Berks County Medical Society Medical Record Summer 2020 - 14

Coronavirus Chronicles: Berks Responds
Interview with Debra Powell, MD, Chief, Division of Infectious Disease, Medical Director
for Infection Prevention, Tower Health Medical Group, Reading Hospital
continued from page 13
I think that preparing for a pandemic is challenging. We have
focused federal funding on other issues instead of public health and
outbreak preparedness. These situations are very complex because
not every virus requires the same PPE since it is based on route of
transmission and treatments have to be customized. Our last scare
with Ebola in 2014 raised great concern and we were fortunate
that the outbreak never took hold in our country. Most Americans
did not pay attention during the prior SARS and MERS outbreaks
since they didn't affect their daily lives. Respiratory viruses have
the highest potential for mass spread and for future preparedness.
We should be stockpiling PPE and funding vaccine and treatment
research for these viral agents. We should also stockpile treatments
for bioterrorism agents. I am also concerned that President Trump
is threatening to defund the World Health Organization. This is
unwise and is a threat to the entire world.
MR: Predictions are always difficult to make but would you comment
on where we go from here? What are your short and long term
presumptions about this disease? What do you foresee as best options for
antivirals or other medications and of course for the ideal of a safe and
effective vaccine? What kind of timeframe do you see for that in wide
distribution?
Predictions are difficult. I expect that we will continue to see cases
until a vaccine is available and the county achieves at least 70 - 80%
immunity. The baseline prevalence data in many populations at this
point is approximately 5%. We have a long way to go to achieve
this level of herd immunity. I think that the earliest timeline for the
vaccine would be by the end of the year or early 2021.
At this point, our inpatient numbers are decreasing but I remain
concerned that we may see increases as people attempt to get back to
their baseline social lives. I strongly recommend that people continue
to wear masks in public, wash their hands, and socially distance.

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MR: You of course have seen nothing like this in your career. Even the
emergence of HIV with the AIDS epidemic, Ebola virus, Zika virus and
others have had nothing like the impact of this pandemic. How has this
had a personal impact on you and your colleagues? Do you think we
have learned and continue to learn from this experience?
You are correct, we haven't seen a pandemic on this scale for 100
years. I do remember the HIV epidemic in the 1980s and the fear
that was experienced by the public and the health care community.
These patients were also placed in strict isolation and it took years
until the cause of the infection was discovered, and tests and
treatments were developed
The Ebola outbreak in 2014 created a lot of concern and procedures
were implemented to isolate patients to ensure staff safety. The
anxiety deceased when regional hospitals were designated to take care
of infected patients. Due to contract tracing and isolation practices,
the outbreak was controlled.
I think what we have learned from this outbreak is that viruses will
continue to evolve and that future outbreaks and pandemics should
be expected. We need to encourage US-made products so we have
more control of the supply chain.
MR: Finally, and I again thank you for your time and thoughtful
responses, where do we go from here? Will we make changes as we return
to a "new normal"? Will we hopefully vaccinate and then manage this
as we do other more "routine" diseases? Will this have a lasting impact
on the way we view diseases and the delivery of health care?
We will continue to wear masks and socially distance throughout the
summer into the fall. Hand hygiene is always recommended. I would
recommend that we discourage large gatherings especially indoor
events in close quarters.



Berks County Medical Society Medical Record Summer 2020

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