Tag: coronavirus

Cancer and covid

Joanne Dragun, M.D.

After 9/11 we witnessed the disruption in travel and the loss of innocence. We gave in and believed if we line up at the airport, put security and barriers around everything we would be safe. There are many similarities this week with the new threat. If we allow, it will be all-consuming and steal our money, entertainment, family and friends interactions even toilet paper. For cancer patients, it may even steal their cure.

Jeanine starts her therapy this week. “Doc, shouldn’t I just wait until this all blows over? I don’t want to get sick” I express to this frightened patient that as long as she is careful (you know the drill: hand washing, no touching the face, avoid others, stay home) we should treat the disease she has, not the one causing fear. The common flu is ubiquitous and deadly* but we don’t stop our lives. We live, we manage, we are brave and not giving into this. Not to be brazen and unwise, just to maintain control. Being anxious, fearful and paralyzed does nothing to contribute to our wellness.

This virus is not seeking us out. It isn’t tracking us down and attacking us in our beds. It’s all in the way the information is approached. We never ever had this level of tracking with other non-curable viruses that caused tens of thousands of deaths. You probably barely recall the bird flu, the swine flu, H1N1. You still worked and lived your life and although many people did succumb to the infection, the world and your own life didn’t stop unless you were directly affected.

In oncology, I actually do have a recommended answer for Jeanine. Medicare (CMS) has come up with suggestions for treatment. Low-risk cancer can wait a few months, medium risk are at the doctor’s and patient’s discretion and high risk should move into care. Cancer centers are well equipped with the ability to sanitize and care for very ill patients. What arrogance this virus has to make us postpone our own well being. In some cancer cases, months are short- should we just abdicate the time we have?

So what are my recommendations after hundreds of hours researching and reading, seeking counsel and advising? If you are well, do not seek healthcare at all. No followup routine visits, no testing, keep yourself away from the ill and frail for your sake and theirs. If you have started therapy or are of moderate or high risk (check with your oncologist) go full steam ahead. If you are newly diagnosed and low risk consider waiting a few months.

This virus isn’t going away but over 90% of us will survive it and even the elderly frail at risk survive 85%. If you venture out you won’t know until up to two weeks after if that was a mistake. But do go out for a walk in nature- the runs to the supermarket or home depot are over for now. A new dynamic has been birthed making communing with nature more precious. Taking a break from our busy lives is something we rarely do so enjoy the peace and solitude. Then be ready to jump back in, hopefully soon. We cannot wait 18 months until there is a vaccine to live. We should be determined to survive and thrive in spite of this virus.

I am going to be strong with you. I am not going to be still hoping a cure will rescue me or a drug will treat me. If that happens fine, but the news would have you believe it is the only way. Make your own way. Don’t be careless but don’t be frightened. Fear didn’t keep cancer away so there really isn’t any therapeutic value in it. You have the power to handle anything that comes your way.

For up to date information: http://www.cdc.gov                                                                                                     *note (hopkinsmedicine.org): flu, 1 billion cases worldwide, up to 646,000 deaths. Up to 60,000 deaths US.

Addendum: The $2 Trillion rescue plan was passed by a self-centered congress yesterday. They laughed and patted each other on the back (hubris ignores social distancing.) While we the people take out an enormous loan for politicians’ special interests, let us pray that my colleagues on the front line will receive the equipment they need and not find it necessary to wear trash bags and bandanas. Doctors, nurses, EMTs are naive- we don’t catch diseases like cancer, heart attacks, strokes, and so they jump in and rescue no matter the thought for their own safety- always. They believe they are invincible even in the face of this invisible pathogen. May God bless their bravery and provide.

 

Going viral

Joanne Dragun, M.D.

If the corona virus doesn’t make us sick, the hysteria will. Are you considering becoming a “prepper” or risk being left without toilet paper or God forbid chocolate? Well hang on because its becoming a bumpy ride.

There is no cure for the common cold and more people die from the flu so let’s get real here: community acquired diseases threaten life everyday, especially in people with significant advanced age and co-morbidities. The panic in China and the petri dish of the Diamond Princess served to escalate the craziness of an ailment that will remain with us and likely not have a ready cure or vaccine. We live with salmonella yet still dine out, we have a cold several times a year but still work, play and engage. These are just some examples of ubiquitous illnesses that we have learned to “deal with” and not over-manage.

