Dr. Blass Weighs Probable Versus Possible in Light of Georgia Reopening

Dr. Mitchell Blass recently shared his firsthand front-line hospital and private office experiences with the AJT. As COVID news changes hourly and in light of Gov. Brian Kemp’s decision to reopen Georgia businesses, Blass furthers his very timely discussion on trends he is seeing, levels of intense cleaning and peering over the horizon.

Jaffe: Last month you had 60 COVID patients, then 12 two weeks ago. Now what?

Blass: The volume of COVID patients is decreasing steadily over time.  I have only seen eight additional patients since we last spoke.  I do anticipate that COVID will remain ever-present worldwide for a very long time.  Smallpox is the only infectious disease which has been 100 percent eradicated by vaccination.

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Jaffe: What is the outlook for a sample COVID patient who was on a ventilator four weeks ago and recovering at home?

Blass: Thankfully he is home and continues to recover.  He is getting stronger each day.  However, his COVID PCR [polymerase chain reaction] test remains positive.  This implies that he may still be contagious to others, and therefore is self-quarantined at home.

Jaffe: Are the added hospital beds overflowing with COVID patients?

Blass: The volume in the hospitals I am on staff at [Northside and Emory Saint Joseph’s] continues to decrease over time. The additional beds are no longer full.  We have adequate [Personal Protective Equipment] PPE. We are able to test for active infection with a COVID PCR and to detect antibody response with a COVID [Immunoglobulin G] IgG test.  Both are available with rapid turnaround times.

Jaffe: Does Gov. Brian Kemp deserve the swift backlash for opening too soon?

Bowling alleys, tattoo parlors?

Blass: I prefer to stay out of politics. That being said, there is a delicate balance that we must be mindful of.  1. Concern about potential spread of COVID and the potential risks to the health of our local community, 2. Concerns about the economic consequences of a continued lockdown, and 3. Concern about civil liberties of the American people. It is OK for all three to exist at once and finding that right balance for any state is a challenge.

We must consider the possibility that close contact between individuals, such as in nursing facilities, hospitals, work and even together in our homes, may be a contributing factor to the spread of COVID.  Whereas when we are out of doors, for a number of reasons, there may, in fact, be less of an opportunity for the virus to be transmitted directly from one person to another.

Jaffe: Can we ease up on cleaning our groceries, and boxes?

Blass: It is important to continue to be mindful of the difference between what is possible and what is probable. Presently, the likelihood of an individual acquiring COVID from mail, groceries and parcels is far less likely than from forgetting to wash their hands and then touching their face. I think it is very reasonable to wash fresh fruits and vegetables.

Jaffe: What is your best hunch on what COVID will look like this winter?

Blass: I think one of the biggest challenges we will face, healthcare providers and patients, will be that the initial symptoms of COVID and seasonal influenza are often very similar; AND there will be individuals that have both concurrently.

Fortunately, there are now rapid and accurate point of care tests available for both COVID and influenza.

I strongly encourage everyone to have a seasonal influenza vaccination.

Jaffe: Some are scared to consume takeout food.

Blass: I have been watching the pandemic very closely.  I am not convinced that there are any cases of foodborne acquisition.

Jaffe: If you’ve learned one thing from this, it would be?

Blass: Healthcare providers are vastly more prepared today than in January.  We have a better understanding of the initial signs and symptoms as well as of infection control measures required in the healthcare setting.

Our hospitals are better prepared from the patient’s ER arrival through discharge.  We have adequate PPE, rapid testing for both active disease (PCR) and immunity (antibody). We are learning more every day about treatment options. No one hopes there will be a second wave, however I have confidence that the healthcare system is more prepared if it should happen.

Today I was tested for COVID IgG antibodies measuring my exposure without ever developing symptoms. Stay tuned.