Very critical: Dr. Rai says hospitals running short on beds, ventilators
GREEN BAY, Wis. (WBAY) - “From trying to find beds to, as of this morning, trying to find ventilators, the kind that we like to use, not the traveling ventilators, those are in short supply,” says Prevea Health President and CEO Dr. Ashok Rai.
Dr. Rai joined us on Action 2 News This Morning Thursday to discuss the critical situation for our hospitals, expanded COVID-19 testing in Brown County, and how we’re far from flattening the curve.
Dr. Rai joins us Tuesdays and Thursdays. Have a question? Email firstname.lastname@example.org.
"If you look at when we had our outbreak in May and flattened for awhile, and they look at the peaks we’re going through right now, far from flattening the curve. If anything, the complete opposite of it.
"You can see what happened in the spring and then kind of went down, and you can see just the percent positivity, or total number of positives, just ramping up here in the fall by date. Flattening the curve means keeping those cases below a certain level of hospital capacity. And like we’ve said, every hospital in town right now has reached pretty close to capacity, one or two beds available a day. That’s definitely the curve being above that line. You can see in May when we were concerned and just how much worse it is now.
“We were really concerned in the spring thinking that that was really bad, and you look at it right now, that’s, what we did in the spring is almost what one hospital can take care of totally filling up versus what we’re doing now, it’s almost triple that number. This was the nightmare situation we talked about, what we were trying to prevent, and unfortunately, we didn’t prevent it.”
HAS DEATH RATE DROPPED?
“You have to understand that while you’re dealing with a pandemic, trying to calculate the death percentage is really difficult. It’s more of a retrospective look. You look back at how many people truly died versus how many people were infected. That number was much higher in the beginning because we didn’t actually know how many people were infected. We didn’t have the ability to test people. So it looked like a really high statistic. It still, depending on the publication you read, could be about one percent right now. That’s one percent of a lot of people that are infected right now. The death rate is one number to focus on. But really it’s that hospitalization rate. How many people are in the hospital? Which remember, is taking up space from other people who need the hospital, too. That’s the critical infrastructure problem that we were trying to prevent. So yeah, it’s easy to say the percent deaths have declined, and just looking at that without bringing in any context. In context, it’s still a really high number.”
CRITICAL SITUATION FOR HOSPITALS
“It’s very critical. From trying to find beds to as of this morning, trying to find ventilators, the kind that we like to use, not the traveling ventilators, those are in short supply. We’ll be able to get more in today, but understand that’s more and more stress on the infrastructure that could easily prevent, once again, that heart attack, that stroke, that car accident from getting the kind of treatment we want them to get.”
"Specifically, in Brown County, if you go back to May when we started testing, we went and tested on site to where we knew the outbreak was, and we expanded to zip codes where their families lived, because we were really able to contain at that point. And then we ended with ‘let’s get total control over this, let’s test people who don’t even have symptoms and do that broadly.’ Right now, we’re going to start testing people who don’t have symptoms. In the next couple of weeks, if everybody could get one test in there. It will tell you you’re negative at that time or positive at that time. But the more people that don’t have symptoms that we can identify as positive and isolate them, that will be one extra step at controlling the spread. Remember, outside of masking, physically distancing and washing our hands, the only true tool that we have is testing and isolating. To isolate, you need to be able to test. So starting today (Oct. 22) you’ll be able to click on no symptoms and still be able to get tested here in Brown County.
CLICK HERE to register for a free test at a Prevea site in the Green Bay area.
“Just the Prevea sites for right now. We got permission from the state to expand that. We had to ask the state for that permission. We’ve been given that permission. So at the Prevea sites, you’ll be able to say no symptoms. Still need to schedule a time of a test. That way we can try to prevent the backlog and schedule a date for that test. But please do it. If you don’t have symptoms, you can get tested as of today. And we’ll continue this for a week or two to see if we can get control over the recent spread.”