If I knew there was a norovirus on a ship, I’d stay away. If a country had a plague-like environment with people dropping on the street, I would cancel my ticket. There are definitely times when a change in plan is necessary, but panic is not.

STOP TOUCHING YOUR FACE! You don’t get the virus through skin. Its when you touch something that has a virus droplet from a cough or sneeze then you transmit it to your nose or mouth. The virus enters thru the nose so turn away and distance from someone coughing. If you had a cold or flu, its always best not to go to work and infect others so same rules apply. Stay home. I would choose to not go to a hospital unless I became ill with fever and shortness of breath and then call ahead so no unsuspecting healthcare worker engages without proper precautions. If you are immuno-compromised or on chemo, stay away from crowds, family with cold or flu, wipe all hi-touch surfaces in your home with disinfectants or bleach, hydrate, don’t smoke or drink alcohol.

If it comes to your town, stay out of hospitals for elective procedures, be aware that confined areas: cruise ships, jail, nursing homes (so many similarities) infection spreads quickly. Travel bug now has a whole new meaning. Children (aka petri dishes) tolerate the virus better then parents and especially grandparents, but can be carriers so no visiting a frail grandma or the nursing home for now- Skype. Wash hands constantly and when you cannot, carry hand sanitizer and wipe your phone down too. Stop touching everything in public. Carry a paper towel for buttons, door handles, etc. then discard quickly. Shut off faucets in public with towel not the hand you just washed. I like to imagine my hands are covered in sticky candy so I touch things less and wipe them more.

You will get a cold, you may get the flu, you probably won’t get Covid 19, but be smart to stay well and grateful that the US health system, even during panic, will make every effort to rescue you. Focus on what is wonderful today and shut off the news. Take a walk in nature and breathe deeply to refresh. What drove people crazy in quarantine wasn’t lack of fast food or Starbucks. It was removal from social interaction. We can still virtual hug. Let’s help others where and when we can. That will have more impact on our lives than fear.

For updates: https://www.cdc.gov

Universal precautions

Joanne Dragun, M.D.1 Comment

The new 2019 coronavirus is shaking the world with 50 million in lock-down in China and spread to 23 countries as of this writing. Pundits say “No cause for concern” but I will caution you to be alert and informed.

Since HIV became evident in the US 1981, the use of “universal precautions” permits care takers to engage with and treat patients while protecting themselves. When Ebola hit our shores, the outstanding care provided to both patients and care givers demonstrated the success of the process of gowns, gloves, masks and visors or glasses to avoid contamination.

We can borrow from this policy in the community and also take precautions. Avoid travel to countries without healthcare standards necessary for containment and treatment. Universal precautions mean to use universally because you do not know who is infected it doesn’t mean it is universally followed in other countries! If you are immuno-compromised with low blood counts, on chemo or otherwise have multiple medical conditions, then you are at high risk to contract contagious illness, the most significant of which is the flu. 61,000 died of flu last year and 8000 so far 2019-2020 season. Millions are infected. So my advice is to universally protect yourself. Frequent hand washing is the best defense, avoid touching your face, nose, mouth, use sanitizer and avoid crowds and family and friends who are ill. If you learn to protect yourself from the flu and common infections then you are more assured of being safe from this new threat.

Viruses are more virulent when they jump from animal to human. I’d like to see China ‘borrow’ US intellectual property of food inspection, clean supermarkets and NO more wet markets where bat-snake-human transmission can occur. China, take some practical intelligence from the US while you are at it and the world would be safer.

We take our amazing healthcare system for granted. If you suffer with an illness, even coronavirus, you will be cared for and survive as long as it does not overwhelm a compromised host.

Recommendations: know your risk, avoid travel to countries not equipped with medical care, wash hands, avoid exposure to crowds and public transport, if you are immune-compromised consider a mask when in those public places. (Thanks Donna who brought this to my attention this week). Operate out of wisdom not fear: exercise, eat healthy, hydrate, avoid others with the flu or colds, oh and avoid buying food where there is bat poop!

Raise your awareness. Check with your oncologist to know if your immune system is compromised.

For official notices medical personnel are receiving go to: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Stay well, stay tuned.