Note: For the second straight week, Dr. John Hearnsberger presented a coronavirus update at First United Methodist Church of Nashville. The presentation was made Sunday in front of an empty auditorium as local churches took to radio and livestreaming under health department guidelines. Dr. Hearnsberger said he and Pastor Daniel Kirkpatrick “have agreed to do this for as long as needed—as long as it serves a purpose and is welcomed by the listeners.”
What a difference a week has made! First I want to make a comparison of some statements and statistics I gave last Sunday with current information this morning. These numbers are changing daily. I dare say, “None of us have ever seen anything like this.”
1. 12 cases in Arkansas. All were in central Arkansas. No deaths. Today there are 118 confirmed cases in 26/75 counties in Arkansas. 32 confirmed cases are in patients 65 y/o or older. 9 cases in children. 13 patients required hospitalization and 4 were on a ventilator. Still no deaths reported. To date there are 96 flu deaths reported in Arkansas.
2. 47/48 continental states had the virus. Now all 50 states plus the District of Columbia have confirmed cases.
3. Over 162,000 world wide and over 6000 deaths. [Last week I said U.S. in error.] Now over 300,000 cases worldwide with 13,000 deaths. The U.S. has 26,900 cases and 348 deaths, for a 2% death rate.
4. Italy has been severely affected by this virus, and the US appears to be following a similar course, and lags about 2-3 weeks behind.
4. No cases documented in Howard County. The nearest Arkansas counties with confirmed cases are Sevier and Clark.
5. Google has launched its COVID-19 information web site — google.com/covid19.
6. Still no vaccine nor specific treatment.
There is no such thing as, “Business as usual.” For example—all public schools are closed. All large events and social gatherings are canceled. Church services, including this one, are canceled. Today’s service is being broadcast by our local radio station KNAS 105 FM, with only a skeleton crew present here in the sanctuary. The deadline for filing your income tax with the IRS had been delayed until July 15th. A federal stimulus is planned for those who are unable to return to work or have lost their jobs due to this pandemic. UAMS is on lock-down. I understand that no visitors are allowed.
Essential businesses remain open to-date. Grocery stores, gas stations, ambulance services, hospitals, medical clinics, post offices, banks, nursing homes, and those businesses needed to support our local industries and farms. But many, if not all, have changed their operating procedures.
I’ll take a moment to describe what Howard Memorial Hospital is doing. Similar procedures are carried out by our local doctor’s offices, ambulance services, and nursing homes. In spite of COVID-19, it is essential these entities remain open if at all possible.
HMH is following the CDC recommendations to prevent and control infections. This information is on our Facebook page.
1. We try to minimize the chance for exposure to the virus by placing known or suspected cases in a separate location, using personal protective equipment [PPE], and educating the staff, patients, and the community on proper hand hygiene.
2. We feel the best way to prevent infection is to follow the same measures used during the normal cold and flu season. Wash your hands regularly, cover coughs and sneezes, and stay home if you are sick.
3. We participate in emergency preparedness training in order to handle an influx of patients, should that occur.
4. Over the last week the administrative team has been working with hospital staff, doctors, and local officials, doing our best to ensure the health and safety of everyone in our community.
These measures include—
a. Screening everyone entering our hospital.
b. Using testing guidelines recommended by the Ark. Dept. of Health.
c. Area ambulance services are screening by phone before entering a home, and making the results of that screening procedure known to the hospital before transporting a patient suspected to have this virus, so proper precautions can be undertaken by hospital personnel before the patient arrives in our Emergency Department.
d. Patients presenting with respiratory symptoms, and I would add fever, will be given a mask, and hospital personnel will put on personal protective equipment prior to interacting with that patient.
e. The main lobby will close daily at 5 PM and reopen at 7 AM Monday-Friday. All persons entering the hospital will be screened. At all other times during the day, and on weekends, everyone will enter the hospital through the Emergency Department and will be screened. Non essential visits to the hospital are strongly discouraged.
f. If we have a confirmed case of COVID-19, we will move to the next stage for a more aggressive lock down of our hospital.
To date we have tested 5 patients for COVID-19. Results are unknown because the tests must be sent to a reference lab. And currently have 22 test kits available.
Here are published data re symptoms of infected persons sick with this virus.
Don’t forget, many carriers may have no or mild symptoms—
1. Fever 99%.
2. Fatigue 70%.
3. Dry cough 55%.
4. Anorexia 40%. [Not hungry]
5. Myalgia 35%. [Muscle aches]
6. Dyspnea 31%. [Short of breath]
7. Sputum 27%. [Productive cough]
Now some good news—
Since the known outbreak of the virus in China at the end of December, China is reporting many less cases and is returning to business as usual. The virus appears to be a naturally occurring organism, probably from animals. Evidence so far is that it is not man made.
It has been reported the the IBM supercomputer, called “Summit,” created in 2014, has run simulations of over 8000 compounds that could fight the virus and limit its ability to spread. Results and uses are unknown today, but at least someone is searching.
Drugs we could potentially use—
1. Remdesivir. A nucleotide analogue that has activity against SARS coronavirus 2, and related viruses, in both the lab and in animals.
2. Chloroquine, which was developed in 1934 and used to treat malaria, and hydroxychloroquine are reported to inhibit the virus in the lab. One published study was associated with an increased rate of undetectable virus in patients at 6 days compared with no treatment at all in a comparable group. The addition of Azithromicin seemed to have helped. Also China reported reduced progression of the disease and reduced duration of symptoms using these drugs. I am not sure this morning, but I do not think the FDA has yet approved these drugs for the treatment of COVID-19.
Finally, as a reminder, I will repeat some things I said last Sunday—
1. Wash your hands frequently, or use a hand sanitizer.
2. Avoid touching your face with unclean hands. [There was a study done by videotaping Australian medical students. They touched their face on average of 32 times an hour.]
3. Avoid contact with anyone who is sick. Distance yourself from other people, now called “social distancing”. Especially distance yourself from anyone who is sick. It is especially important to avoid contact with the elderly, debilitated, and immuno-compromised.
4. Cover coughs and sneezes.
5. Stay home and work from home if possible.
6. Be especially careful in all public places.
Remember—Think. Be aware. Use logic and reason. Don’t panic. Avoid rumors and hype. Listen to Dr. Anthony Fauci whenever you have a chance. We are all in this together, and each of us must do our part to prevent and contain this pandemic.
“Now go out into the world and treat everyone you meet exactly how you’d like them to treat you.” Mike Masterson quote.