After my last newsletter I reached out once again to community leaders and journalists after hearing some nurses were still getting in trouble for asking for a mask at Hoag. It has been a fast and furious fight but at long last all staff and patients are masking up. Here is the revised Daily Pilot article. This was a public health emergency and I am grateful for all of your support during the past week.
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The Surge should hit OC at the end of April and start of May.
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Coming in for testing:

ACTIVE INFECTION- May present as almost anything in pediatric patients. Usually there will be abdominal symptoms.

Monday April 13, I can test patients with mild symptoms for active infection. This nasal swab takes up to 48 hours and is a cash test offered by a local lab. Cost is 150.00 per patient. Alternatively I can send out tests to Quest that get billed to insurance. They come back in 4-10 days.
FOR PAST INFECTION: Please be cautious getting a test for past infections done at a clinic. These are black market tests and you should not rely on them. We do not know the false positive and false negative rates. FDA has not approved of them.

In approximately 2 weeks, Alex can send out to our local lab the IgG and IgM blood test for past infection. That test is only 100 dollars cash. Not sure when it will be covered by insurance by this lab. If available I can send to Quest. I will keep looking for this to be available.
Learning More As Time Goes On:
I joined fellow pediatricians in a Virtual Town Hall meeting this week. At that time there was only one child under 17 admitted to CHOC with COVID19. They did say they were treating half a dozen or more 17/18 year olds. We now believe most children will not be hit hard by this disease.

THERE WAS CONJECTURE that perhaps the recurrent pediatric coronaviral infections impart some immunity. In my office we see coronavirus often on respiratory swabs. Good news for parents who caught it from their snot nosed kids!

But don't be too complacent:
Consider the recent mortality rate of flu which is ~0.1% of people who contracted it. This season ~62K people in the US died from Influenza.

For Coronavirus the mortality rate is much larger at 1.38%. Also note that transmission rates are higher. So we are expecting a terrible overload to the healthcare system.

News for ADULTS: obesity is the biggest risk for a poor outcome (with secondary hypertension, DM, CHF etc). The immune response is different in obese people which causes the high morbidity rate. In addition, for all patients, treatments such as hydroxychloroquine and azithromycin have far greater toxicity than good when used prophylactically.
Are you cleaning groceries but not wearing a mask shopping? Get with the program!
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