The Front Lines, Part 2: Caring for COVID-19 Patients

The video starts with a title screen. A maroon and orange gradient aura shifts in the upper right corner of the screen as words appear. They read “The Front Lines: Physician’s Assistant Stuart Brodkin Answers Questions About Working in the Midst of COVID-19” and appear over a short resume blurb. The blurb reads: “Stuart Brodkin: Physician’s Assistant.”

After a few seconds the words pan up the screen as a question fades in from below. The question reads: “What are some of the current ways healthcare workers care for, or treat, those with or suspected of having the virus?”

Stuart Brodkin:

So, the biggest thing that most people should be aware of with this virus or this disease is that these patients decompensate very quickly in terms of requiring supplemental oxygen or airway protection. 

As Stuart talks, words appear on the right side of the screen emphasizing his points. The text only serves to clarify what is being said and does not add any new information that isn’t already present in what Stuart has to say.

Stuart Brodkin:

So, these are a select population of people who are immunocompromised, and that would kind of be defined as your elderly over the age of 65. People who have underlying immunocompromised state like cancer patients, but we're also starting to see how overall health has some impact in that.

So, we're seeing that people that have insulin resistance or diabetes or body mass index greater than 30 these people are what I would deem as immunocompromised as well. That could be a 20 year old.

So, your own personal wellbeing, you might not categorize yourself as immunocompromised, but in fact, you may be. So, at least early on if you come in with flu like symptoms. So fever, sore, throats, body aches just feeling generally fatigued, this is someone who may have COVID or the coronavirus.

These patients basically, if they are hemodynamically stable, meaning their vital signs all look okay, and they're not having any issues from a respiratory standpoint, we basically send these patients home to self isolate for a couple of weeks. But, the patients obviously that we're seeing that we're admitting to the hospital, these patients, they get sick pretty quickly.

In terms of treatments, I don't know that there's really anything that there's been significant evidence to suggest that we have a treatment at this time. So, obviously the Hydroxychloroquine's been getting a lot of press. I know that, not me directly, but I know of other institutions that are using that with Zithromax and seeing some good success. But, these are patients before they actually go into respiratory failure. The ones that are in respiratory failure, they're not really seeing as far as I can understand this, much success with that.

So, antivirals, Remdesivir is one that is starting to see some traction. And, that would be for someone that's obviously much sicker. They're doing a lot of immunotherapies, which in turn will help with vaccines in the future. So, really what I would stress is trying to do anything you can to boost your own immunity. Things that you can do, exercise, obviously.

You guys probably speak to that quite a bit with Thorne, but there's not a whole lot that we can do other than respiratory support once you develop the acute respiratory distress syndrome or require ventilation.

So, those are ones that really aren't doing so well. I think 80% of those people that get vented don't ever come off the vent.

So, that's pretty significant. And, that's where the fear comes in. But, for the majority of the world, they may be asymptomatic or have very mild symptoms.

Closing text appears onscreen reading: “Make the most of your health while staying at home. Subscribe to our newsletter and get the latest content on COVID-19 along with insights, education, and advice you won’t find anywhere else.