Covid-19 and Pathology

Hi everyone,

The coronavirus pandemic has caused many changes in the last month or so in the United States. People are advised to stay at home and maintain distance from each other, not travel, see their family and friends, in addition to wearing masks, in addition to staying away from large gatherings. Most non-essential businesses such as hair salons have closed and restaurants are either closed or only offering take-out. Elective surgery and non-emergent doctor's visits have been canceled or rescheduled.

Many people have filed for unemployment. Covid-19 has upended livelihoods and caused social changes which may last for the next 1-2 years, not to mention the massive government financing of companies and businesses here in America. Thankfully, of the people I know personally, they have kept their jobs and are working from home or going to the office very rarely.

In terms of medical training, the consensus among medical schools, in general, is that medical trainees should not be in the clinics/hospital during this time. My medical school's policy is that medical students should not physically attend rotations for the time being. The educational components are being completed from home virtually. In my masters of public health, all the classes are being taught remotely.

It has been interesting to compare the public health response of different countries and the actions they have taken against the novel coronavirus. In some countries, aggressive contact tracing and widespread testing has managed to curb or contain the spread of the virus. In the US, the government's sluggish and piecemeal response has made it difficult to effectively contain the virus. An example is the use of a smartphone app to trace the people a person could have been in close contact with, if they are found to test positive for coronavirus.

Hospitals and healthcare workers in New York, the epicenter of the pandemic in the North East US, have been overwhelmed by Covid-19 cases. In addition, the shortage of PPE (personal protective equipment) such as facemasks, gowns, and gloves in addition to other healthcare equipment has exacerbated the crisis.

Many features are being uncovered as the pandemic progresses. One example, that has come out recently is that Covid-19 can cause a coagulopathy leading to strokes or pulmonary embolism in young people. Another is that the virus may cause cardiac symptoms in individuals, causing medical examiners to erroneously attribute their deaths to cardiac cause without sufficient testing of the decreased. Without testing, there is likely an undercounting of deaths related to coronavirus here in the United States.

One fear is that the virus will mutate as it passes from host to host and grow more and more virulent as time passes. The other fear, is that we will not be able to find an effective vaccine for the virus. The hope of returning to normality hinges on the creation of a vaccine or finding an effective treatment. There have been some attempts to use convalescent plasma, however it is unclear how much of a benefit it will provide, in addition to there not being enough plasma available (in addition to the usual transfusion risks although it is generally tolerated well). Like many things about this situation, convalescent plasma from recovered Covid-19 patients has not been extensively tested.

Unfortunately, there has been a lot of misinformation circulating about which treatments may be effective against the virus, ranging to medications to homeopathy. This is troubling and misguided  because it can lead to shortages in essential medicines needed to treat other diseases that are not related to the pandemic.

As difficult it is to stay away from loved ones and conduct our daily lives from home, it is necessary to take precautions to prevent the spread of this highly contagious virus. I hope that pathologists and researchers will be able to contribute to scientific knowledge about Covid-19 as things progress, in order to prevent morbidity and mortality. Now more than ever, we must cooperate to prevent this pandemic from worsening.

How have you been effected by Covid-19?

Have there been changes to your workplace (or pathology laboratory) as a result of the coronavirus pandemic?

Feel free to share any thoughts or comments.