Friday, March 20, 2020

COVID-19 and Lung Transplant

Scary times for lung transplant recipients and others with compromised immune systems.  It seems that there is new information on COVID-19 coming at us hourly, and none of it is very positive.  It's getting kind of scary out here. On a positive note what the rest of the world is considering a new normal of social isolation and infection control, we have been practicing since day 1 post-transplant.

We've been wearing masks, using hand sanitizer and washing our hands long before it was cool.  Now we just have to tighten things up a bit.  A message from my Team:


To all Lung Transplant Patients:

We write to share with you specific instructions with respect to COVID-19 given your medical history. While the severity of COVID-19 infection is highly variable, it is especially severe among patients with complex medical problems and weakened immune systems, both of which apply to you. As a lung transplant patient, this puts you at a high risk of developing the most severe form of the disease from this virus. Unfortunately, we do not have any approved medications to this disease at this time. Thus, we are recommending the following:

  1. Please stay at home. That includes not goingto restaurants, theaters, games, banks, malls, work, etc. Avoid visitors at home. Only leave home for absolutely unavoidable activities.
  2. Please have a designated person be your contact with the 'outside .' This caregiver also needs to be careful so that they do not get infected themselves. Try to avoid shaking hands if you meet people, avoid touching objects or touching your face. Practice regular and thorough hand washing with regular soap or use approved hand sanitizers.
  3. You should not go to elective or regularly scheduled follow up clinics if are feeling well. Please call the transplant clinic if you have any questions.
  4. If you are acutely ill, please call lung transplant clinic or send a MyChart message. Please avoid coming to the clinic without calling us. We want you to be safe and will guide you regarding where to come for the treatment.

The novel coronavirus, referred to the COVID-19 virus, is spreading rapidly throughout the country and there are now multiple confirmed cases infected with this in the Dallas County in addition to the cases in Collin and Tarrant County .

The virus can stay alive on inanimate objects such as door handles, arm chairs, and table surfaces anywhere from 9 hours to days. There are reports that up to 40% of infected patients do not develop symptoms, but some of these patients can still spread the infection to other people. This potentially contributes to the spread of this infection.

these characteristics of this virus, we expect the infection to spread over the next few weeks and additional cases tobe confirmed locally. We cannot predict the pace and extent of the spread of the virus in the community, or the time it may take for its prevalence in the community to drop significantly. The worst case scenario of widespread and prolonged community spread (people to people transmission) placing everyone at a significant risk of getting infected...

It is now more important than ever that we track our health and are diligent about taking our meds.  My Team requires that lung transplant recipients performs daily home vitals and spirometry. This is so very important. If you know how your temperature, blood pressure and lung function trends with the weather, allergies and other variables, you will recognize when something is wrong.  If something is wrong, your Team can use your records to help quickly diagnose the issue. When I had a Pulmonary Embolism, my at home spirometry helped to quickly rule out other causes of my shortness of breath. 

My Team has defined triggers for when we should contact them.  Some prompt a MyChart message, others a call no matter the time, and others a call on the way to the ER.  These triggers haven't changed.  Any respiratory virus can be hazardous to us. This new variant of Coronavirus is more aggressive than most, but our defenses are the same.

If you wear a cloth mask, please make sure you wash it after use. 

If you wear a paper procedure mask, only wear it once.  If you must reuse a paper mask, wait days before reusing to allow any virus to die off before reusing.

I personally use a Neti Pot daily. A nasal rinse seems to help me.

These are scary times, but we can get to the other side.  Listen to your Team, they have your best interest at heart.  Our Teams are communicating with each other.  No matter what country, the transplant community is a small one and they are sharing information.  They are learning from each other and adjusting protocol as necessary.

Do I have worries?  Oh yeah, plenty. Am I panicked? Nope.  Just very cautious, and caution is warranted. Caution can save our lives :)

My biggest worry is a supply chain disruption, running out of meds is something I have no control over. What I can do is change any 30 day supply prescriptions to 90 day, and that is in process as I type.

Stay safe my friends.  Comments and ideas are always welcome.

No comments:

Post a Comment