Coronavirus Care Planning ‘More Important Than Containment’



What your doctor is reading on Medscape.com:

FEBRUARY 14, 2020 — Although quarantines and the number of people affected are dominating the headlines about the coronavirus, emergency preparedness — not COVID-19 containment — is the more appropriate response, said Amesh Adalja, MD, an infectious disease specialist at the Johns Hopkins Center for Health Security in Baltimore.

“We’re seeing an over-reaction in the form of quarantines,” he told Medscape Medical News. “But that’s not the full picture of the virus.”

The very aggressive early actions taken in China set the tone for the world, Adalja explained. “It will take time to right-size the response. We need to move away from focusing on containment and understand how it affects humans.”

Adalja will try to unravel the mystique around the novel coronavirus, with up-to-the minute information on the bug, during a panel discussion on worldwide threats to health security at the Society of Critical Care Medicine (SCCM) 2020 Critical Care Congress in Orlando.

Overall, our health systems might be more prepared than in the past, but making the right decisions is still a challenge, he explained.

More than 80% of people affected have a mild form of COVID-19. “This is not SARS,” he pointed out. Although the respiratory transmission of COVID-19 makes its spread very efficient, the illness caused is milder than was seen during the SARS outbreak.

Given the current information, Adalja said he believes the severity of COVID-19 lies somewhere between a community-acquired coronavirus, such as OC43, HKU1, or NL63, and SARS. It’s likely to evolve much like H1N1, from a novel pandemic coronavirus strain to an endemic seasonal strain that causes about a quarter of cases of the common cold, he said.

Still, there will be an impact on ICUs.


Impact on ICUs

“Like any respiratory illness, people of advanced age and those with other medical conditions get hit the hardest. That’s where it’s clustering, so hospitals need to be ready for a surge of patients,” he warned.

Because this is the first year of the virus, it will likely hit hard this year, “but it will be a mild pandemic,” he predicted. “We now know it’s not like SARS; it’s not as fatal. That’s a relief.”





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