Top Wichita doctors draw best-case, worst-case for coronavirus
As the coronavirus COVID-19 disease begins to infect and affect more Wichita-area residents and the Sedgwick County Commission increases its effort to fight the virus, many are wondering just how bad it can get.
The answer according to medical professionals, is bad — very bad.
County Commission Chairman Pete Meitzner, who doubles as chairman of the County Board of Health, said he was told in a conference call with hospital leaders Monday that there could already be as many as 1,000 residents afflicted with coronavirus disease COVID-19.
Many don’t yet know they have it because the disease incubates for five to 14 days before symptoms surface, and the county’s efforts to track the disease are hampered by a lack of clinical testing supplies.
With no vaccine and no approved treatment, local efforts to fight the disease have turned to prevention — including widespread business shutdowns, closing of schools, a 10-person limit on public gatherings and a pending order for residents to stay at home to slow the rate of spread and avoid overwhelming hospitals..
The Wichita Eagle asked two physicians on the front line to sketch out the best-case and worst-case scenarios Wichita could be faced with.
These are their answers, in their own words:
Dr. Thomas Moore
“Best case scenario, we continue to see some cases here and there. Maybe we will see some severe cases, but we have the resources we can deploy and keep them alive until they recover.”
“I don’t even want to contemplate worst case. The worst case scenario is we’re totally full in all the hospitals. We’re erecting tents in the parking lots. Patients with treatable conditions can’t get in – patients with heart attacks, strokes, diabetic coma – patients with completely treatable and potentially curable conditions can’t get access to health care and they die. They die on their way to the hospital or some other place where they’re turned away.”
“Sedgwick County (has) a population of approximately half a million people. This virus, conservatively, is expected to infect 40 percent of the U.S. population, so you take 40 percent of 500,000, that’s 200,000 people who are infected.”
“Of those, 17 percent will require hospitalization, so you’re talking about 35,000 people that will need hospitalization in the next six weeks. We can’t handle that. No one can handle that.”
“It will break us and frankly it will be complete chaos. So that’s the worst case scenario. That’s why we’re working so hard to prevent this.”
“This clearly isn’t the flu. This disease has a significantly higher, 10-fold higher, at least, mortality rate than influenza. We have been fortunate enough to not see people die of this disease locally. I’m sure that day will come. I’m hoping very much that it doesn’t.”
“The second case (of COVID-19) that we had . . . came from an endemic area (Oregon) where the virus was circulating. He had no reason to have the severe disease that he did. And it damn near killed him.”
— Dr. Thomas Moore is a physician specializing in infectious diseases, practicing with Infectious Disease Consultants of Wichita and serving as medical director of infection prevention at Wesley Medical Center.
Dr. Chloe Steinshauer
“The best-case scenario is it looked like we over-reacted. I think the best-case scenario is we enact this (stay-at-home order) and we don’t see a surge of cases in our ICU (Intensive Care Unit) utilization — and it’s the same as it’s always been and we see a few severe cases coming in intermittently, but we have the resources to be able to take care of them.”
”The absolute worst-case scenario is like the one you see in Italy … They (Italian doctors) have had to make very tough,very difficult decisions with their patients on who they can continue trying to save and who they have to (allocate) their limited supplies to.”
“Allocation of care guidelines are something that’s existed since there have been mass-casualty events around the world. It is not based strictly on age, it’s actually a really complex set of criteria looking at co-morbid medical conditions and degree of critical illness, among other factors.”
“The whole goal of this (stay-at-home order) is to prevent overloading the system to the point where we even have to think of allocating care.”
“Encouraging people to social distance and the education programs that are going on to wash hands and the closure of schools by Gov. Kelly were all excellent measures to help. Now that we are seeing community spread we need to be more aggressive and we need to be more aggressive early.”
“That’s what we’ve seen in places where that’s worked. Singapore, Hong Kong, South Korea have all been successful with that. Some of the communities in the United States have been a little more aggressive and have been successful.”
— Dr. Chloe Steinshouer is a specialist in pulmonary and critical-care medicine, practicing with Pulmonary and Sleep Consultants of Kansas and serving as medical director of the Intensive Care Unit at Wesley Medical Center.
