ER doctor: We are not yet at the point of just 'living with' COVID-19

·5 min read

On Monday evening, Des Moines writer Andie Dominick caught up again with Dr. Tom Benzoni, a local emergency room physician, to talk about the coronavirus pandemic. He has been interviewed for the Register numerous times since the coronavirus pandemic hit Iowa.

Here are previous installments from 2020 on March 31, April 28, May 12, May 26, June 8, June 21, July 1, July 18, Aug. 10, Aug. 24, Sept. 11, Oct. 30, Nov. 16, Dec. 16, and 2021 on Jan 7, Jan. 26, Feb 22, March 22, April 15, May 11, June 1, June 23, July 24, Aug. 15, Sept. 13, Oct. 22, Dec. 4 and Dec. 27.

Here are edited excerpts from the Jan. 17 conversation:

As always, I first want to know what’s going on in the hospitals.

Well, it’s packed, but we are seeing a little downturn in COVID. We’re also seeing a tremendous number of people coming in to be tested.

A patient states she’s been having chest pain, fevers and muscle aches for a week and she had a negative test two days ago. Now it’s the weekend and she wants another one.

A patient has headaches, a sore throat and says everyone in her house is positive and she would like a test at the ER.

I find that an irritating misuse of emergency services, and hospitals are telling Iowans not to visit for only a test.

Well, from the patient’s point of view, it makes sense to come in.

I know people who have never been tested for COVID and others who have made it a hobby. Can you walk through how to decide when to get a test?

Only get a test if you’re going to use the results. Are you making sure you’re negative before you visit an elderly relative? Do you have an underlying condition and are going to seek interventional treatment if you’re positive? Don’t test if you’re going to ignore the results.

More: At-home COVID test website launches early. How to order free testing kits from the government

More: Omicron is not that mild: 50,000 to 300,000 more US deaths projected by March: COVID-19 updates

Are you seeing ER patients who were vaccinated and boosted?

Yes, but it’s very important to understand they are not sick-sick. They are not so sick they have to be admitted. They have aches and pains. In fact, back pain is really interesting and one of the common complaints now with COVID.

The CDC recently announced what many of us figured everyone knew all along: Cloth masks are not as effective as N95 and KN95. Thoughts?

Any mask is more effective than no mask, but one problem is there’s no definition for a “cloth mask.” It can be made of rayon or tightly woven cotton.

If you have a standard surgical mask and you’re breathing through it, it’s about 75% effective, or as good as condoms. The 95s are, well, 95% effective — if you wear them properly.

Leaders in some countries are conveying it is time to “learn to live with” the virus. Are we at that point?

We will eventually get to that point. We are not there now. We learned to live with coronaviruses one through four, and that’s how we learned basic hygiene rules. Don’t share your pop bottle with your brother. Don’t cough on people.

Those courtesies seem like common knowledge. Then again, look up Dr. Joseph Lister. He was castigated and about thrown out of medicine for suggesting doctors should wash their hands after leaving the bare-handed autopsy room.

So sometimes what we think is common knowledge isn’t.

What’s your best advice for a relatively healthy person who tests positive now?

First, don’t spread it. From a personal care perspective? This is coming from a doctor who works nights, but we do know getting sufficient rest is important for the immune system. Put down the alcohol. It’s not going to sterilize your interior. Get enough sleep.

Is a throat or nasal swab better?

Well, it depends on how the test is being done. A nasal swab should not feel like an eye biopsy. It’s got to go straight back. If you’re going to do an oral swab, you’ve got to get all the way back in your throat. It should feel like it’s coming out the back of your head.

Chile is now among the handful of countries offering “second boosters” or fourth shots. Thoughts?

We don’t know yet what effect a fourth shot will have. There probably won’t be much negative effect because the vaccines are safe. It makes sense that it may provide a boost to immunity.

Should parents keep a healthy, vaccinated young child home after notification of a classroom outbreak?

This is part of the difficulty of risk mitigation. If everybody in the household is healthy and vaccinated, they are at low risk of severe illness. Then again, if the child is going to visit elderly or frail family members, that has to be considered. You don’t visit Grandma when you’re sick.

I want to believe any future variants will be less deadly, but where do you think we are going from here?

I’m reminded of horoscopes. As long as you stay far enough out and general enough, you’ll always be right.

I think as more people build immunity through immunization or wild infection, the virus will tend to tamp down. I don’t think it will rise up and become more virulent. It will likely start to enter the pool of our other coronaviruses and there may be a few more tough waves, but over time the severity will be less and less.

And there may be another variant that comes along with much more severe symptoms, but less transmissibility so it hits fewer people.

We don’t know what the pattern is going to be.

The most important thing to understand at this moment is don’t spread this virus. Do everything you can not to spread it.

This article originally appeared on Des Moines Register: Opinion: We are not yet at the point of just 'living with' COVID-19

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