Dr. Alok Sengupta, chairman of Mercy Hospital St. Louis emergency department, says that after Missouri Governor Mike Parson and St. Louis County officials announced the first COVID-19 case in St. Louis on Saturday, March 7, the “emergency department has been inundated with phone calls from patients just asking what to do and how to be tested.” What they can do, he tells them, “is continue the same recommendations we have for influenza or other viral illnesses with good hand hygiene, covering their mouths when they cough and avoid contact. That’s preferable.”
The Centers for Disease Control and Prevention has also released recommendations on preventing the illness, taking care of your mental health, and discussing the virus with children. Another big question: Will warmer temperatures slow the COVID-19 outbreak? “It is not yet known whether weather and temperature impact the spread of COVID-19. Some other viruses, like the common cold and flu, spread more during cold weather months but that does not mean it is impossible to become sick with these viruses during other months. At this time, it is not known whether the spread of COVID-19 will decrease when weather becomes warmer,” according to the CDC.
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To help those concerned, Mercy has launched a phone service (314-251-0500) for St. Louisans to call and speak with COVID-19 specialists who will provide callers with guidance based on symptoms. Later this week, Dr. Sengupta says Mercy will announce an off-site clinic for testing. Below, Dr. Sengupta answers other frequent questions surrounding COVID-19.
How can people get tested if they’re worried they have COVID-19? Our health department still has certain criteria that have to be met before a patient is tested. Those include either travel to one of the infected high-risk areas along with having fever and respiratory symptoms without another explanation. Those are the patients that the health department is testing. If you don’t meet those criteria, then the test isn’t available for patients. We’ve seen a lot of patients come into the emergency department asking to be tested and we’re not able to provide that test. Mercy has started a phone service today that provides patients the ability to talk with experts in the field to help guide them. And by the end of the week, we’ll have an off campus off-site center where testing can be performed. But once again, we’re going to follow the CDC and health department recommendations on who should be tested for this.
If people feel like they have symptoms associated with COVID-19, how can they distinguish this virus from say a cold or the flu? It makes it hard for a person who has a fever and a cough to distinguish what they have, but there’s only been one case in the St. Louis area as of now. If they’ve not been in contact with that person, then it’s very unlikely at this point that they have been exposed to COVID-19. The CDC says patients who are at risk are someone who’s been within six feet of a patient for an extended period of time. And that extended period of time they’re defining as about 15 minutes.
What about the concern of possible interaction with St. Louis’ first confirmed case, the college-age woman who traveled to Italy, or her family? The other family members have not tested positive or been symptomatic for COVID-19, so the risk for anyone being in contact with them is extremely low. The other thing to remember is 85 percent of patients who do have COVID-19 have very mild symptoms, similar to a cold. And the patients who are really at risk are elderly patients with comorbid conditions such as asthma or COPD, or any other kind of respiratory disease—those are the patients at risk for getting sicker. Most people will be able to fight off this infection as they would a cold.
Could you talk a bit about comparing COVID-19 to the flu? I think flu comparisons are good when talking about how to address it. The same hand hygiene techniques and stuff we recommend to avoid catching the flu, applied to this virus and all viruses. The epidemiologic studies are still fairly new and it’s hard to know where we’ll end up. We know that this is more virulent than flu for elderly patients with comorbid conditions. But I think what’s driving a lot of the concern is just the uncertainty since this is a new virus we haven’t been able to study yet.
How are St. Louis hospitals preparing for a spread of COVID-19 or influx of patients? At Mercy, we’ve had a task force in place for the last couple of months, as we’ve seen this spread throughout the world. Each of our hospitals has an infection control team that follows all this closely. They’ve been in contact with the health department daily and really, multiple times a day, getting the latest information. Our emergency departments have always been prepared for these kinds of viruses spreading, and we follow the personal protective equipment recommendations from the CDC and the health department. We have put screening questions into our electronic health record to help us identify potential cases right away.
Should we be trimming out unnecessary contact with other people? I think people should lead their daily lives. Obviously, if you’re in bigger groups there’s a higher risk for contracting an infection—all infections—you just need to weigh those risks. If you’re in a risk category where you’re immunocompromised or you have other medical conditions, consider that before going out into a large group.
More information can be found at stlcorona.com. To report an illness, or if you’re experiencing fever, cough, shortness of breath, call St. Louis County Department of Health’s 314-615-2660. If you have general questions call 1-877-435-8411.
