or DNA, encased in a protein shell. Handwashing and hand sanitizers disrupt the protein shell and destroy the virus.  Please wash your hands frequently and thoroughly. 

Dr. Jack McPherson, MDH Director of the Hospitalist Program:

1. Over the months we have dealt with COVID-19 things have changed. Initially a shutdown was deemed unnecessary, but then became widespread. Initially the goal was to flatten the curve, but now our shutdown has gone far beyond that. Initially no masks were recommended, but now they are of prime importance. Initially steroids were contraindicated in very ill patients, but now they are a mainstay of treatment. Initially Hydroxychloroquine was utilized and even was released by the FDA as an emergency treatment option. Later it fell out of favor and the FDA withdrew its temporary use license. Now a new study and some European studies show it may be significantly beneficial. Initially we were told to progress to intubation and ventilators early in hypoxic patients. Now we are inclined to try less invasive options first. We certainly have learned that our standards of care have and will change. 
2. Science does not always drive decision making. When we look at the risk of COVID-19 to school age children and the negative impact of them being out of school, science dictates they should be in school, provided they wear facemasks, practice social distancing, and wash their hands frequently.
3. The employees at MDH have been amazing at preparing for caring for a large number of very ill patients. In record time they had our hospital ready to function at 125% of its capacity and ready to care for 300% of our capacity for ICU patients. This only validates what I have always known - we have amazing employees.  
4. All of MDH's employees have bravely risked their own health to care for others. We have an amazing group of professionals who are dedicated to their life's work of caring for others.   
5. Our country has done an amazing job of responding to an unknown crisis. Car manufacturers have produced massive numbers of ventilators. Multiple sources have worked hard to close our gap in PPE. We hopefully are getting close to developing a vaccine. There has been a frantic search for medical treatment options. I stand amazed at the American resolve.
6. The list of symptoms and signs of COVID-19 continues to grow. Initially we knew that fever, cough, chest pain, fatigue, and hypoxia were common symptoms. Over time we have added GI symptoms, loss of taste, and loss of smell. Other subtle symptoms have been added to the list. We have about 10 laboratory markers that we can follow in patients who have significant illness related to COVID-19.