As a long time user of texags, more than 20 years I feel obligated to give users an accurate update on where we stand with the Coronavirus.

For background purposes, I graduated from Texas A&M in 1991. I graduated cum laude in medical school in 1997, was chief resident at t.u. Southwestern in 1999. I know sucks having a t.u. diploma but I hang it upside down.

Since then I have been in private practice for over 20 years. I have been elected secretary, vice president and president of Texas Osteopathic Medical Association district 5. Also elected to the physician board of multiple independent physician associations. Elected Best in Medicine in 2019. For texags forum critics (football related as I have name in Kyle Field as Eppright donor) lol

Lots of misinformation out there now and it's important to be getting your information from someone directly in the medical community and not just media.

Here is a link my professional Facebook page where I am updating my patients on the most current information. This update is from Information as current as last night. I also have an update from last on that site that is helpful too.

https://m.facebook.com/story.php?story_fbid=2638055689810705&id=1998386763777604&sfnsn=mo

If I have time I will try to answer any serious question you have here.

Great info, thanks for posting!

Thanks for the information Dr. I have a little girl who has asthma how concerned should I be or what actions should I take if she gets infected? When she does get sick I normally have put her on the nebulizer because her oxygen levels will fall.

Thanks

Thanks for posting this. It was a very informative and easy read. My wife is medical for the military and I never know what the hell she is talking about until she dumbs it down for me. My family and I live in a very small town near the base that is full of Germans over 70 years of age. The ones I have talked to are slightly concerned and have been limiting their travel. Some area schools have already closed and I'm sure my kids school will do the same soon. Thanks again for the unbiased read.

Any place with lots of people over 70 should immediately stop all visitors unless absolutely necessary until this pandemic is under better control.

In reply to Jclover Most kids are fortunately not being affected by this virus. Virologist believe this is because coronavirus has been around for ever as a cause of the common cold. Kids get an average of 4 to 5 colds per year. Thus they may enough antibodies made to the old coronavirus to give them some immunity.

That said if your daughters asthma is severe enough that she desaturates meaning oxygen level drops then I would keep her home. If she was to catch the virus, she needs to be watched closely because she would fall into a higher risk category.

For those with family members at home that are high risk. You must practice good reverse isolation practices. Meaning when you get home, change clothes, wash hands better yet shower before getting around them. Your don't want to bring the virus home on you and infect them.

Also do not let them eat or drink after you. Do not cough or sneeze on them. If you cough or sneeze do into your arm to Nick exhaling the virus into the air.

If you feel sick do not stay in the same room with them. Isolate yourself to your own room.

In reply to Reveille Any concern/elevated risk with pregnant women?

We don't know a lot but here is the latest inside information on Covid-19 and pregnancy. Essentially, pregnant women should conceded immunosuppressed and treated as such based on this information.

Pregnant women are at increased risk for severe pneumonia and respiratory infection due to immunosuppression. In some cases, respiratory infections can lead to birth complications. For example, a study of pregnant women who were hospitalized with influenza found a substantially higher preterm birth rate than that of the general population.

The investigators of a new study, published in The Lancet, have advanced the understanding of the impact COVID-19 infection could have on pregnancy. The article detailed clinical characteristics and potential for intrauterine vertical transmission in a cohort of 9 pregnant women who developed COVID-19 pneumonia late in their pregnancies.

The study team found that clinical characteristics of COVID-19 pneumonia in pregnant women were similar to those reported for adults who are not pregnant. The investigators also reported that in this small group of cases there was no evidence of intrauterine infection caused by vertical transmission.

The study was conducted by retrospective review of laboratory results, health records, and chest CT scans. The 9 women were admitted to Zhongnan Hospital of Wuhan University, in Wuhan, China, the epicenter of the outbreak. Admissions took place from January 20 to January 31, 2020.

Intrauterine vertical transmission was assessed in 6 of the 9 patients by testing cord blood, amniotic fluid, and neonatal throat swabs. Breastmilk samples were also tested.

The symptoms of the 9 individuals were similar to those seen in the general population. Fever was present in 7 patients, cough in 4 patients, myalgia in 3 patients, malaise in 2 patients, and sore throat in 2 patients.

Increased aminotransferase concentrations were observed in 3 patients. Lymphopenia occurred in 5 patients and fetal distress monitoring was required in 2 patients. None of the patients advanced to severe COVID-19 pneumonia or died as of February 4, 2020.

Thanks for posting Doc.

I can't emphasize enough that in order to control this pandemic, you need to be getting your information from reputable medical sources and not the media. The misinformation and media scar tactics are one of the scariest parts of this pandemic.

