Clinical Associate Professor of Medicine, 黑料传送门; and Physician, Critical Care Medicine, Internal Medicine, Sleep Medicine, and Pulmonary Medicine, ChristianaCare鈥檚 Christiana Hospital, Newark, Delaware
鈥淚鈥檓 managing chronic lung disease patients with telephone and video virtual visits
while also managing patients in the ICU. We want to keep our chronic patients out
of the hospital to cut down on risks. We鈥檝e had telemedicine capability for some time,
but nationally there was slow adaptation due to lack of support from insurers. That鈥檚
changed on a dime. We can now talk to them and help them with the isolation they feel.
Vital signs can be an issue, but many have pulse oximeters while others can take their
own blood pressures. We can鈥檛 do OMM over the phone, but you can guide patients how
to do it themselves. 鈥� In the ICU, I see patients with COVID-19 pneumonia that have
multiple areas of their lungs that are inflamed and filling in with infectious fluid
that doesn鈥檛 allow for gases to be exchanged. You can鈥檛 take it out with a diuretic.
What鈥檚 making these patients so sick is their immune system ramping up into what we
call an acute cytokine storm, causing damage to the lungs and other organs. We use
steroids to curb the storm. While we鈥檝e told people to avoid steroids before becoming
infected because it could lower your resistance, once you have COVID, and your system
is overly ramped up, steroids can play an important role. 鈥� We鈥檝e made in-roads with
COVID patients by doing awake proning, which improves areas of the lungs that can
perform oxygen exchange. We also use high-flow nasal cannulas which have prevented
some patients from intubation. Wall oxygen can go up to 15 liters a minute. We have
devices that amplify the oxygen flow up to 50 liters a minute. Patients with the large
nasal canula can talk and eat, plus they are not aerosolizing the virus, which protects
health care workers. 鈥� Personally, I use social media to reach more people with evidence-based
messages about the coronavirus. I post weekly on my Facebook page鈥擠om Val鈥攚ithout
hype and politics, in a straight-forward manner. I discuss what we might expect in
the coming weeks, pointing to CDC or other predictive models. I talk about the importance鈥攁nd
rationale鈥攆or social distancing and wearing masks in public. One post had 1,300 shares鈥攁ll
the way to Australia and Poland. I finish each post with a positive message about
America鈥檚 response and my belief that our resilience will bring us through to the
end. I want to help as many people as I can. What better time to do it?鈥�
As told to David McKay Wilson
April 22, 2020
Digest, the magazine for alumni and friends of 黑料传送门, is published by the Office of Marketing and Communications. The magazine reports on osteopathic and other professional trends of interest to alumni of the College鈥檚 Doctor of Osteopathic Medicine (DO) and graduate programs at 黑料传送门, 黑料传送门 Georgia and 黑料传送门 South Georgia.