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COVID-19

Dr. Daniel Edney Q&A on COVID-19: ‘Use some good Mississippi common sense’

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Dr Daniel Edney
Dr Daniel Edney (photo from the Mississippi State Board of Medical Licensure)

Dr. Daniel Edney is one of ten physicians serving on Mississippi’s COVID-19 coronavirus task force. He also practices here in town at Medical Associates of Vicksburg, specializing in in internal medicine.

“We must flatten the curve to stem the tide of this virus,” Edney told the Vicksburg Daily News in a previous interview. At that time, he emphasized that people must start taking COVID-19 seriously. He remains adamant that all of us must do what we can to follow social-distancing and hygiene guidelines to stem the numbers of COVID-19 infections.

“It will get worse before it gets better,” he wrote in an email, “but it is going to get better.”

We followed up with Dr. Edney this past weekend, and he requested we email him our questions. He provided a great deal of valuable information and some good news about the pandemic as well.

The questions and his responses are below, lightly edited for clarity.

Q. Since we last spoke, what developments have you seen here locally and on the state level that you can share?

A. Obviously, the cases statewide have increased as have deaths as we expected but remember, the numbers released every day currently are five to seven-days old and really show where we were a week ago. The MSDH is getting more aggressive with offensive measures including legal quarantine orders in areas that are the hottest right now like Desoto County. I anticipate more such measures in the coming week.

Good news is that South Korea appears to be stabilizing their outbreak through aggressive testing and containment strategies. It appears they MAY have passed their apex as has China, if we can believe what they report. Italy continues to worsen and leads the way for European countries that are all still escalating in cases and deaths.

Q. Testing has ramped up around the state, and the University of Mississippi Medical Center is now testing. Can you expound on this?

A: UMMC was approved to do in-house testing of an already commercially available test that will allow them to do 180 tests per day with a one-day turnaround rather than five to nine days we have now, but this will be for the tests that UMMC will be running on “UMMC intensive care units, UMMC inpatients, and UMMC employees.” I suspect that they will work to build capacity to run the samples from the drive-through test sites they are doing around the state but not at this time.

Testing has ramped up since we can now use our regular commercial lab partners rather than the state public health lab, which has been swamped. We have still been instructed as of last Friday to continue to test only those who are symptomatic and preferably with fever and higher risk factors. As testing continues to improve, I believe that we’ll be able to expand our testing, but it is very important that practicing physicians follow the recommendation of our public health experts and conduct our testing as advised.

Q. Approximately how many tests have you and your associates sent out. Is there additional information obtained? We are trying to ascertain what the identifying criteria is for how cases are counted by county.

A. Our clinic is following the Health Dept. recommendation of screening the patients using tele-medicine technology from home so that we are not bringing patients to the clinics unnecessarily. Those who have low risk symptoms and no fever are being monitored at home, and those with higher risk symptoms and especially fever are being brought in using full isolation to be tested. Remember, if you are tested then you need to isolate.

Last week our clinic did about 30 tests, and I expect that to increase significantly this week. Also, Abbott Labs has been approved to produce and sell a point-of-care test just like the current flu test that we will be able to use in our clinics and finally have immediate results. Once this is available, I suspect the restrictions on testing will relax. We are evaluating everyone who calls in concerned and testing everyone who meets the current criteria, but this is a fluid situation and constantly changing on us.

Q. Have you hospitalized anyone? Obviously, you can’t violate HIPPA guidelines, but can you give us some demographic information in a general sense.

A. The Health Dept. is the better source for that. I can tell you that the patient at Promise is showing steady improvement and not requiring a ventilator.

Q. In our previous conversation you indicated that you felt that the mortality rate may be higher worldwide that what is being cited by the World Health Organization (3.4%).

A. The best news of all for us is that so far, the U.S. mortality rate is about half of what we anticipated at about 1% to 1.5% whereas we were seeing 2% to 4% in other countries. That is still much worse than the flu, which is usually 0.1%, and still requires aggressive public health action to keep our deaths as low as possible.