We are putting many at risk we all of the hoarding of medical supplies by people from fear. My biggest fear is running out sanatation supplies at medical facilities due to people hoarding then. That could cause a significant surge in severe cases.

Quote:

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This virus is not airborne but is spread through respiratory droplets. This means close contacts within 6 feet can inhale these droplets and become infected. Coughing, sneezing, kissing or eating and drinking after others spread this disease. It can also potentially, I emphasize potentially not proven spread via contaminated surfaces as we know now it can live up to 3 days on certain surfaces.

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Thank you for doing this Doc, we need honest information!
Gig 'em

In reply to Reveille

Reveille said:

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Any place with lots of people over 70 should immediately stop all visitors unless absolutely necessary until this pandemic is under better control.

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Thanks for starting this thread. I started one last night on the health and fitness forum trying to get actual medical discussion all in one place (do you mind checking it out, some asking questions there don't have premium access).

As for this comment, churches are somewhere that weekly there are large gatherings of over 70 folk. Thoughts on avoiding those?

Appreciate the calm demeanor and information. We have too many people jumping off the deep end or just putting their head in the sand and ignoring.

Also for those with loved ones over 70 or high conditions like cardiopulmonary disease use technology to help protect them. Instead of visiting person to person, communication through Google duo, FaceTime or Facebook messenger. Those are all ways to see them without putting them at risk. It is important to limit all contact those groups to only those that are absolutely necessary!

That is a great update! Thank you for putting this out so that as many people as possible understand what we can do to minimize the spread of this virus.

I will try but very limited on time. I have a large practice with over ten thousand patients to care for. But I care if copy and past anything there. Everyone deserves to be treated property.

Any frequently asked questions post here and I will try to respond.

As for churches I think they need to stay away if they are over 70 or have other high risk conditions.

Churches need to provide steaming sermons for the time being to help decrease the spread of this virus.

Remember the real fear of this verus the FLU is the lack of a vaccine. Without a large portion of the population being vaccinated the virus has the potential to spread much more rapidly. This can cause the hospitals to not be able to meet the demands of the critical ill. So we have to keep those that are more likely to get severe disease safe.

What do I need at home? Great question but really not too much. It is highly likely you will have only minimal symptoms. Got instance NBA player last night was waiting to get cleared to play because he didn't feel very bad.

So an over the counter cough syrup, Kleenex to sneeze into, Tylenol for fever preferribly over Advil/Naprosyn/Aspirin because those can damage the kidneys. Plenty to drink preferribly Gatorade to hydrate better. Also food to keep a healthy diet to get immune system strong. Finally, disinfectants to clean areas where you where to pervert others from getting sick.

If you are sick then you should wear a mask around others when they check on you. If you don't have a mask available for to others hoarding them use an old t-shirt.

Thanks, Doc.

Very well written and to the point.

Staff, please suggest that everyone visiting this board read this post, or place it as an "article" where everyone visiting this site can find it easily.

This is the time for facts.

In reply to Reveille Thank you for the update on pregnant women and the risk. With my wife being 15 weeks pregnant this has definitely caused me to be concerned more than I normally would.

Look honestly none of us know how many real cases are out there but we all agree that the denominator is way too small. Read my previous update from last week and it will help you understand why.

But the reality is as more testing is becoming available the case numbers are going to dramatically increase rapidly. No place with a significant number of people is immune.

It will take a week or two to even see results of what we are doing now because the virus has an incubation period of 2 to 9 days average of 5. People unfortunately shed the virus prior to showing symptoms.

This causes a lot of unknowns on where someone obtained it. Because 80 percent never have severe symptoms they may get it spread it and never even know they had it. But it is these people that could potentially inadvertently infect the high risk groups. So only way to really do it down is with good medical safety practices isolation of high risk patients and frequently washing hands to prevent spread to more asymptomatic patients.

How long are they contagious?

We really don't know yet! But patients can shed RNA from 1-4 weeks after symptom resolution, but it is unknown if the presence of RNA equals presence of infectious virus. For now, COVID-1 9 patients are "cleared" of isolation once they have 2 consecutive negative RNA tests collected 24 hours apart.

Well done, Reveille. Thanks!

I suggest everyone take the time to read his Facebook post linked above. Thanks for sharing Doc!

In reply to Harkrider 93 Yes he would be considered risky based on his age and smoking history. I would say it is not advisable to be in any crowded environment. Based on the statistics we have from China he would be in the groups with high mortally rate of around 14%.

I was texting the ID doc in Bryan and College Station what he was expecting and he said anywhere from 20-70% of the population. Are you hearing similar numbers? Because that's a lot