There’s not much to update from last week.  Overall, we’re in the same place as we were a week ago. The big question out there is: when will we be done with this?  When can we all come out of this stay-at-home stuff?  

I push back a bit against those questions, as the important question isn’t when.  Ultimately, when is the outcome at a long line of processes.  We have to take a few steps back.  What conditions have to exist for us to end the stay-at-home order?

It seems as though we, as a society, have thus far focused on accomplishing 2 goals.  One is to keep the overall number of deaths directly due to COVID-19 to a minimum.  The second is to ensure that the capacity of our healthcare system isn’t surpassed.

As time has gone on, we have realized that in accomplishing the two above goals, we have experienced the collateral damage of watching our economy implode almost overnight.  We haven’t seen our economy take a dive like this since the great depression.  In a somewhat sick twist of irony, we also know that poor economic conditions lead to poor health outcomes.  They’re just not as immediate or attention-grabbing as someone dying, alone and connected to a ventilator, from an infectious disease against whom we have no current treatment or cure.

While I’m not a governmental or public health leader, if we remain focused on the above two health metrics (avoiding COVID19 deaths and working within the healthcare system’s capacity), we need to figure out the following before we can even determine when we can reopen:

  • How do we figure out who has already had COVID? 
  • Or, more explicitly: how do we identify those who are immune to COVID19?
  • Using the answers to the above questions as our guide, how do we avoid a second “bump” of cases?

Right now nobody knows (with any sort of certainty) the answers to the questions above — and if we move forward without intentionally addressing these questions we may see a surge in COVID19 cases and deaths — which would make the economic sacrifice we’ve all made for the last month for naught.  

Answering each of these questions is going to require a huge amount of time, work, money. We’re going to have to work together in ways that our current systems and structures aren’t used to doing.  This will be a slog.  Be prepared for a lot of unknowns, some tentative movements forward, and possible backslides and backpedaling.

Enough with the dire projections.  On to the rest of the update!


Clinic & clinical updates:

  • Please let us know if you have been impacted financially by the COVID-19 pandemic and need help with the cost of your monthly membership. We want to help you and are able to do so through the generosity of our KCDPC members.  Just fill out and return this form — or just call us to talk about it (and we can help you through the technology).
  • Though we are still here to care for you, as part of the stay-at-home order we may be working from home and condensing in-person visits (as needed) into a few hours a day; please call (913-730-0331) to confirm someone is at the office if you’re needing to physically swing by!
  • There are currently two types of tests for COVID-19.  Molecular PCR testing one via nasal swab or wash looks to see if someone is currently infected with the SARS-COV2 virus.  The Antibody (IgG/IgM) testing done via blood or serum looks to see if someone has had the infection and that the body produced antibodies against the virus.
    • Molecular (PCR) testing.
    • Antibody (IgG/IgM) testing.
      • We are working to get access to the IgG/IgM antibody testing kits;  we are likely 2-3 weeks out from offering this at this point.  And we have no idea what the price will be.
      • We also aren’t yet sure what to do with the results of antibody testing — how accurate is the test? Are there false positives?  IF someone tests and has antibodies — are they really immune to COVID19?  
  • If someone does test positive for COVID-19 via PCR and they are well enough to stay at home, they’re to quarantine at home and follow some basic guidelines to prevent the spread to others.
    • Recommendations for when the general public can return to work after confirmed illness with COVID-19 are still shifting; the CDC has released guidance on how healthcare workers can be screened and cleared for return-to-work following illness. These guidelines are changing quickly, and we will help you through them if they end up applying to you.
    • What’s less clear is when to return to work if you have respiratory symptoms but have either tested negative for COVID-19 or have been unable to be tested.  The current recommendations are that you can return to essential jobs when:
      • You have had no fever for at least 72 hours (that is three full days of no fever without the use medicine that reduces fevers)
      • other symptoms have improved (for example, when your cough or shortness of breath have improved)
      • at least 7 days have passed since your symptoms first appeared
  • The basic facts about the virus remain unchanged: it is spread via droplet (and likely aerosolized in some situations), affects the elderly more frequently than the young (and affects people with conditions like high blood pressure, diabetes, heart disease, and lung disease far more severely than people who don’t have those conditions), and can be present — and transmitted — even in those who don’t have symptoms.
  • There is no valid, evidence-based cure or treatment for the illness other than supportive care; however, scientific trials are ongoing across the US and the world.
    • The medicines that have been in the news — Plaquenil, hydroxychloroquine, azithromycin, Z-packs, remedsivir — are all still in the clinical trial phase and we really don’t know if they will work.
    • The NIH has consolidated the recommendations for treatment here.
  • Vaccine development is still in the works but also takes time to confirm that they actually work and do not cause harm; this is still a long ways out.
  • Seeing as we have no vaccine or clear treatment, the best plan is to protect yourself and prevent contracting the illness!  If you must go out, try your best to keep a 6-foot radius from others.  Better yet — stay home as much as possible and take advantage of delivery services or curbside pickup.  Handwashing is essential, as is good rest, healthy eating, exercise, and all the usual best practices.  
    • This past week, the CDC update its recommendations regarding the use of face masks and is encouraging everyone to wear one (and even has instructions on how to make your own!)
    • We have had some donations to the clinic of cloth masks; if you want one, please let us know and we can arrange for a clean, no-touch handoff!


Local updates:

  • Both Kansas and Missouri are enforcing stay-at-home orders at this point.
  • What info direct from the source in real time? Keep up to date on both Kansas and Missouri statistics through their websites.


National political and economic updates:

  • Our favorite tracker for cases thus far is the dashboard compiled by Johns Hopkins University of Medicine.  
  • On April 20, 2020 Politico hinted that the Congress and the White House are nearing a deal on another stimulus package with more aid money for small business and hospitals — and with hope for expanding testing. Stay tuned!
  • The CDC is tracking the number of tests they have done + the number done by public health (= state) labs, however, these numbers do not appear to contain testing done at hospitals and large, commercial labs (which is actually where the majority of testing is occuring at this point).