Sunday, July 5, 2020

UPMC doctor sees too much focus on rising COVID-19 cases, too little on declining severity and hospitalizations


Updated Jun 24, 2020; Posted Jun 24, 2020 By David Wenner | dwenner@pennlive.com
A UPMC doctor on Wednesday said the number of people hospitalized with COVID-19 within UPMC is the lowest in many weeks, and people who test positive aren’t getting as sick.
Dr. Donald Yealy pointed out that is occurring even in the midst of Pennsylvania’s reopening and the ongoing social justice protests.
He suggested the country is focusing too much on rising COVID-19 case counts.
“We need to change our mindset and focus not exclusively on the number of cases, but on the severity of illness. We shouldn’t just be counting those who have a diagnosed infection,” Yealy said. “For the vast majority of people testing positive, their illness is mild, or they don’t even know they have any symptoms of COVID-19 infection.”
Yealy also said UPMC has tested more than 15,000 patients who were receiving non-COVID-19 care, with only about one in 400 testing positive. He said the rate, which has held steady for weeks, suggests that aren’t many people carrying COVID-19 who don’t know it.
“In summary, what our experience shows is that fewer people are being admitted, and when they are, they tend to be much less sick than at the beginning or at the peak phases of the pandemic,” he said.
Yealy said the declines might result from factors such as doing a good job of protecting the elderly and others who are highly vulnerable, and a rising portion of new cases involving younger people who are healthier and less likely to need hospitalization.
He also said UMPC has improved tools for helping the sickest patients, including the drug Remdesivir, and has “gained experience in how to best care for” COVID-19 patients. He noted that early in the pandemic, doctors usually put the sickest patients on breathing ventilators. But UPMC learned “it was difficult for them to successfully come off, and their outcomes simply aren’t as good.”
Yealy said UPMC presently has only 14 patients on ventilators across its 40 hospitals, which include six in Dauphin, Cumberland, York and Lancaster counties.
Yealy said the lessening impact of COVID-19 might be related to summer weather and people spending less time in close quarters.
However, Yealy and another UPMC official who spoke during a briefing with reporters on Wednesday warned against disregarding the need for face masks and other precautions to prevent spread of COVID-19.
Tami Minnier, UPMC’s chief quality officer, said “we need to stay vigilant. We need to be able to continue wearing our masks, wearing our masks appropriately, washing your hands frequently, using social distancing. Despite all of the points that Dr. Yealy made, that is our plan going forward for keeping all of us safe.”
Yealy said it’s important for younger people who don’t get very sick from COVID-19 to understand the danger it poses for others.
“We’re not saying go out and do whatever you want. Be smart about it. Use the hand washing. Wear the mask, distance [yourself] if you’re going to visit elderly relatives or immunocompromised friends. Those are still important. That’s the smart public health that we still need to be vigilant about,” he said.

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