Newest info this morning has our U.S. mortality rate at 1.7%. Still much lower than we feared.

Q. The situation in our neighboring state of Louisiana has grown substantially. How concerned are you about the virus spreading from there?

A. New Orleans especially is bad and getting worse. It is requiring many of the measures currently being employed in New York. Clearly, we are seeing spillage of cases over into Gulf Coast counties and Southwest Mississippi including Natchez. We have seen the one case for us that appears to have been related to New Orleans.

We are treating our Louisiana patients by tele-medicine to allow them to remain under their state lock-down order, and I believe that order is protecting us on this side of the river as fewer people are traveling back and forth compared to usual. Certainly, we do advise our patients not to travel to Louisiana if at all possible and stay out of New Orleans and Baton Rouge. However, if you’re watching the state’s numbers, our biggest risk in Vicksburg is related to the Metro Jackson area which is much closer to us with increasing patient counts, although nothing like New Orleans. We do advise everyone to limit their travel to the Jackson area to only that which is essential.

Q. There are numerous rumors about usage of aspirin, Aleve, etc. What do you recommend?

A. All the information we have regarding medicines that may be good or bad are coming from countries hit earlier than we were and from those states first hit—and are all anecdotal. I am reading from American doctors in the hot zones a mixed message on all of it.

At this point, we are being told that anti-inflammatories like Motrin are probably OK, and to follow your doctor’s advice. The hydroxychloroquine and azithromycin combination MAY help, but proper controlled studies are just now beginning, and that will answer these questions. We also do have a few antivirals that are currently being studied and showing promise, and the vaccine is progressing rapidly and so far, so good. It will become our most powerful weapon when it is eventually deployed.

Q. We continue to hear that there is not enough personal protective equipment. People have started to make homemade masks. Can you give your thoughts on this?

A: Merit Health River Region and Promise both have adequate supplies of PPE, but all of our supplies are limited. We also need PPE in our clinics, nursing homes and for first responders. Currently, virtually everything being produced is going to New York, the West Coast and New Orleans where the need is desperate. We are having to be careful not to waste what we have and are working to make our supplies last. We are praying that the ramping up of PPE production will take care of us but currently, that is one of our unknowns.

Please understand that every patient tested as an outpatient consumes some of our PPE, and this is another reason why we must be careful with testing. If you have a loved one that is on the front lines in our hospitals, would you rather we use PPE for them in the highest risk areas or to test someone who thinks they might could possibly have it who has a mild sore throat and no fever? PPE is currently a valuable resource for our health-care system and must be managed appropriately.

Other good news is that we currently have plenty of ICU and ventilator capacity and are being told that we can double our capacity statewide, including ventilators, tomorrow if needed. Plans are under way to have COVID-19 only facilities, especially for convalescence for those stable enough to leave the hospital but not ready to go home (if it comes to that), and our experts at the U.S. Army Corps of Engineers are able to re-purpose facilities if needed, as we are seeing in Louisiana and New York. They truly are doing amazing work.

It’s important to know that we are not at our apex and likely will not reach it for another two to four weeks, and that it’s very important to follow the restrictions that our state, city and county officials have put into place. It will get worse before it gets better.

One of the most important new restrictions is not to be in retail areas with more than 10 people. That is one of the remaining high-risk areas we had left with restaurants and churches already doing their part. We are wanting all HIGH RISK people to truly shelter in place until well after the apex, and you can see what that means at the CDC.gov website. It basically means stay at home with as little outside personal contact as possible. That takes some preparation and planning to achieve. If you love someone in that category, then make this happen. And everyone: follow the restrictions to help protect our most vulnerable neighbors.

It will get worse before it gets better, but it is going to get better. This too shall pass, and remember that God is in control and not this virus—but He does expect us to listen and use some good Mississippi common sense.

For more information, please visit the MSDH website.

 

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