In these trying times, ideas on dealing with CoVid-19 in the medical field are mandatory, from any part of the planet. This Pandemia will change, without doubt, the way we scientists deal with population emergency situations in the near future. As a physician working at high altitude, several novel ideas arise, that may aid in the life-saving management of such critical situations. As such, allow me to propose the following:
1) On Jan 30, 2019, in a Radio-TV in TVU La Paz, Bolivia interview in Spanish.
I suggested that patients with Coronavirus detected at airports or other points of entry should be taken to isolated areas outside cities where vacant buildings ought to be adapted for intensive care (or containers with sunroofs). They should not at all be taken to city or town hospitals as, particularly in a country with limited resources, as they would overwhelm existing intensive care units and thereby displace all work with routine critically ill patients. In addition, it would become a nucleus that spreads the disease to the otherwise healthy population. The areas should be surrounded by open space, with security and the sterilization techniques mentioned in the 3rd point should be applied.
Furthermore, In the city of La Paz, Bolivia (3100-4100m) establishing these modified buildings in the Altiplano (High Plateau) at 4,100 meters above sea level would indeed be beneficial as ultraviolet radiation is relatively high and can help as a natural bio-sterilization resource. Furthermore, the Intensive Care Units (ICUs) should have roofs to let sunlight come through.
The recent good news is that Dr. Augusto Ittig an intensive care specialist in Jujuy, Argentina has established his Coronavirus isolation and intensive care treatment, following theses guidelines.
2) I originally mentioned that there was an exponential growth of this Pandemia. Actually, it is a Hyper-Exponential, since it does not follow the regular exponential progression (y = A * Bx) but rather, in CoVid-19, 1 patient in a closed environment full of people can infect 50 or more in one shot from the very beginning.
3) The management of intensive care units has to be modified. As mentioned in the above interview, the Covid-19 is like a nuclear attack. It could actually be termed a BIO-NUCLEUS ATTACK. Viruses are targeting our nuclear cell areas, in search of self-reproduction, as is well known. Hence, the protection suits for the medical personnel should be full-body impermeable overalls leaving only the face exposed. Goggles, face masks and gloves should, of course, be worn. Upon exiting the Intensive Care Unit, the personnel should pass through a mandatory shower with plenty of soap or other disinfectants, followed by hot drying air for the whole body. This can help reduce significantly the viral transmission. This is similar to radioactive contamination, and it could be termed BIO-ACTIVE CONTAMINATION and we physicians need to evolve urgently to these new 21st-century health safeguarding strategies. After all, we all have the obligation of saving the lives of the courageous intensive care physicians and para-medical personnel that can end up giving their lives in order to save others.
4) Finally, those that actually survive the severe complications with lung (and heart tissue) sequelae will have pulmonary (and perhaps myocardial) fibrosis that will give rise to a pulmonary (and perhaps to some degree, cardiac) insufficiency with resulting complications at a later date. If those patients remain at high altitude, they will present Chronic Mountain Sickness (Poli-erythro-cythemia), as a compensatory mechanism in order to provide sufficient oxygen transport to the tissues. At high altitude, if properly understood, it can be adequately managed.
We have also published these other ideas of the CoVid-19 Prevention Strategy.
Prof. Dr. Gustavo Zubieta-Calleja High Altitude Pulmonary and Pathology Institute IPPA La Paz, Bolivia March 17th, 2019
Submitted to the BLDE Journal.