On the front lines of fighting the coronavirus pandemic is Robert Phelan, an emergency medicine doctor in Dallas.
Over the last couple of weeks, Phelan estimates seeing at least three COVID-19 patients in each of his emergency rooms daily. He owns three free-standing emergency rooms in Highland Park, and the Lakewood and Preston Hollow areas of Dallas.
He has seen a range of cases from mild to more severe.
One patient, a 58-year-old man, tested positive for COVID-19. He was told to isolate, but when he got worse on the sixth day, he returned to the emergency room. Phelan administered hydroxychloroquine, known for treating malaria, along with other appropriate measures and saw vast improvement within 24 hours.
The patient, Stephen Lockwood, was pleased with the course of treatment. He had come to Dallas from the Seattle area to do some work for a few days. He started experiencing symptoms on the day he was supposed to fly back to Seattle.
At first, he experienced a high fever, but then he began experiencing respiratory issues including difficulty breathing. The hydroxychloroquine and azithromycin treatment, along with a nebulizer, seemed to work wonders.
He’s now recovering after about 10 days of symptoms and is waiting on his negative test result. He’s checked with co-workers and none seem to have been infected so far.
“Either take it seriously or you’ll get it seriously,” Lockwood told The Texan. “I wouldn’t recommend it for anyone, not even my worst enemy.”
Phelan said when the virus looked like it would be spreading earlier this year, he read a study from China about the treatment benefits of hydroxychloroquine and ordered a few bottles for his emergency rooms to have on hand. He’s been unable to get any more of the medicine and is surprised.
“Where did all the hydroxychloroquine go? An old common drug, who scooped it up?”
Because of the limited number currently available, Phelan doesn’t always administer a test for COVID-19 to his patients.
If they have had known exposure, decreased white blood count, and CT scans that show symptoms, but are young and have no other known underlying health conditions that make them at-risk, Phelan usually doesn’t do an official test.
It’s important to note that these cases, wherein there’s a clinical diagnosis but an official test is not administered, are not reported to the state health officials because they are a presumptive diagnosis, not an official one.
However, the patients who are clinically diagnosed with COVID-19 but not confirmed with an official test are told to self-isolate and sent home with prescriptions for medicines to keep them comfortable as they recover: anti-nausea medication, antibiotics to avoid infections resulting from a lowered immune system, and pain medications.
Phelan believes the follow-up test to determine if a patient has recovered is critical.
“A patient can keep spreading the virus after he feels better for two weeks or longer. The negative test after his recovery is very important.”
When asked if he thinks the shelter-in-place order in Dallas County is necessary, Phelan was doubtful.
“We are making rules out of fear. It is logical to isolate the elderly and vulnerable. We should flatten the curve if we can, but it is not worth ruining the economy.”
He would like to know the total number of people who have the virus, which would show the actual death rate more clearly.
Phelan is upset by a side effect of the warnings not to leave home. He has seen patients with serious issues who wait longer than is prudent before coming to the emergency room.
For example, Phelan noted that he can usually catch appendicitis early, “but because people have been told to stay home, now patients are coming in with their appendixes already ruptured.”
Phelan urges patients to consider the advantage of going to a free-standing emergency room if worried about the spread of COVID-19.
“Each of our rooms is isolated from the rest of the facility and has its own air conditioning system that replaces the air in the room every five minutes, twelve times an hour. The air also passes through a HEPA filter and we ozonate each room after someone comes through.”
Kim Roberts is a reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.