Chicago Arthritis and Regenerative Medicine update 20200415

Update on the happenings from Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine.
-Covid19/Corona Virus updates
-Testing challenges
-Good news!

Hello, this is Siddharth Tambar from Chicago arthritis and regenerative medicine. In this video this is meant to give you an update as to what’s going on here at Chicago arthritis and regenerative medicine on April 15th, 2020. In the middle of the covid-19 outbreak. There are some interesting challenges and also some positive things. I’ll start with the challenges and then get to the positive things.

So interestingly, I do have several patients that it’s come to my attention have turned out to be covid-19 positive. These are patients where we’ve done telemed evaluations because they have some chronic issues that were assisting with in either their autoimmune spectrum or chronic musculoskeletal issues. And it’s interesting. There is variety in terms of who is who has been affected but in general these are people that are typically a little bit higher risk either based on age or other medical issues. And what’s interesting is thankfully all these people have they seem to have done well, meaning they’ve recovered. Only one person was actually hospitalized and required formal medical treatment and has done well. In all cases they’re now all sort of quarantined, their families quarantined, and they seem to be recovering.

We’ve a couple of cases where people have really good stories from the last maybe six to eight weeks that sounds like based on their travel history that maybe at one point in the last month, maybe they were infected with covid-19. Hard to prove that this point of course, but some suspicion that these people could have had that. Another really challenging thing that I’m hearing is still about the testing. I think that’s improved but I’ve heard cases where people who very clearly were at some risk, not necessarily high high risk people based on age or other comorbidities. But as an example someone who works at a hospital and had fevers, cough, dry cough, as well as had lost his sense of smell, some classic things that have been described about covid-19. And he tried to get checked out at the hospital that he works at and they really wouldn’t test him. And he ended up actually getting testing on his own and tested positive. Paying out of pocket for that and tested positive. And thankfully he did that because he’s now self-quarantined, his whole family is self-quarantined. They’re doing all the right things. These are good citizens and good people of our society that have done that but they’ve had to find solutions that had to go above and beyond what our system could even help them out with which is which is disappointing at like that bigger picture level, but at that local micro-level to know that people still take that that seriously not only their own health, but their responsibility to others was heartening to me. And I’ve seen that in a couple of cases and so I’m actually happy to see that.

It brings me to the to another challenge, which is we’re getting to the point where either to some degree society is trying to get back to business as usual in two weeks, toward early May or that may get pushed off until mid-may. I think for those of us that can think about this rationally and sensibly life going back to normal is still going to be delayed for some time. We’ll have some version of normal, but it’s not going to be full on what we were two to three months ago. I think we have to be honest with that. And one idea is can we start to check some degree of antibody testing to determine who’s been exposed previously to covid-19, who has more of an acute exposure, and who hasn’t been exposed so that we can start to risk stratify people when it comes back to going to work. Take into consideration not only some of their other medical comorbidities, medications that they’re on, but their actual exposure history to covid-19. Because as time goes on we may realize that a lot more people have been exposed and are now possibly immune or lower risk- maybe is the way to think about it. Some of the challenges that I’m hearing and and I am someone and our clinic and our outfit is trying to actually get antibody testing kits, but some of the things that we’re hearing some of the challenges include what is the validity of some of these kits when it comes to testing. And how have they been tested and how they been verified. And the challenge is that in an attempt to get more kits out there, some of these may have very limited testing, some of these may have been tested in a very small number of patients. Some of these may have been tested not over months, maybe not even over weeks, maybe over days and so that that is that’s a little bit of a challenge. And as a individual physician the way that I try to think about this is if the evidence is muddy and the situation is little bit hazy, first and foremost is there good evidence that we can rely on. And are there low-risk, efficacious options for my patients to help us make good smart decisions. And sometimes there’s a little bit of conflict in those two things, meaning is there great evidence and what is a smart low-risk good option. And it can be a challenge but trying to make some good smart medical decisions is always the right way to go and I don’t know if we have the full answers right now in terms of what antibody tests are best and most appropriate to use but my hope is that over the next couple weeks we start getting more clarity on that so that we can start making smart decisions as to how people can get back into some degree of their normal life. And from a medical standpoint for our patients who have chronic issues that still need to be treated, how do we manage some of those treatment decisions, whether it’s medications, procedures, other types of treatments- How do we manage that in a low-risk smart way for not only that individual but for society as a whole.

So those are some of the challenges, here’s some good things, I think. We’re still able to connect with patients. I think the telemedicine route as a tactic has been working really well. I think people are taking to it. I think people appreciate the ability to communicate directly with their physician and get some guidance and trusted opinions. I’ve had some pretty good conversations not only with my existing patients who already know and trust me, but also newer patients that need guidance for some of their issues that have been developing or have been chronic. And I think that is fantastic because we can take the technology that’s available and we can still help people out in ways that are ethical, professional, and still beneficial and value-driven.

Lastly, I think resilience and strength and joy and happiness and gratitude are still important at this time. It is April 15th, and we had 2 inches of snow this morning in Chicago. And for those that don’t know this that can happen in this sort of climate. And in the morning my daughter and I had the chance to go outside and try to enjoy the snow. And what’s interesting is there wasn’t a lot of snow. We can small snowman. There wasn’t a lot of snow so that we couldn’t actually go sledding, but we were able to have a little bit of a snowball flight. That’s a way to try to enjoy what we do have. Certain things are not going to be ideal, but we can still find joy and happiness in life. And I think it’s important to still try to find those kind of opportunities because that’s what makes living worthwhile and that’s what makes struggle worthwhile. You can still find happiness. So be strong, be resilient. I hope everyone is doing well. Have a good day and live well, bye bye.

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***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses Covid19, testing issues, telemedicine, and good news.