Dr. James D. Quarles became concerned about COVID-19 as soon as the U.S. saw its first confirmed case of the respiratory virus.
That was Jan. 20.
Now, there are more than 15,000 confirmed COVID-19, or novel coronavirus, cases in the U.S. More than 200 people have died.
Kentucky had 63 positive COVID-19 cases as of Friday afternoon, with one confirmed case in Franklin County. Two people had died from the virus statewide.
Last weekend, Quarles, a Frankfort primary care physician, realized the situation was getting worse when he learned his medical supply company was out of N95 masks.
“We put out a request on Facebook for masks, and Frankfort responded big time!” Quarles said in an email interview Friday. “Patients and friends donated enough masks for us to make it several weeks, and we are eternally grateful!”
And they’re needed. Gov. Andy Beshear asked all medical offices to cancel nonessential procedures starting Wednesday until further notice.
As COVID-19 cases are expected to rise, Beshear wants to make sure there will be plenty of doctors and nurses available to help anyone who needs medical care.
As of Friday morning, Quarles had tested three of his patients for COVID-19. Two of those tests came back negative and one result was still pending.
When asked if he’s concerned about the current COVID-19 testing capacity, Quarles said he was concerned in the beginning that not enough people were being tested, but now physicians are able to order tests through private labs.
Until recently, local health departments were the only ones with the capacity to test for COVID-19, and due to limited testing supplies, not everyone with symptoms qualified for a test.
Typically, the health department would test people for COVID-19 if they were experiencing a fever, cough and shortness of breath, had traveled out of the country and/or were in close contact with someone who had tested positive.
Now, physicians can order tests for patients who have not traveled internationally or been in close contact with someone who has tested positive.
“If a patient has fever, cough, and shortness of breath, they should first stay home and not rush to their doctor's office or the emergency room,” Quarles said. “They should call their health care provider and ask them for advice. For my patients with mild symptoms, we have had them self quarantine and ride it out at home.”
For patients experiencing moderate to severe shortness of breath, the protocol is different.
“For my patients with more moderate symptoms like shortness of breath, we have had them drive to the office, call our office from the parking lot, then we will perform the test in their vehicle,” Quarles said. “We are wearing personal protective equipment, of course.”
To test for COVID-19, a nasal and/or throat swab is administered, Quarles said.
People experiencing severe shortness of breath should contact their health care provider or the emergency room.
One key rule people experiencing COVID-19 symptoms must follow: If they require going to a doctor’s office or the hospital for treatment, let the doctor’s office or hospital know before they arrive they are experiencing those symptoms.
Quarles said first responders also need to be notified.
There are several private labs processing COVID-19 tests. In Kentucky, those labs include the LabCorp, Quest Diagnostics and Solaris Diagnostics, in addition to the taxpayer-funded lab at the University of Louisville.
Private labs take usually longer to process tests than the health department. Health department test results are coming back within 24 hours while private labs are taking up to two days.
Quarles, who uses Solaris Diagnostics in Nicholasville, said he’s never seen an illness spread this quickly.
“Granted, I have only been practicing for 15 years, but to my knowledge, nothing has occurred like this since the Spanish flu pandemic in 1918,” he said.
Although his patients are concerned about the virus, Quarles said most of them are not panicking.
“My patients genuinely care about their health, and want to stay well, so they have been quarantining at home and trying to keep out of my office as much as possible,” he added.
Quarles said social distancing is necessary to keep the virus from spreading.
“COVID-19 is spread by respiratory droplets from the nose and mouth,” he said. “These droplets, when coughed or sneezed, usually travel less than 6 feet.”
Recently, there have been reports circulating on social media claiming people with COVID-19 should avoid taking ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs) and take Tylenol instead. The reports claim NSAIDs can make the virus worse.
“I have not seen scientific proof of that claim as of yet,” Quarles said. “I think ibuprofen and Tylenol both work well for fever reduction and reduction of aches and pains while fighting off the virus, but if a patient is concerned, they can take Tylenol only if they choose.”
Until this pandemic subsides, Quarles is encouraging everyone to practice social distancing.
“Stay home!” Quarles said. “Practice good hand hygiene, stay six feet away from each other, call your doctor before walking into their office and stay well!”