For the past 7 years, I have had the pleasure of supporting RxRevu as Chief Medical Officer, while continuing to work with patients in the specialties of Allergy, Asthma, and Immunology at Immunoe Health Centers in Colorado.  Across March and April, our nation’s care teams have faced unprecedented challenges and have had to adapt to a new normal.  I hope that sharing my perspective from the front lines will shed some light on what healthcare workers are facing day-to-day.

As of April 12th, Colorado had seen 280 deaths from COVID-19, putting the state at 14th in terms of deaths across the nation. Thirty of those deaths were individuals below 60 years of age, while 250 deaths were individuals above age 60.  This early data emphasizes the fact that the mortality rate skews to those older than 60, especially individuals with diabetes, heart disease, and respiratory disease. We have seen an influx of patients among this demographic, since they are more prone to COVID-19 transmission and symptoms.

Colorado’s mortality rate is about 15th in the country, as ranked per a 100,000-patient population. Given that Colorado was an early leader in COVID-19 cases – likely because of incoming visitors to the ski country – this mortality rate indicates that current shutdowns and social distancing have been effective.  If we had not proactively shut down most of our businesses and recreational centers early on, we likely would have seen a massive uptick in sick patients and deaths.

There certainly is a trade-off between public safety and economic well-being, but most of the preventive measures have been (and will continue to be) necessary until four things are in place: 1) enough ICU beds, ventilators, and ICU staff to handle the surge in ill patients; 2) enough testing to check people who are currently infected; 3) enough generalized testing to check immunity of those in the public who could go back to work; and 4) enough confidence in a successful medication routine. When all four of these requirements are met, I believe that the isolation measures could be relaxed to allow Coloradans to return to work or school.  Absent in this equation is talk of a vaccine, which is not likely to be available until 2021.

With new data being presented every day, I encourage people to pay less attention to the number of total cases being identified across the state, which is a function of whether testing is available in that region. I have already had many patients with classic symptoms of COVID-19 who were not able to get testing done for one reason or another.  Our teams are working around the clock to care for the thousands of patients who are ill – while others may not be presenting symptoms or are being told to self-quarantine without testing or treatment.

While I have a lot of COVID-19 patients who are incredibly sick, I know that Colorado is well prepared to face this extraordinary challenge.  RxRevu continues to support one of the largest health systems in Colorado, UCHealth, in its needs for important cost and efficacy information to assist providers in cost-effective prescribing.  Our understanding is that UCHealth is able to handle its current patient needs (as long as there aren’t massive spikes in volume). They are reorganizing their floors to make room for the sick, and they have been collecting PPE from various national and local sources to protect their staff.  They are also privileged to have a community who has offered food to their doctors so they can care for patients across longer days. Every day they struggle to make decisions that impact the lives of those in our state, and they are working with industry leaders to implement best practice policies and technologies to care for COVID and non-COVID patients alike. One example of a dramatic shift is UCHealth’s increase in telemedicine visits.  They are now doing more than 3,000 video visits per day – up from about a dozen – illustrating the obvious adaptations they must make.

We are certainly still in the middle of this crisis, but I know that it will pass.  Our country was caught off guard, and we were not as prepared as those countries who faced the last two coronavirus epidemics (SARS and MERS).  The US faced the 2009 H1N1 outbreak – which was handled similarly to a typical flu outbreak – but it was much easier to control than this novel virus. Our country has quickly shifted its primary focus to handling healthcare needs, and I believe that once each state has sufficient supplies for testing and care, they will be able to decide how to move forward.  Still, it is more important than ever for each of us to do our part to care for our community, so in order to help our healthcare teams, I implore you to stay home and stay safe.

Written by Dr. Kevin O’Brien, Chief Medical Officer at RxRevu, Allergy and Immunology at Immunoe Health Centers

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