POST-COVID NEGATIVE TESTS
After having COVID, do you need to have a negative test result to indicate you are no longer contagious?
“It’s probably one of the more common questions we get, and it creates some confusion because the CDC had one recommendation in the beginning and obviously changed it in the middle of the summer. You don’t need a negative test. After 10 days, you’re considered not to have the replicating version of the virus in your body anymore. In other words, you’re not transmitting it. So after 10 days, you can go back out into society after perfectly isolating yourself from it. Actually, if you do get tested after 10 days, there’s a good chance you’ll still be positive. And you can still get positive tests even 12 weeks down the line. But it’s important to know, it’s 10 days and you’re done. Some people may have to go 20 days because they have other problems associated with their health, such as severely immuno-compromised. But for the general public, 10 days, you don’t need to be tested again. I know a lot of employers are a little confused on that one. You don’t need a negative test to come back to work.”
HOW ARE MULTIPLE TESTS COUNTED?
“They look at an individual. When you give your address, it’s really the county that you live in that’s being reported. You’re only counted once if you’re positive. They’ll look at it over a 90-day time period. You can test 10 times positive in that 90-day time period and counting you once. The state has a little description about that on their DHS website, a little asterisk about how they count the positives once.”
"On Oct. 8, the New England Journal of Medicine published a trial. It’s what we’d call a randomized control trial. Certain people got remdesivir. Some people got a placebo. Think about it as water. And they compared the outcomes. And it showed those that got remdesivir did slightly better than those who got placebo. And by slightly better we mean they stayed in the hospital less. They had less time on the ventilator. Less time in the ICU.
"The World Health Organization did another study that was published this week. Not what we’d call a randomized control trial. Not one that’s peer reviewed yet. And it didn’t show that benefit. So it created some confusion. The medical community is likely going to side with the randomized control trial out of the New England Journal of Medicine, while still analyzing the World Health Organization trial.
"We use it [remdesivir] often. We actually use it a lot. If you’re requiring oxygen, and we give it soon enough, the intent is to prevent you from having that long hospital stay, having to go into the intensive care unit.
“There’s not many things we have in the quiver, but remdesivir is one.”
FAMILY, ISOLATION AND QUARANTINE
One member of a family of four tested positive for COVID-19. What should the rest of the family do?
"If you’re positive, you need to isolate away from the rest of your family. Family of four, mother, daughter, father, however it works out, is positive, they need to isolate away. Stay in their bedroom. Go to the basement. Don’t interact with the rest of the family. Have your own bathroom. Honestly, wear a mask inside the house if you have to walk by somebody. That’s really important to know.
"What about the other three that will now be in quarantine in that house? One’s in isolation because they’re positive. The ones who are not positive are in quarantine for 14 days. Around day five or six, we recommend you getting tested. If you turn positive, and you still don’t have symptoms, you start 10 days of isolation at that point.
“So it can get a little confusing. Positive people isolate. Negative people or people that are exposed quarantine. And we expect on day five or day six the likelihood of you turning positive is there. You need to get a test. If that test is negative, you still need to complete the 14 days of quarantine.”
MALL WALKING SAFETY
Is it safe to keep up a mall walking regimen?
“Exercise is always important and we really do recommend it in the winter months. If you have to be inside for your exercise, just make sure that you’re physically distanced and you’re masking. If you’re in a mall, which is a pretty big open space, make sure you’re giving yourself tons of space. Make sure you’re masking. And make sure everybody else around you is masking. If the mall is going to have mall walking, hopefully they’ll enforce that masking.”
RECOVERY AND MASKING
If you’ve recovered, do you still need to wear a mask?
“The CDC would say right now that they would still prefer you wearing a mask, because we still don’t have definitive proof of transmission after. There’s been some studies back and forth on this. So to err on the side of good judgment, still wear a mask. Set the example. Those that are positive probably understand the important of wearing a mask.”
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