April 3, 2020 update.
It’s been a week since our last update, and two and a half weeks since our Bay Area counties issued a shelter in place order. I want to update everyone on what we’re seeing here, and what local hospitals and counties are reporting. I hope that you are feeling well, and that you are adjusting to the changes that have affected us all.
I remain encouraged that while the numbers of SARS-CoV-2 (it has a new name!) have been increasing in San Mateo and Santa Clara Counties, we have not seen a dramatic surge as of yet. The current doubling time of cases in both counties is around 7 days. By contrast, in other ‘hot spots’ such as New York and Italy, cases were doubling about every 3 days.
Bay Area hospitals are continuing to report that they have available capacity if needed. Santa Clara County is reporting that they have more than 50% of hospital beds available. Santa Clara County reported 63 cases in the last 24 hrs. This amounts to 3 cases per 100,000 people in the county. The total number of cases is about 52 per 100,000 population, or about 1 in 2000. One hospital in Mountain View reported that over the last 5 days, they have tested 118 people in the emergency room. Of those, only 5 were positive. This is a positivity rate of 4.2%, which is down from the 10% rate that they had during the week prior.
I attended the virtual Town Hall meeting of Stanford Hospital today. They continue to report that they have much more capacity than usual, given the cancelation of elective cases. They have about half of their hospital beds open (which is unusual at any time of the year.) They are currently projecting that cases will likely increase through about the middle of April, but they acknowledge that this is an estimate.
With regards to testing, Stanford is increasing its capacity to test for the virus. They are still requesting that we only test people with symptoms, or who are at high risk through exposure. They hope to expand testing to include asymptomatic people in the future. They are also working on what is called serologic testing (testing for antibodies to the virus.) This would be a blood test that would show if the person had had it in the past. It could also test for recent infection (but would not likely be positive in the first week of the illness.) I am continually monitoring testing availability. If this type of test becomes available to us, I will order them and let you know. Otherwise, I anticipate that within the next two to three weeks we may to be able to order this through Quest (which could be done in our office) or Stanford.
With respect to medications to treat the virus, none are available in pharmacies for outpatient use. Remdesivir is showing promise, and is an IV treatment given in the hospital only. Chloroquine and Hydroxychloroquine are oral medications that also may be effective, but they are not available currently in pharmacies. I also received an email yesterday from the California Medical Board reminding physicians that chloroquine and hydroxychloroquine are not approved by the FDA for this illness, and that hoarding or prescribing them to people who are not ill is outside of accepted medical practice.
While I feel that the reports coming to us from the community, local hospitals, and our state and local governments are reassuring, I in no way want to minimize the risks associated with this pandemic, nor the importance of vigilance with complying with the distancing orders from our local officials. I do, however, remain hopeful that we will get through this.
Please don’t hesitate to reach out to us with any comments, questions, or concerns.
Dr. Ian Kroes & Dr. Patricia Santana, Peninsula Doctor Concierge Medicine Physicians
Covid-19 Bay Area update #7 by Peninsula Doctor Physicians
April 3, 2020 update.