When the first case of COVID-19 appeared in Shelby County last week, apprehension sparked a foreboding that grew into widely-held fear among some of the city’s most vulnerable, according to Dr. Stanley Dowell, who has multiple affiliations with local hospitals.
“I would say about 60 percent of my patients are calling with fears of having the coronavirus,” Dowell said. “Many of those calls represent unfounded reasons for believing they have the virus. We have been swamped with phone calls all day, every day.
“Unfortunately, myth seems to travel faster than fact. Since the growing spread of COVID-19 started, I have mitigated the effects of misinformation, not the infection, itself.”
All of that was before this week’s announcement by the Shelby County Health Department (SCHD) that Shelby County had reached the stage of “community transmission,” which means that infections are being detected in persons who have not been to an affected outbreak area.
SCHD Director Dr. Alisa Haushalter said seniors are one of the most vulnerable groups, particularly those with one or more conditions.
“Internal Medicine is my specialty,” said Dowell, a Meharry Medical College School of Medicine graduate (1983), with 37-plus years of diverse experience. “Most of our patients are seniors who live with one or more chronic conditions. The kind of mass fear and panic is something we have not seen since, perhaps, in the very first days of HIV when not much was known about the disease.
“Just the heightened level of fear can exacerbate the condition of our patients. So we take this hysteria very seriously.”
Dowell and his staff have worked to allay the fear that is driving many to make appointments with him.
“There was an 84 year old, who wanted to be tested for the coronavirus. Her grandson had come home from UT, and he hugged her, as he always does,” Dowell said. “Well, I asked if he had been traveling, and she said, ‘Yes, he’s been at school up in Knoxville.’ Once we can get our patients calm, we can test them for flu or allergies, if there are symptoms, and I just explain to them how a virus works.
“If one of our patients calls in with fever and flu-like symptoms, I tell them not to come in, but to take Tylenol, drink plenty of fluids, and wait 24 hours,” Dowell said.
“If the fever persists, then I am concerned. At that point, we need to test for flu. Allergies do not give the patient a fever. Patients who are elderly and more infirmed, I have them stay home. The symptoms we can treat, we treat. If no risk factors or travel are involved, I call in a prescription for their symptoms.”
Dowell said if people are asymptomatic, he advises them to follow the directives of the Centers for Disease Control (CDC) and the health department.
“The messaging of Shelby County Health Department instructs those who may not feel well but showing no symptoms to self-monitor or isolate for 14 days,” Dowell said. “In that time of isolation, two things happen. If the virus is present, it runs its course and dies. When it dies in isolation, that means that it was not passed to someone else.
“After isolation, a person who had the virus is ‘recovered.’ And if the coronavirus is like other viral infections, antibodies develop and the person has a level of immunity.”
Fatalities occur when a person already has some chronic illness, such as COPD, heart disease or kidney failure (and) the virus brings on added respiratory distress, he said.
“If the lungs are not working at full capacity, it makes the heart work harder, heart rate goes up. The virus runs its course, but respiratory issues are exacerbated.”
Dowell said there is added risk when an organ system is compromised by disease, but that does not necessarily end in death. Ventilators and quality care in a hospital will be critical to full recovery.
He anticipates a slower spread of the infection once people come out of mass isolation.
“There are no antibodies yet, and so, the spread is pretty rapid. I guess it will get a little worse before it gets better. And, it will get better. Our challenge right now is managing the level of panic.”
The health department advises those who feel sick to contact their doctor.
“People should definitely do that,” said Dowell. “But many think they are infected, even without fever or other risk factors. These are uncertain times. Fear and panic are understandable, given the closures this week in Memphis.
“We’ve got to get the community transmission under control, and we will. Faith, prayer, and calm are needed now.”